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