Available Studies
ROS, MAP, MARS, Clinical Core
Categories
Motor and Gait
Gait score is a domain of the global parkinsonian summary score. The gait score is calculated using a modified version of the motor portion of the United Parkinson's Disease Rating Scale (mUPDRS). A trained nurse clinician scores gait based on the following 6 items:
Turning is assessed by asking participants to turn 360 degrees. Posture is examined from the front and side. Postural stability is assessed by asking participants to stand with feet 6 inches apart and instructing them to "try not to fall" while the nurse clinician pulls on participants' shoulders with increasing strength until participants lose balance. The number of steps required to correct balance as well as the strength of the pull are recorded. To assess ability to rise from a chair, participants are asked to sit in a straight-backed chair with armrests, with their arms crossed over their chest. They are then asked to stand without using arms. Those who are unable to do so are prompted to stand with the help of their hands. Shuffling gait is assessed by asking participants to walk as fast as possible for about 10 feet, turn around and walk back. The nurse clinician observes speed, movement, and base. Body bradykinesia/hypokinesia represents a global view of the slowness and deliberateness of movement and is assessed by observing rapidity of movements, decrease in arm swing and spontaneous movements.
Each item is scored according to the respective scale below. The gait domain score is calculated by adding the ratings for the individual items, dividing by the maximum possible score for the domain, then multiplying by 100. The domain score ranges from 0 to 100, with higher scores reflecting more gait disturbance.
Rater responses for each item:
Item 1: Turning
Value | Coding |
---|---|
0 | Pivots on narrow base |
1 | Hesitates or widens base, but steady |
2 | Turns slowly and awkwardly |
3 | Would likely fall without aid |
4 | Cannot turn |
Item 2: Posture
Value | Coding |
---|---|
0 | Normal erect |
1 | Slightly stooped posture, could be normal |
2 | Moderately stooped, can be leaning slightly to one side |
3 | Severely stooped with kyphosis, can be moderately leaning to one side |
4 | Marked flexion with extreme abnormality of posture |
Item 3: Postural stability
Value | Coding |
---|---|
0 | Normal, takes 1 step to correct balance |
1 | Possible retropulsion, takes 2 steps back to correct balance |
2 | Definite retropulsion, takes 3 or more steps, but recovers unaided |
3 | Would fall if not caught |
4 | Unstable, tends to lose balance spontaneously |
5 | Unable to stand without assistance |
Item 4: Arising from a chair
Value | Coding |
---|---|
0 | Normal |
1 | Slow, could be normal |
2 | Needs more than 1 attempt, but does not push with arms |
3 | Pushes self up from arms of chair |
4 | Using arms, tends to fall back or requires more than one attempt, but able to stand without help |
5 | Unable to arise without help |
Item 5: Shuffling gait
Value | Coding |
---|---|
0 | None |
1 | Walks slowly, may take short steps, could be normal |
2 | Walks slowly, shuffles, no festination or propulsion |
3 | Walks with difficulty, shuffles, may festinate or propulse, requires no assistance |
4 | Severe disturbance of gait, shuffles, may festinate or propulse, unable to ambulate without assistance |
5 | Cannot walk at all due to shuffling gait, not even with assistance |
Item 6: Body bradykinesia/hypokinesia
Value | Coding |
---|---|
0 | None |
1 | Minimal slowness, giving movement a deliberate character, possibly reduced amplitude |
2 | Mild degree of slowness and poverty of movement which is definitely abnormal, alternatively, some reduced amplitude |
3 | Moderate slowness, poverty or small amplitude of movement |
4 | Marked slowness, poverty or small amplitude of movement |
Note: This variable is not calculated if more than half of the items are missing.