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Unified Parkinson's Disease Rating Scale (UPDRS)
Please visit this website for more information about the instrument: International Parkinson Movement Disorder Society
Core: Parkinson's Disease (PD) [select either UPDRS (for studies focused preferentially on advanced PD participants) or MDS-UPDRS (for studies focused on all severities and especially on mild/moderate participants)]
Short Description of Instrument
The Unified Parkinson's Disease Rating Scale (UPDRS) is considered historically a major comprehensive inventory of the multiple elements of Parkinson's disease with items extracted and refined from prior scales. It was the basis of the more recently developed Movement Disorder Society-revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and is still used especially in longitudinal research where assessments began prior to the development and wide usage of the MDS-UPDRS. It is also favored for programs focusing on advanced Parkinson's disease because its clinimetric anchors have item rating for severe and extreme or marked impairments and disabilities, severity measures largely collapsed into a single "severe" rating in the MDS-UPDRS. The UPDRS has four parts: Part I (Mentation, Behavior and Mood), Part II (Activities of Daily Living), Part III (Motor Examination) and Part IV (Complications).
Comments/Special Instructions
As the MDS-UPDRS has emerged as largely a replacement for the UPDRS, algorithms for transposition mapping from one scale to the other have been published. However, for particular applications, the UPDRS remains a vital tool.
Scoring and Psychometric Properties
Scoring: Items in Parts I, II, and III are rated 0-4, ranging from 0=normal to 4=extreme or marked. Part IV is a check list of complications, both motor and non-motor. In all cases, the rating convention (extensive written instructions are not an implicit or attached part of the scale) has been to "rate what you see" so that impairments will include deficits from co-morbidities outside of Parkinson's disease itself.
Psychometric Properties: Extensive clinimetric evaluations have been published for this scale, and it is both reliable (internal consistency and stability) and valid (content, criterion and construct). It is responsive to intervention and has been the primary outcome of most major clinical trials in the past.
Key Reference:
Fahn S, Elton RL, Members of the UPDRS Development Committee. The Unified Parkinson's Disease Rating Scale. In Fahn S, Marsden CD, Calne DB, Goldstein M, eds: Recent Developments in Parkinson's Disease, Vol. 2. Florham Park, NJ: Macmillan Healthcare Information, 1987. pp. 153-163, 293-304.
Additional References:
Goetz CG, LeWitt PA, Weidenman M. Standardized training tools for the UPDRS activities of daily living scale: newly available teaching program. Mov Disord. 2003 Dec;18(12):1455-8.
Goetz CG, Nutt JG, Stebbins GT. The Unified Dyskinesia Rating Scale: presentation and clinimetric profile. Mov Disord. 2008 Dec 15;23(16):2398-403.
Goetz CG, Stebbins GT. Assuring interrater reliability for the UPDRS motor section: utility of the UPDRS teaching tape. Mov Disord. 2004 Dec;19(12):1453-6.
Goetz CG, Stebbins GT, Tilley BC. Calibration of unified Parkinson's disease rating scale scores to Movement Disorder Society-unified Parkinson's disease rating scale scores. Mov Disord. 2012 Sep 1;27(10):1239-42.
Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003 Jul;18(7):738-50.
Document last updated August 2022