Parkinson's disease demonstration physical examination [Xie Daixin]

Parkinson's Disease Comprehensive Scoring Scale

UNIFIED PARKINSON DISEASE RATING SCALE(UPDRS) QUESTIONAIRE

Part III: Motor Function (18-31, Doctor's Examination)

18.
Language

(0) Normal;

(1) Mild impact on expression, pronunciation and volume;

(2) moderate impact, monotonous, stuttering but understandable;

(3) Serious impact and difficult to understand;

(4) Completely incomprehensible
.

19.
Facial expressions

(0) Normal;

(1) Facial expressions are slightly affected

(2) Facial expressions are slightly affected, but significantly reduced;

(3) Facial expressions are moderately affected, and lips sometimes cannot be closed
.

(4) The mask face is severe, completely loses facial expression, and the lips are opened 1cm or more
.

20.
Resting tremor (such as pill-like tremor)

(0) None;

(1) mild, sometimes occurring;

(2) Medium amplitude, intermittent;

(3) Medium-range, in most cases;

(4) Large magnitude and
persistence.

21.
Tremor of hand movements or posture

(0) None;

(1) mild, sometimes occurring;

(2) Medium amplitude, occurring during action;

(3) Medium amplitude, occurring in a certain posture or during movement;

(4) The amplitude is large, which affects eating
.

22.
Muscle stiffness (the patient sits and relaxes, checks the limbs)

(0) None;

(1) Mild, which can only be detected when the patient makes another movement and diverts attention (ignoring the gears

like stiffness);

(2) mild to moderate;

(3) Significantly stiff, but still relatively easy to complete the full movement;

(4) Severe stiffness, difficulty in completing complete movements
.

23.
Finger pinching (the largest and fastest frequency of thumb and index finger pinching)

(0) Normal (> 15 times/5 seconds);

(1) Slower frequency and smaller amplitude (11-14 times/5 seconds);

(2) Obvious obstacles
.
Progeria, may have intermittent (7-10 times/5 seconds);

(3) Serious impairment
.
Including difficulty starting, intermittent (3-6 times/5 seconds);

(4) Barely able to extend the index finger (0-2 times/5 seconds).

24.
Hand motor function (full extension, full clenching)

(0) Normal;

(1) The frequency is slower and the amplitude is small;

(2) Obvious obstacles
.
Progeria, may have intermittent;

(3) Serious impairment
.
Including start-up difficulties, intermittent intervals;

(4) Almost impossible to complete
.

25.
Rapid alternating movements of the hand (alternating patting of the palm of the hand and the back of the hand on the palm of the other hand)

(0) Normal;

(1) The frequency is slower and the amplitude is small;

(2) Obvious obstacles
.
Progeria, may have intermittent;

(3) Serious impairment
.
Including start-up difficulties, intermittent intervals;

(4) Almost impossible to complete
.

26.
Flexibility of the legs in the state of knee flexion (raise your feet about 10 cm when sitting, and tap the ground with your heels)

(0) Normal;

(1) The frequency is slower and the amplitude is small;

(2) Obvious obstacles
.
Progeria, may have intermittent;

(3) Serious impairment
.
Including start-up difficulties, intermittent intervals;

(4) Almost impossible to complete
.

27.
Stand up from a chair with armrests

(0) Normal;

(1) Slower, may require more than one effort;

(2) Hands need to be used on the armrest;

(3) Have a tendency to fall backwards after standing up, and may need to work hard more than once, but do not need the help of others;

(4) You can't stand up
by yourself.

28.
Posture

(0) Normal upright;

(1) Back microcamel, which can be seen in normal elderly people;

(2) Obviously abnormal hunchback, which can be slightly tilted to one side;

(3) The hunchback is accompanied by curvature of the spine, which can be significantly tilted to one side;

(4) Severe postural abnormalities
.

29.
Gait

(0) Normal;

(1) Walking slowly, there may be dragging steps, broken steps, but no panicked gait;

(2) Difficulty walking, but little help
is needed.
There may be a panicked gait;

(3) Severe handicapped and need help;

(4) Do not walk
with assistance.

30.
Postural stability (the patient stands in a standing position, opens his eyes, separates his feet moderately, and is mentally prepared for the sudden pulling of his shoulders by the examiner behind him)

(0) Normal;

(1) Fall backwards, but recover by themselves;

(2) No postural reflex, requiring the help of the examiner to avoid falling;

(3) Very unbalanced, may fall at any time;

(4) Only with help can you stand
.

31.
Slow movement and reduced movement of the body (slow movement, hesitation, small arm swing amplitude and lack of general movement)

(0) None;

(1) A slight slowdown and a decrease in amplitude, which can be seen in some normal people and is sometimes difficult to distinguish;

(2) moderate slowness, lack of movement, and some degree of reduced range of motion;

(3) marked slowness, lack of movement and small range of motion;

(4) Severe slowness, poor movement and little
range of motion.

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