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RehabMeasures Instrument

Rush Dyskinesia Rating Scale

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A scale to assess the severity of overall dyskinesias based on interference in activities of daily living, to distinguish chorea from dystonia (the two major types of dyskinesias in PD) and to identify the single most disabling form of dyskinesia (Goetz et al., 1994).

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Instrument details

Area of Assessment

Activities of Daily Living
Quality of Life
Upper Extremity Function

Assessment Type


Administration Mode

Paper & Pencil




  • Parkinson's Disease & Neurologic Rehabilitation

Key Descriptions

  • The patient performs 3 tasks:
    1) Walk
    2) Drink from a cup
    3) Putting on and buttoning a coat
  • Severity of dyskinesias are rated using the following scale:
    0: absent
    1: minimal severity, no interference with -voluntary motor acts
    2: dyskinesias may impair voluntary movements but patient is normally capable of undertaking most motor tasks
    3: intense interference with movement control and daily life activities are greatly limited
    4: violent dyskinesias, incompatible with any normal motor task
  • Check which type of dyskinesias observed (Chorea, Dystonia, Other). More than one response is permitted.
  • Check the type of dyskinesia that is causing most disability with the testing tasks. Only one response is permitted (Goetz et al., 1994).

Number of Items


Equipment Required

  • Cup
  • Lab coat

Time to Administer

10-15 minutes

Required Training

Training Course

Age Ranges


18 - 64


Elderly Adult

65 +


Instrument Reviewers

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

Measurement Domain

Activities of Daily Living

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:





Highly Recommend




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


Not Recommended


Recommendations Based on Parkinson Disease Hoehn and Yahr stage: 














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)





Not reported


This scale was created by the Movement Disorders Society and is modification of the Obeso Dyskinesia Scale.

In this study (Goetz, et al 1994), the scale was administered by physicians and nurses. It was performed by observing subjects performing the tasks from a video tape (not in person). 

(Colosimo et al, 2010) Main strengths: Assesses functional disability of dyskinesia and clinimetric testing revealed relatively high inter-rater and intrarater reliability. 

Weaknesses: Assessments are done at one time point therefore may not reflect the rest of day. Patient may also exhibit more or less dyskinesias in the clinic versus at home. The assessment is also confined to an observer rating of motor disability during specified tasks and may not capture disability related to other tasks. The various types of dyskinesias may present at different times of day and/or may depend on medication cycle.

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Parkinson's Disease

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Interrater/Intrarater Reliability

Parkinson’s Disease

(Goetz et al, 1994; n = 40) 

  • Use of Kendall’s coefficient of concordance (W) for severity of dyskinesia ratings
  • Use of ĸ coefficient of agreement for inter-rater agreement of types of dyskinesias observed. 
  • Use of Cramer coefficient for type of dyskinesia and most disabling dyskinesia 
  • Severity of dyskinesias 
    • Significant inter-rater reliability for severity of dyskinesia (Test 1: W = 0.760, df = 19, p < 0.001; Test 2: W = 0.876, df = 19, p < 0.001)
    • Intra-rater consistency was high for the whole group (physicians and nurses): r= 0.855, p < 0.001; physicians significantly more consistent than nurses: r= 0.908 vs. r= 0.826, = 2.44, p < 0.05 
  • Types of dyskinesias observed 
    • Significant levels of agreement on both tests (test 1: ĸ = 0.394, p < 0.001; test 2: ĸ = 0.422, p < 0.001) 
    • Intra-rater consistency was high for the whole group: C = 0.705, p < 0.01 
  • Most disabling dyskinesia 
    • Significant levels of agreement to most disabling dyskinesia for both tests (test 1: ĸ = 0.419, p < 0.001; test 2: ĸ = 0.378, p < 0.001) 
    • Intra-rater consistency was high for the whole group: C = 0.837, p < 0.01


Parkinson’s Disease : 

(Goetz et al, 2013; n = 68 (n = 36 in experimental group receiving Amantadine, n = 32 in placebo group); mean age (years) = Amantadine group = 65.4(8.2), placebo group = 68.5(6.9); PD duration(years) = Amantadine group = 9.0(3.5), placebo group = 9.4(4.9); Dyskinesia duration(years) = Amantadine group = 4.2(3.8), placebo group = 3.9(3.6); median Hoehn and Yahr Stage = 2 (1-4)) 

  • Poor sensitivity to change in dyskinesia severity over time (P = 0.621; Effect size = 0.003)


Colosimo, C., Martinez-Martin, P., et al. (2010). "Task force report on scales to assess dyskinesia in Parkinson's disease: critique and recommendations." Mov Disord 25(9): 1131-1142. Find it on PubMed

Goetz, C. G., Stebbins, G. T., et al. (2013). "Which Dyskinesia Scale Best Detects Treatment Response?" Movement Disorders. 

Goetz, C. G., Stebbins, G. T., et al. (1994). "Utility of an objective dyskinesia rating scale for Parkinson's disease: inter- and intrarater reliability assessment." Mov Disord 9(4): 390-394. Find it on PubMed