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Orthostatic Symptom Grading Scale
Please visit this website for more information about the instrument: Orthostatic Symptom Grading Scale
Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
Self-report orthostatic rating scale that assigns 0-4 points for 5 items: frequency of orthostatic symptoms, severity, conditions under which symptoms occur, interference with activities of daily living, and ability for stand for periods of time. The instrument has been validated against objective measures of autonomic dysfunction and has been shown to have high internal consistency.
Scoring and Psychometric Properties
Scoring: 5 questions addressing frequency and severity of orthostatic symptoms, relationship of symptoms to orthostatic stressors, and the impact of symptoms on activities of daily living and standing time. Respondents rate each item on a scale of 0 to 4. Adding the scores for the individual items creates a total score.  
Psychometric Properties: The 5-item scale demonstrated strong internal consistency (coefficient a=.91). Factor analysis revealed a single factor solution accounting for 74% of the variance. Factor loadings for the 5 items ranged from 0.78 to 0.90.
If an OGS values of 9 or greater sensitivity was of 65.6% and specificity of 69.2%. If an OGS value of 10 or greater, sensitivity was 58.2%, and specificity was 78.2%.
Strengths: Developed by experts in autonomic dysfunction and is a specific instrument for orthostatic hypotension severity.
Weaknesses: Restricted to symptoms of orthostatic hypotension. Doesn't ask if improved or worsened by anti-parkinsonian drugs. Not a tool to assess overall autonomic symptom burden.
Key Reference:
Schrezenmaier C, Gehrking JA, Hines SM, Low PA, Benrud-Larson LM, Sandroni P. Evaluation of orthostatic hypotension: relationship of a new self-report instrument to laboratory-based measures. Mayo Clin Proc. 2005 Mar;80(3):330-4.
Document last updated August 2022