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    Patent Pending

    Webster Rating Scale for Parkinson’s Disease

    Quantifies degree of disability in Parkinson’s disease.
    When to Use
    Do you use the Webster Rating Scale and want to contribute your expertise? Join our contributor team!
    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
    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
    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
    Swings both arm well
    0
    One arm swing definitely decreased
    +1
    One arm fails to swing
    +2
    Both arms fail to swing
    +3
    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
    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
    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
    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
    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
    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:

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    Next Steps
    Evidence
    Creator Insights
    Dr. David Webster

    About the Creator

    David D. Webster, MD, (d. 1998) was a neurologist and internationally-known Parkinson's disease specialist. He was a professor and later the chief of neurology at the University of Minnesota. Dr. Webster was also a World War II veteran, serving as a lieutenant after studying radar, a then-new technology, at MIT and Harvard.

    To view Dr. David Webster's publications, visit PubMed

    Are you Dr. David Webster? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. David Webster
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