Kwaliteitsstandaard atypische parkinsonismen

Pagina 227 9. Leg agility Patient is sitting and taps heel on ground in rapid succession, picking up entire leg. Amplitude should be approximately 10 cm, rate the worst affected leg. 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. 10. Heel-knee-shin test The patient is requested to raise one leg and place the heel on the knee, and then slide the heel down the anterior tibial surface of the resting leg toward the ankle. On reaching the ankle joint, the leg is again raised in the air to a height of approximately 40 cm and the action is repeated. At least three movements of each limb must be performed for proper assessment. Rate the worst affected limb. 0 Normal. 1 Mildly dysmetric and ataxic. 2 Moderately dysmetric and ataxic. 3 Severely dysmetric and ataxic. 4 Can barely perform the task. 11. Arising from chair Patient attempts to arise from a straight-back wood or metal chair with arms folded across chest. 0 Normal. 1 Clumsy, or may need more than one attempt. 2 Pushes self up from arms of seat. 3 Tends to fall back and may have to try more than once but can get up without help. 4 Unable to arise without help. 12. Posture 0 Normal. 1 Not quite erect, slightly stooped posture; could be normal for older person. 2 Moderately stooped posture, definitely abnormal; can be slightly leaning to one side. 3 Severely stooped posture with kyphosis; can be moderately leaning to one side. 4 Marked flexion with extreme abnormality of posture. 13. Body sway Rate spontaneous body sway and response to sudden, strong posterior displacement produced by pull on shoulder while patient erect with eyes open and feet slightly apart. Patient has to be warned. 0 Normal.