Kwaliteitsstandaard atypische parkinsonismen

Pagina 226 2 Mild in amplitude and persistent. Or moderate in amplitude, but only intermittently present. 3 Moderate in amplitude and present most of the time, 4 Marked in amplitude and present most of the time, 5. Action tremor Assess postural tremor of outstretched arms (A) and action tremor on finger pointing (B). Rate maximal tremor severity in Task A and/or B (whichever is worse), and rate the most affected limb. 0 Absent. 1 Slight tremor of small amplitude (A). No interference with finger pointing (B). 2 Moderate amplitude (A). Some interference with finger pointing (B). 3 Marked amplitude (A). Marked interference with finger pointing (B). 4 Severe amplitude (A). Finger pointing impossible (B). 6. Increased tone (rate the most affected limb) Judged on passive movement of major joints with patient relaxed in sitting position; ignore cogwheeling. 0 Absent. 1 Slight or detectable only when activated by mirror or other movements. 2 Mild to moderate. 3 Marked, but full range of motion easily achieved. 4 Severe, range of motion achieved with difficulty. 7. Rapid alternating movements of hands Pro-supination movements of hands, vertically or horizontally, with as large an amplitude as possible, each hand separately, rate the worst affected limb. Note that impaired performance on this task can be caused by bradykinesia and/or cerebellar incoordination. Rate functional performance regardless of underlying motor disorder. 0 Normal. 1 Mildly impaired. 2 Moderately impaired. 3 Severely impaired. 4 Can barely perform the task. 8. Finger taps Patient taps thumb with index finger in rapid succession with widest amplitude possible, each hand at least 15 to 20 seconds. Rate the worst affected limb. Note that impaired performance on this task can be caused by bradykinesia and/or cerebellar incoordination. Rate functional performance regardless of underlying motor disorder. 0 Normal. 1 Mildly impaired. 2 Moderately impaired. 3 Severely impaired. 4 Can barely perform the task.