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Unified Dystonia Rating Scale (UDRS)
Please visit this website for more information about the instrument: Unified Dystonia Rating Scale
Supplemental: Mitochondrial Disease (Mito)
Short Description of Instrument
The UDRS evaluates the severity and duration of dystonia in 14 body areas (Appendix SIV, supporting information published online). (Monbaliu et al., 2010)
Means of Administration: Physical therapy
Intended Respondent: Participant
Comments/Special Instructions
Must be administered by a trained professional (Monbaliu et al., 2010)
Scoring and Psychometric Properties
Scoring: 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 predominantly 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.
Psychometric Properties: In Monbaliu et al. (2010), the interrater reliability of the Barry-Albright Dystonia Scale (BADS), Burke-Fahn-Marsden Movement Scale (BFMMS), and UDRS total scores was found to be moderate to good and internal consistency in measuring dystonia in patients with cerebral palsy 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.
Strengths: Applicable to adult population. Assesses more body areas than other dystonia scales.
Weaknesses: Requires more training to administer than other dystonia scales, e.g., BADS. More time consuming than BADS and BFMMS, designed for adults.
Key Reference:
Comella CL, Leurgans S, Wuu J, Stebbins GT, Chmura T; and The Dystonia Study Group. Rating scales for dystonia: a multicenter assessment. Mov Disord. 2003 Mar;18(3):303-312.
Additional References:
International Classification of Functioning, Disability and Health (ICF). (2001) Available from: International Classification of Functioning, Disability and Health (ICF) ( Accessed 03 October 2023.
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.
Pavone L, Burton J, Gaebler-Spira D. Dystonia in childhood: clinical and objective measures and functional implications. J Child Neurol. 2013 Mar;28(3):340-50.
Document last updated March 2024