Purpose
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).
Area of Assessment
Activities of Daily Living
Coordination
Dexterity
Quality of Life
Upper Extremity Function
Assessment Type
Observer
Administration Mode
Paper & Pencil
Cost
Free
Diagnosis/Conditions
- Parkinson's Disease & Neurologic Rehabilitation
- 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).
Required Training
Training Course
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
Activity
Participation
Measurement Domain
Activities of Daily Living
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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LS/UR
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LS/UR
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LS/UR
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LS/UR
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NR
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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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No
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No
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Not reported
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Considerations
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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