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Subject ID ___________ Date ________ Stage ___ (0-3)

International Cooperative Ataxia Rating Scale (World Federation of Neurology)

I. Posture and gait disturbances


1. Walking capacities (10-m test including half turn, near a wall, at about 1.5 meters) ___
0 = normal;
1 = almost normal naturally but unable to walk with feet in tandem position;
2 = walking without support but clearly abnormal and irregular;
3 = walking without support but with considerable staggering; difficulties with half turn;
4 = walking with autonomous support no longer possible, the patient uses the episodic support of the wall
for the 10-meter test;
5 = walking only possible with one stick;
6 = walking only possible with two special sticks or stroller;
7 = walking only with accompanying person;
8 = walking impossible, even with accompanying person (wheelchair)

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

5. Body sway with feet together, eyes open ___


0 = normal
1 = slight oscillations
2 = moderate oscillations (< 10 cm at the head)
3 = severe oscillations (> 10 cm at the head)
4 = immediate falling

6. Body sway with feet together, eyes closed ___


0 = normal
1 = slight oscillations
2 = moderate oscillations (< 10 cm at the head)
Subject ID ___________ Date ________ Stage ___ (0-3)

3 = severe oscillations (> 10 cm at the head)


4 = immediate falling

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

Posture and gait subs-score (static score) ____/34

Disease severity _____


Based on the Posture and Gait component of the ICARS assessment reported in table 3 of Schmitz-
Hubsch et al 2006:

Based on the standard deviation values reported:


Stage 0: 0 - 1.3
Stage 1: 5.4 – 14.4
Stage 2: 15.1 – 25.1
Stage 3: 26.4 – 32.4

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 ____________________________________

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