Found a bunch of self-assessment tests for PD today.  Here’s how I did…

WEBSTER SCALE

This scale was developed as a simple rating scale that can be used to evaluate the degree of total parkinsonian disabilities. It applies a gross clinical rating to each of the 10 listed items, assigning value rating of 0–3 for each item, where 0 = no involvement and 1, 2, and 3 are equated to early, moderate, and severe disease, respectively. Scores range from 0 to 30, and decline represents decrease in severity of PD signs. Values of 1 to 10 indicate early illness; 11 to 20, moderate disability; and 21 to 30, severe or advanced disease.

Bradykinesia of Hands – Including Handwriting
0 = No involvement.
1 = Detectable slowing of the supination-pronation rate, evidenced by beginning difficulty in handling tools, buttoning clothes, and with handwriting.
2 = Moderate slowing of supination-pronation rate, one or both sides, evidenced by moderate impairment of hand function. Handwriting is greatly impaired, micrographia present.
3 = Severe slowing of supination-pronation rate. Unable to write or button clothes. Marked difficulty in handling utensils.

Rigidity
0 = Non-detectable.
1 = Detectable rigidity in neck and shoulders. Activation phenomenon is present. One or both arms show mild, negative, resting rigidity.
2 = Moderate rigidity in neck and shoulders. Resting rigidity is positive when patient not on medication.
3 = Severe rigidity in neck and shoulders. Resting rigidity cannot be reversed by medication.

Posture
0 = Normal posture. Head flexed forward less than 4 inches.
1 = Beginning poker spine. Head flexed forward up to 5 inches.
2 = Beginning arm flexion. Head flexed forward up to 6 inches. One or both arms raised but still below waist.
3 = Onset of simian posture. Head flexed forward more than 6 inches. One or both hands elevated above the waist. Sharp flexion of hand, beginning interphalangeal extension. Beginning flexion of knees.

Upper Extremity Swing
0 = Swings both arms well.
1 = One arm definitely decreased in amount of swing.
2 = One arm fails to swing.
3 = Both arms fail to swing.

Gait
0 = Steps out well with 18–30 inch stride. Turns about effortlessly.
1 = Gait shortened to 12–18 inch stride. Beginning to strike one heel. Turn around time slowing. Requires several steps.
2 = Stride moderately shortened – now 6–12 inches. Both heels beginning to strike floor.
3 = Onset of shuffling gait, steps less than 3 inches. Occasional stuttering-type or blocking gait. Walks on toes-turns around very slowly.

Tremor
0 = No detectable tremor found.
1 = Less than one inch of peak-to-peak tremor movement observed in limbs or head at rest or in either hand while walking or during finger to nose testing.
2 = Maximum tremor envelope fails to exceed 4 inches. Tremor is severe but not constant and patient retains some control of hands.
3 = Tremor envelope exceeds 4 inches. Tremor is constant and severe. Patient cannot get free of tremor while awake unless it is a pure cerebellar type. Writing and feeding himself is impossible.

Facies
0 = Normal. Full animation. No stare
1 = Detectable immobility. Mouth remains closed. Beginning features of anxiety or depression.
2 = Moderate immobility. Emotion breaks through at markedly increased threshold. Lips parted some of the time. Moderate appearance of anxiety or depression. Drooling may be present.
3 = Frozen facies. Mouth open ¼ inches or more. Drooling may be severe.

Seborrhea
0 = None.
1 = Increased perspiration, secretion remaining thin.
2 = Obvious oiliness present. Secretion much thicker.
3 = Marked seborrhea, entire face and head covered by thick secretion.

Speech
0 = Clear, loud, resonant, easily understood.
1 = Beginning of hoarseness with loss of inflection and resonance. Good volume and still easily understood.
2 = Moderate hoarseness and weakness. Constant monotone, unvaried pitch. Beginning of dysarthria, hesitancy, stuttering, difficult to understand.
3 = Marked harshness and weakness. Very difficult to hear and to understand.

Self-Care
0 = No impairment.
1 = Still provides full self-care but rate of dressing definitely impeded. Able to live alone and often still employable.
2 = Requires help in certain critical areas, such as turning in bed, rising from chairs, etc. Very slow in performing most activities but manages by taking much time.
3 = Continuously disabled. Unable to dress, feed himself, or walk alone.

My total Webster Scale Score — 18

According to the AHRQ: scores of 1 to 10 indicate early illness; 11 to 20,  moderate disability; and 21 to 30, severe or advanced disease.

I also took something called the Parkinson’s Disease Quality of Life Questionnaire.  You can score from 37, which is “no symptoms” to 185, which is “totally disabled.”  I got a 108.  This gets broken down in to sub components.

Parkinsonian Symptoms (score can range from 13 to 65) — 35

Systematic Symptoms (7-35) 16

Social Functioning (7-35) 24

Emotional Functioning (9-45) 34

So, according to the PDQL, I’d be at the upper edge of “moderate disease”.

I also took the PDQ-39 test, so named because it’s a Parkinson’s Disease Questionnaire with 39 question.  There’s a complicated method of scoring and I’ll spare you the explanation.  It is broken into the following areas and scores, which range from 0 to 100  (lower is better):

Mobility — 77.5

Activities of Daily Living — 20.83

Emotional Functioning — 37.5

Stigma of PD — 12.5

Support from Spouse/Others — 0 (perfect score!)

Cognition — 50

Communication Ability — 33.3

Discomfort — 91.67

My overall PDQ Single Index?  40.4125 — which would place me at the upper end of Phase III in the Hoehn & Yahr Scale.

So, by all accounts (and keep in mind, it’s a self assessment), nearly 10 years into this thing I’m at the border of moderate/advanced Parkinson’s disease.  I’m still doing comparatively well in the areas of “activities of daily living” and such… but the progression….

Progresses.