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RehabMeasures Instrument

Modified Parkinson Activity Scale

Last Updated

Purpose

Designed for functional assessment of Parkinson’s Disease

Acronym Modified PAS

Area of Assessment

Activities of Daily Living
Functional Mobility
Gait
Strength
Upper Extremity Function

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Parkinson's Disease & Movement Disorders

Key Descriptions

  • Consists of 14 items arranged into three domains:
    1) Chair Transfer (2 items)
    2) Gait Akinesia (6 items)
    3) Bed Mobility (6 items)
  • Observer scores the quality of movements while the patient performs these activities.
  • Scores range from 0 (dependent) to 4 (normal).
  • Exception: if patient is unable to stand without using hands, then the patient is retest with use of hands and scoring changes to a 0 (dependent) to 2 (normal) range.
  • Total possible score = 56

Number of Items

14

Equipment Required

  • Chair with 40 cm seat height (or if at patient’s home, the chair that causes the greatest problems to the patient and is used frequently)
  • Plastic Cup, ¾ full of water
  • Tape
  • Bed
  • Pillow, sheets and blanket or duvet

Time to Administer

10-15 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Suzanne O’Neal, PT, DPT, NCS & the PD EDGE Task Force of the Neurology Section of the APTA

Body Part

Upper Extremity
Lower Extremity

ICF Domain

Body Function
Activity
Participation

Measurement Domain

Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations Based on Parkinson Disease Hoehn and Yahr stage: 

 

I

II

III

IV

V

PD EDGE

LS/UR

LS/UR

LS/UR

LS/UR

NR

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

PD EDGE

No

No

No

Not reported

Considerations

No ceiling effect found in this study however the number of subjects were relatively small (n = 15)

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Parkinson's Disease

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Standard Error of Measurement (SEM)

Parkinson’s Disease:

(Keus et al, 2009; n = 15; median age = 68.4; median disease duration = 8 years (60.1-72.9); median UPDRS-III score = 42 (38-51); Hoehn & Yahr Stage 2 (n = 2), 2.5 (n = 5), 3 (n = 6), 4 (n = 1)) 

Modified PAS total (score range 0-56): 

  • SEM = 0.23 

Doman chair transfer (score range 0 - 8): 

  • SEM = 0.40 

Domain gait akinesia (score range 0 - 24): 

  • SEM = 0.24

Minimal Detectable Change (MDC)

Parkinson’s Disease

(Keus et al, 2009) 

  • MDC = 7.2

Interrater/Intrarater Reliability

Parkinson’s Disease:

(Keus et al, 2009) 

  • Mean Modified PAS scores did not differ between experts and non-experts (p = 0.28)

Criterion Validity (Predictive/Concurrent)

Parkinson’s Disease:

(Keus et al. 2009) 

  • Correlation between Modified PAS scores and the UPDRS motor scores was good (rs = 0.64). 
  • Correlation between Modified PAS scores and the VAS-Global Functional was better (rs = 0.79)

Floor/Ceiling Effects

Parkinson’s Disease: 

(Keus et al, 2009) 

  • No ceiling effect found.

Bibliography

Keus, S. H., Nieuwboer, A., et al. (2009). "Clinimetric analyses of the Modified Parkinson Activity Scale." Parkinsonism Relat Disord 15(4): 263-269. Find it on PubMed