Icarsform
Icarsform
Icarsform
2. Gait speed (for patients with preceding scores 1-3, those with >3 are assigned a score of 4 in
this test) ___
0 = normal;
1 = slightly reduced;
2 = markedly reduced;
3 = extremely slow;
4 = walking with autonomous support no longer possible
3. Standing capacities, eyes open (Assess the subject's ability to perform the following: stand on
one leg -> tandem position -> feet together -> natural [comfortable] stance) ___
0 = normal, able to stand on one foot > 10s
1 = able to stand with feet together but unable to stand on one foot for > 10s
2 = able to stand with feet together but unable to stand in tandem position
3 = unable to stand with feet together but able to stand in natural position without support, with no or
moderate sway
4 = stand in natural position without support but with considerable sway and considerable corrections
5 -= unable to stand in natural position without strong support of one arm
6 = unable to stand even with strong support of two arms
4. Spread of feet in natural position without support, eyes open (Have subject stand in a
comfortable position and measure the distance between the medial malleoli) ___
0 = normal (< 10 cm)
1 = slightly enlarged (11 – 24 cm)
2 = clearly enlarged (25 cm to 34 cm)
3 = severely enlarged (> 35 cm)
4 = unable to stand in natural position
7. Quality of sitting position (Have subject sit on a hard surface with thighs together, arms
folded) ___
0 = normal
1 = slight oscillations of the trunk
2 = moderate oscillations of the trunk and legs
3 = severe disequilibrium
4 = unable
In between scores are given a rating between the stages, e.g. a subject with a P&G score of 2 is rated
0.5; a score of 15 is rated 1.5, and so on.
RATED BY ____________________________________