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Webster Rating Scale for Parkinson’s Disease

Bradykinesia of hands
None 0
Detectable slowing of supination-pronation rate; beginning difficulty in hand dexterity 1
Moderate slowing of supination-pronation rate (1 or both sides); moderately impaired hand function; micrographia present 2
Severe slowing of supination-pronation rate; unable to write; marked difficulty w/utensils 3
Rigidity
Non-detectable 0
Detectable rigidity in neck and shoulders; activation phenomenon present; mild negative resting arm rigidity (1 or both) 1
Moderate rigidity (neck + shoulders); resting rigidity present if not on meds 2
Severe rigidity (neck + shoulders); resting rigidity cannot be reversed by meds 3
posture
Normal posture; head flexed forward <4” 0
Beginning poker spine; head flexed forward >5” 1
Beginning arm flexion; head flexed up ≤6”; 1 or both arms raised but still below waist 2
Simian posture onset; head flexed forward >6”; 1 or both hands elevated above waist; hands sharply flexed; beginning interphalangeal extension, knees flexed 3
Upper extremity swing
Swings both arm well 0
One arm swing definitely decreased 1
One arm fails to swing 2
Both arms fail to swing 3
Gait
Steps out will with 18-30” stride, turns about effortlessly 0
Gait shortened to 12-18” stride; beginning to strike 1 heel; turnaround time slowing; requires several steps 1
Stride moderately shortened to 6-12”; both heels starting to strike floor forcefully 2
Onset of shuffling gait; steps <3”; occasional stuttering-type or blocking gait; walks on toes; turns around very slowly 3
Tremor
No detectable tremor 0
<1” of peak-to-peak tremor movement (limbs or head) at rest or in either hand while walking or during finger-to-nose test 1
Maximum tremor envelope fails to exceed 4”; severe but not constant tremor; retains some hand control 2
Tremor envelope >4”; constant severe tremor; persistent while awake unless pure cerebellar type; writing, feeding self impossible 3
Tremor
Normal; full animation; no stare 0
Detectable immobility; mouth closed; beginning anxiety/depression features 1
Moderate immobility; emotion breaks thru at markedly increased threshold; lips parted sometimes; moderate appearance of anxiety/depression; drooling may be present 2
Frozen facies; mouth opens ≥0.25”; severe drooling 3
Seborrhea
None 0
Increased perspiration, secretions thin 1
Obvious oiliness present, secretion much thicker 2
Marked seborrhea, entire face and head covered by thick secretions 3
Speech
Clear, loud, resonant, easily understood 0
Beginning of hoarseness, loss of inflection and resonance; good volume, still easily understood 1
Moderate hoarseness/weakness; constant monotone unvaried pitch; beginning of dysarthria, hesitance, stuttering, difficult to understand 2
Marked harshness/weakness, very difficult to hear and understand 3
Self-care
No impairment 0
Still provides full self-care but rate of dressing definitely impeded; able to live alone, may be employable 1
Requires help in certain critical areas; very slow in performing most activities but manages by taking much time 2
Continuously disabled; unable to dress/feed self or walk alone 3
Result:

Background

Result Interpretation

Ranges Ranges