Purpose
The MDS-UPDRS is a comprehensive assessment designed to monitor the burden and extent of Parkinson’s disease across the longitudinal disease course and provide a clinical endpoint in therapy trials.
Acronym
MDS-UPDRS
Area of Assessment
Activities of Daily Living
Balance – Non-vestibular
Behavior
Cognition
Communication
Coordination
Depression
Dysarthria
Eating
Functional Mobility
Gait
Life Participation
Pain
Psychosis
Quality of Life
Sleep
Swallowing
Upper Extremity Function
Administration Mode
Paper & Pencil
Cost
Not Free
Actual Cost
$1000.00
Cost Description
Individual/personal use: Free
Industry use: $20,000
Government or non-profit organization funded use (ex: sponsored clinical trial or industry funded publication): $1,000
- The Unified Parkinson’s Disease Rating Scale (UPDRS) was originally developed in the 1980’s and had become the most widely used clinical rating scale for Parkinson’s Disease (PD). In 2001, the Movement Disorder Society (MDS) sponsored a critique of the UPDRS and developed a new version of the scale termed the MDS-UPDRS in 2007. The MDS-UPDRS retained the strengths of the original scale but resolved identified problems outlined in the critique particularly a lack of consistent anchors among subscales as well as low emphasis on non-motor features of PD.
- The MDS-UPDRS has 4 parts with a total summed score.
- Part I: non-motor experiences of daily living (13 questions). Part I has 2 components:
1) Part IA concerns a number of behaviors that are assessed by the investigator with all pertinent information from patients and caregivers.
2) Part IB is completed by the patient with or without the aid of the caregiver but independently of the investigator. It can, however be reviewed by the rater to ensure that all questions are answered clearly and the rater can help explain any ambiguities.
- Part II: motor experiences of daily living (13 questions). Part II is designed to be a self-administered questionnaire similar to Part IB but can be reviewed by the investigator to ensure completeness and clarity.
- Part III: motor examination (33 scores based on 18 questions with several right, left or other body distributions scores). Part III has instructions for the rater to give or demonstrate to the patient and is completed by the rater.
- Part IV: motor complications (6 questions). Part IV has instructions for the rater and also instructions to be read to the patient. This part integrates patient derived information with the rater’s clinical observations and judgments and is completed by the rater.
- Parts IA, IB and II of the MDS-UPDRS do not have separate ON or OFF ratings however for individual programs or protocols the same questions can be used separately during ON and OFF times. ON and OFF definitions are provided to ensure uniformity among raters and the score sheets documents the ON/OFF status associated with the Part III assessment.
- All items have 5 response options with uniform anchors of
0 = normal
1 = slight (symptoms/signs with sufficiently low frequency or intensity to cause no impact on function)
2 = mild (symptoms/signs of frequency or intensity sufficient to cause a modest impact on function
3 = moderate (symptoms/signs sufficiently frequent or intense to impact considerably, but not prevent function)
4 = severe (symptoms/signs that prevent function)
Higher scores indicate greater impact of PD symptoms.
Required Training
Training Course
Instrument Reviewers
Initially reviewed by Alicia Esposito, PT, DPT, NCS and the PD EDGE task force of the Neurology Section of the APTA in April of 2013.
ICF Domain
Body Function
Activity
Participation
Measurement Domain
Activities of Daily Living
Cognition
Emotion
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
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Abbreviations:
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HR
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Highly Recommend
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R
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Recommend
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LS / UR
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Reasonable to use, but limited study in target group / Unable to Recommend
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NR
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Not Recommended
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Recommendations Based on Parkinson Disease Hoehn and Yahr stage:
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I
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II
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III
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IV
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V
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PD EDGE
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HR
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HR
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HR
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HR
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HR
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Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N)
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Students should be exposed to tool? (Y/N)
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Appropriate for use in intervention research studies? (Y/N)
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Is additional research warranted for this tool (Y/N)
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PD EDGE
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No
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Yes
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Yes
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Not reported
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Considerations
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