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    Parkinson Hoehn and Yahr Scale

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    Carol Artigas Gómez
    The document describes the Hoehn and Yahr scale used to rate the stages of Parkinson's disease from 1 to 5 based on motor function and disability. Stage 1 involves only unilateral involvement while stage 5 involves confinement to bed or wheelchair. The scale is simple but lacks detail and focus on motor deficits alone.

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    Parkinson Hoehn and Yahr Scale

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    Carol Artigas Gómez
    378 views3 pages
    The document describes the Hoehn and Yahr scale used to rate the stages of Parkinson's disease from 1 to 5 based on motor function and disability. Stage 1 involves only unilateral involvement while stage 5 involves confinement to bed or wheelchair. The scale is simple but lacks detail and focus on motor deficits alone.

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    The document describes the Hoehn and Yahr scale used to rate the stages of Parkinson's disease from 1 to 5 based on motor function and disability. Stage 1 involves only unilateral involvement while stage 5 involves confinement to bed or wheelchair. The scale is simple but lacks detail and focus on motor deficits alone.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    378 views3 pages

    Parkinson Hoehn and Yahr Scale

    Uploaded by

    Carol Artigas Gómez
    The document describes the Hoehn and Yahr scale used to rate the stages of Parkinson's disease from 1 to 5 based on motor function and disability. Stage 1 involves only unilateral involvement while stage 5 involves confinement to bed or wheelchair. The scale is simple but lacks detail and focus on motor deficits alone.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Chapter 2

    Parkinsons Disease: Hoehn and Yahr Scale


    This chapter contains a video segment which can be found at the
    URL: http://www.springerimages.com/Tarsy

    Background
    The Hoehn and Yahr scale (HY) is a widely used clinical rating scale, which defines
    broad categories of motor function in Parkinsons disease (PD). Among its advantages
    are that it is simple and easily applied. It captures typical patterns of progressive motor
    impairment which can be applied whether or not patients are receiving dopaminergic
    therapy. Progression in HY stages has been found to correlate with motor decline,
    deterioration in quality of life, and neuroimaging studies of dopaminergic loss.
    However, because of its simplicity and lack of detail, the scale is not comprehensive.
    It is also limited by its focus on issues of unilateral versus bilateral disease and the
    presence or absence of postural reflex impairment, thereby leaving other specific
    aspects of motor deficit unassessed. Also it does not provide any information concerning nonmotor aspects of PD. A modified version of HY is sometimes used.
    Hoehn and Yahr Scale

    Modified Hoehn and Yahr Scale

    1: Only unilateral involvement, usually with


    minimal or no functional disability
    2: Bilateral or midline involvement without
    impairment of balance
    3: Bilateral disease: mild to moderate
    disability with impaired postural reflexes;
    physically independent
    4: Severely disabling disease; still able to
    walk or stand unassisted
    5: Confinement to bed or wheelchair unless
    aided

    1.0: Unilateral involvement only


    1.5: Unilateral and axial involvement
    2.0: Bilateral involvement without impairment
    of balance
    2.5: Mild bilateral disease with recovery on
    pull test
    3.0: Mild to moderate bilateral disease; some
    postural instability; physically independent
    4.0: Severe disability; still able to walk or stand
    unassisted
    5.0: Wheelchair bound or bedridden unless
    aided

    References
    1. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;
    17:42742.
    2. Goetz CG, Poewe W, Rascol O, et al. Movement disorder society task force report on the Hoehn
    and Yahr staging scale: status and recommendations. Mov Disord. 2004;19:10208.

    R. Bhidayasiri, D. Tarsy, Movement Disorders: A Video Atlas, Current Clinical Neurology,


    DOI 10.1007/978-1-60327-426-5_2, Springer Science+Business Media New York 2012

    Chapter 2

    Parkinsons Disease: Hoehn and Yahr Scale

    Video
    There are five video clips which illustrate patients at HY stages 15.
    Clip 1: HY1. The patient exhibits resting tremor in right hand and impaired rapid wrist rotations in
    right wrist. Facial expression appears normal. Gait is brisk and right arm swing is reduced in
    amplitude but present bilaterally. Clip 2: HY2. The patient exhibits continuous large amplitude
    resting tremor in both upper extremities, which persists as an action tremor during finger-nosefinger testing. There is prominent facial masking. Gait and turns are normal but with reduced arm
    swing bilaterally. Hand tremor activates while walking. Rapid alternating movements are slow in
    both upper extremities. Pull testing (not shown) is normal. Clip 3: HY3. Tremor is absent and
    facial expression is mildly reduced. Rapid open-close hand movements and wrist rotations are
    normal but rapid finger tapping is slow in right hand. There appears to be rigidity to passive manipulation in both upper extremities. The patient arises easily without use of hands. Gait is brisk with
    good arm swing, but while turning the patient displays freezing of gait and gait ignition failure.
    Pull testing is repeatedly positive. Clip 4: HY4. Facial masking is prominent. There is bilateral
    resting and postural tremor in upper extremities. The patient requires assistance to stand. The
    patient is able to walk independently with flexed posture, absent arm swing, shortened stride
    length, and activated hand tremor. Clip 5: HY5. The patient is wheelchair bound and flexed at
    waist. There is global akinesia with very slow and poorly maintained rapid alternating hand movements. The patient requires assistance to stand and must be led in order to walk with persistent
    flexed posture and shortened stride length.

    http://www.springer.com/978-1-60327-425-8

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