CDE Detailed Report

Refer to instructions on form.

Index-fingertip to thumb-crease; 15 reps as fast as possible; practice 15 reps once before rating; if time > 6 sec, add 1 to rating. Use stopwatch:

Educate patient regarding the sensation. Tested with 128 cps tuning fork set to near full vibration; eyes closed; test over index finger and great toe.

Enter numeric value for score of 0-28. Refer to instructions on form.

For sitting posture patient can sit in a chair or examination table.

Enter number value of 0-11. Refer to instructions on form.

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned.

Enter numeric value for score of 0-117. Refer to instructions on form.

Stance assessment begins with feet 20 cm apart. Place marker tapes in the exam room 20 cm apart and the insides of the feet are lined up against these. Subsequent stance tests get more difficult. Stance and gait tests may be done barefoot if patient does not have appropriate footwear, however, it should be done the same way for serial measurement. Inside of feet 20 cm apart marked on floor. Use stopwatch; 3 attempts; time in seconds.

The index fingers are placed in front of each other with flexion at the elbow about 25 cm from the sternum. Observe for 10 seconds. Score amplitude of oscillations:

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned. Otherwise each of 3 trials is timed and then averaged. Grading scores are then given as noted.

Use a tape recorder that can play at slow and fast speeds (1.2 & 2.4 cm/sec). Record at normal (2.4) speed. Use a digital stopwatch. Patient seated comfortably and instructed to repeat the syllable "pata" as quickly and distinctly as possible for 10 seconds until told to stop. Start recorder and record patient's name and date. Preset stopwatch for 10 seconds. Say "go" and as soon as patient starts speaking, start timer. Say "stop" when timer beeps at end of 10 seconds. Count # of "patas" for each 10 seconds, using playback at slower speed.

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned.

The index fingers are placed in front of each other with flexion at the elbow about 25 cm from the sternum. Observe for 10 seconds. Score amplitude of oscillations

For one foot stance, the patient is asked to stand on dominant foot and the other leg is elevated by bringing it forward with knee extended; this gives some advantage to the patient. Stance and gait tests may be done barefoot if patient does not have appropriate footwear, however, it should be done the same way for serial measurement.

Use a tape recorder that can play at slow and fast speeds (1.2 & 2.4 cm/sec). Record at normal (2.4) speed. Use a digital stopwatch. Patient seated comfortably and instructed to repeat the syllable "pata" as quickly and distinctly as possible for 10 seconds until told to stop. Start recorder and record patient's name and date. Preset stopwatch for 10 seconds. Say "go" and as soon as patient starts speaking, start timer. Say "stop" when timer beeps at end of 10 seconds. Count # of "patas" for each 10 seconds, using playback at slower speed.

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned.

Assess kinetic or intention tremor during and towards the end of movement: examiner holds index finger at 90% reach of patient; test at least 3 nose-finger-nose trials; movement slow > 3 sec.:

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned.

Refer to instructions on form.

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned. Otherwise each of 3 trials is timed and then averaged. Grading scores are then given as noted.

Assess kinetic or intention tremor during and towards the end of movement: examiner holds index finger at 90% reach of patient; test at least 3 nose-finger-nose trials; movement slow > 3 sec.:

If a patient can stand in a particular position for 1 minute or longer in trial 1, trials 2 and 3 are abandoned.

Make sure the stopwatch is set to zero. Introduce this section by saying, "Now, we're going to be measuring your arm and hand function." If this is the first visit, as, "Are you right- or left-handed?" Make a note of the dominant hand for subsequent instructions. Place the 9-HPT apparatus on the table directly in front of the patient. Arrange the apparatus so that the side with the pegs is in front of the hand being tested and the side with the empty pegboard is in front of the hand not being tested. Secure with Dycem. Read the following instructions to the patient: "On this test, I want you to pick up the pegs one at a time, using one hand only, and put them into the holes as quickly as you can in any order until all the holes are filled. Then, without pausing, remove the pegs one at a time and return them to the container as quickly as you can. We'll have you do this two (2) times with each hand. We'll start with your [DOMINANT] hand. You can hold the peg board steady with your [NON-DOMINANT] hand. If a peg falls onto the table, you retrieve it and continue with the task. If a peg falls on the floor, keep working on the task and I will retrieve it for you. See how fast you can put all the pegs in and take them out again. Are you ready? Begin." Start timing as soon as the patient touches the first peg, and stop timing when the last peg hits the container. If a peg drops on the floor, the examiner will retrieve it and put it back in the peg box. However, if a peg drops onto the table, the patient is to retrieve it unless it is beyond their arm reach; then you can retrieve it for them. It is possible that a peg may fall beyond the reach of the examiner; therefore we recommend that you keep a few extra pegs in hand so that testing is not interrupted. Do not put extra pegs in the testing apparatus as this may confuse the subject. Record the patient's time under "Dominant hand -- Trial 1." If the subject stops after having put all the pegs into the holes, prompt the subject to move them as well by saying, "And now remove them all." If the subject begins to remove more than one peg at a time, correct him/her by saying, "Pick up one peg at a time." The total time to complete the task is recorded in seconds including one decimal place, rounded as needed. Round up to the next tenth if hundredths place is > = .05, round down if hundredths place is