The UPDRS or the Unified Parkinson’s Disease Rating Scale is a critique of Parkinson’s disease prepared by The Movement Disorders Society Task Force for Rating Scales. The strength of the scale lies in its extensive utilization, the implementation of the same in the clinical spectrum of the disease, the complete coverage of comprehensive motor signs, & the clinimetric including validity and reliability.
The disadvantage of the scale includes metallic floss, the absence of clear instructions for raters, ambiguities in the form of written text, and absence of several aspects related to non-motor movements of the Parkinson’s disease. Due to the feedback received by the Society Task Force, it recommended development of a new version of the scale and also provide affords that establishes clinimetric properties especially that address and define Minimal Clinically Relevant Difference and Minimal Clinically Relevant Incremental Difference. The task force also recommended the co-relation with the present scaling system. With the introduction of the new scaling system, it is possible to create an unbiased UPDRS that requires testing using different genders, age groups, and racial.
Developed in the 1980s, the Unified Parkinson’s Disease Rating Scale became the clinical scaling system to diagnose Parkinson’s disease. In most of the scenarios, the scaling system became the foundation for finding out the treatment-related benefits. The original scaling system consists of four parts.
Part one includes assessment of behavior problems such as intellectual decline, depression, and hallucinations. The second part contains the evaluation of patient’s perceptions of their ability to carry out day-to-day activities, including walking, eating, and dressing. Third part helps in evaluating the disability and has the presence of ratings for stiffness, tremor, slowness, and balance. The fourth section, which is final, consists of several treatment complications which involve painful cramps, involuntary movements, and irregular medicinal responses.
One of the critical aspects of the scale is to provide practical, comprehensive, and easy administration of the Parkinson’s disease. The scale is helpful regardless of the treatment, the severity of the condition, gender, and age.
Need for Changes
The scaling system, which is present for the over 20 years, is the best rating scale ever present to diagnose, provide treatment, and assess the condition of Parkinson’s disease in a patient. However, several investigators commented on the weaknesses present in the scaling system. In the current research trials, which are focusing on early detection of the Parkinson’s disease, the scaling system fails because it does not contain the pattern that is helpful in detecting the changes in the early stages. Currently, due to the advancement of the technology and medical field, experts recognized that many aspects of the disease do not have any association with the original Unified Parkinson’s Disease Rating Scale.
It was at this point that the Movement Disorder Society prepared a new version and released the same in the year 2008. The latest version underwent clinical trials in its original English format. One can anticipate the release of introduction and official foreign translations very soon.
The New Scaling System
The new scaling system consists of 6 categories with over 42 questions. It involves direct interaction between the patient and the caregiver. The questionnaire includes rating, which the caregiver records on a daily basis to monitor the condition of the patient. Depending on the response and the points, the caregiver alters the medication and the diet to maintain the balance. It is also helpful in finding out the symptoms that may lead to the occurrence of Parkinson’s disease in its early stage.