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Unified Dystonia Rating Scale (UDRS)
Availability
Available in the public domain: Unified Dystonia Rating Scale MDS website Link
Classification
Supplemental: Mitochondrial Disease (Mito)
Short Description of Instrument
The UDRS10 evaluates dystonia in 14 body areas (Appendix SIV, supporting information published online). The UDRS has a severity and duration rating. The severity factor ranges from 0 to 4. The duration factor is a 9-point ordinal subscale and ranges from 0  to 4 at intervals of 0.5. This factor assesses whether dystonia occurs at rest or in action, and whether it is predominandy at maximal or submaximal intensity. The individual score for each region is the sum of the duration and motor severity factors. The  maximal total score of the UDRS is 112, calculated by summing the individual region scores. In the UDRS, the duration factor does not differentiate between rest and activity, and it expresses dystonia as a percentage of duration and amplitude, combined within one item. The score content of the motor severity factor usually includes a measure of amplitude described as a percentage and sometimes a velocity description  of the dystonic movement.
 
Construct measured: Severity and duration of dystonia in various body parts
Generic vs. disease specific:
Means of administration: Physical therapy
Intended respondent: Participant
# of items: 14 regions
# of subscales and names of sub-scales: N/A
# of items per sub-scale: N/A
Comments/Special Instructions
Advantages: Applicable to adult population. Assesses more body parts than other dystonia scales.
 
Limitations: Requires more training to administer than other dystonia scales, e.g. BADS. More time consuming than BADS and BFMMS, designed for adults.
 
Must be administered by a trained professional. (Monbaliu, 2010) In this study, the interrater reliability of the BADS, BFMMS, and UDRS total scores was found to be moderate to good and internal consistency in measuring dystonia in patients with CP was high. The high level of association between the three scales supports the   concurrent validity. On the other hand, several items of the BADS and BFMMS, and   most items of the UDRS, showed low interrater reliability. The high SEM and SDD reduce the sensitivity of the scales for clinical use. Further limitations are the insufficient accordance with the new CP definition and classification and the amalgamation of several levels of the ICF model. Thus, further study into the assessment of dystonia in patients with CP is warranted.
Scoring
I. Duration Factor 0 none
0.5 occasional (<25% of the time); predominantly submaximal
1.0 occasional (<25% of the time); predominantly maximal
1.5 Intermittent (25-50% of the time); predominantly submaximal
2.0 Intermittent (25-50% of the time); predominantly maximal
2.5 Frequent (50-75% of the time); predominantly submaximal
3.0 Frequent (50-75% of the time); predominantly maximal
3.5 Constant (> 75% of the time); predominantly submaximal
4.0 Constant (> 75% of the time); predominantly maximal
2. Motor Severity Factor EYES AND UPPER FACE
0. none
References
Monbaliu et al, 2010, Pavone et al, 2012, Storch et al, 2007
 
Monbaliu E, Ortibus E, Roelens F, Desloovere K, Deklerck J, Prinzie P, de Cock P, Feys H. Rating scales for dystonia in cerebral palsy: reliability and
validity. Dev Med Child Neurol. 2010 Jun;52(6):570-5.
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