Webster Rating Scale for Parkinson's DiseaseLoading...Bradykinesia of handsNone0Detectable slowing of supination-pronation rate; beginning difficult in 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 or button clothes; marked difficulty in handling utensils+3RigidityNon-detectable0Detectable 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+3PostureNormal posture; head flexed forward < 4 inches0Beginning poker spine; head flexed forward > 5 inches+1Beginning arm flexion; head flexed up 6 inches or less; 1 or both arms raised but still below waist+2Simian posture onset; head flexed forward > 6 inches; 1 or both hands elevated above waist; hands sharply flexed; beginning interphalangeal extension, knees flexed+3Upper extremity swingSwings both arm well0One arm swing definitely decreased+1One arm fails to swing+2Both arms fail to swing+3GaitSteps out with 18-30 inch stride, turns about effortlessly0Gait shortened to 12-18 inch stride; beginning to strike 1 heel; turnaround time slowing; requires several steps+1Stride moderately shortened to 6-12 inch; both heels starting to strike floor forcefully+2Onset of shuffling gait; steps < 3 inch; occasional stuttering-type or blocking gait; walks on toes; turns around very slowly+3TremorNo detectable tremor0< 1 inch 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 inch; severe but not constant tremor; retains some hand control+2Tremor envelope > 4 inch; constant severe tremor; persistent while awake unless pure cerebellar type; writing, feeding self impossible+3Tremor faceNormal; full animation; no stare0Detectable 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 inch or greater; severe drooling+3SeborrheaNone0Increased perspiration, secretions thin+1Obvious oiliness present, secretion much thicker+2Marked seborrhea, entire face head covered by thick secretions+3SpeechClear, loud, resonant, easily understood0Beginning 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+3Self-careNo impairment0Still 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+3