"Parkinson's Disease and UPDRS"
(Unified Parkinson's Disability Rating Scale)
By Dr. Mrs. S. Ghatak, MBBS
Parkinsonism, a disease of
C. N. S., usually presents itself with multiple disability factors including psychological, speech and physical problems.
Various type of problems need different careful management through rehabilitation, which requires very particular assessment and reassessment programmes. Apart from signs and symptoms required for the diagnosis for the disease of Parkinsonism, proper rehabilitation and measurement of its outcome must be surveyed by any
specialized scoring system like UPDRS. Moreover, the drugs change the disease symptoms and the rehabilitation too.
Scoring systems like UPDRS might be very useful for proper measurement of rehabilitation outcome.
UPDRS includes various factors.
Mentation,
Behaviour and Mood
-
Intellectual impairment
-
Thought disorder
-
Depression
-
Motivation
- initiative
Activities of daily living
-
Speech
-
Salivation
-
Swallowing
-
Handwriting
-
Cutting
food - handling utensils
-
Dressing
-
Hygiene
-
Turning
in Beds - Adjusting Bed Clothes
-
Falling
- unrelated to freezing
-
Walking
-
Tremor
-
Sensory
Complaints related to Parkinsonism
Motor
There
are definitive scoring grades (0-5) in each of the above mentioned factors
giving a range of total score (0-199). 199 is the severe most form of
Parkinsonism.
In the last five months, MRC has treated ten patients of PD with psychological, speech and various motor training programme as a team approach basis.
It has been seen that eight out of ten patients has showed significant reduction of scoring numbers in the subsequent follow up, the drugs and doses remaining the same and this system has really helped
assessing the PD patient regarding its rehabilitation outcome. MRC looks forward to study through UPDRS. When the drugs and the rehabilitation are two variables and the statistical result is awaited for, with hope.
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