The Hoehn and Yahr scale (HY) is a widely used clinical rating scale, which de fines broad categories of motor function in Parkinson’s disease (PD). Among its. versus no therapy in mild to moderate Parkinson’s disease: a large pragmatic randomised controlled trial (PD REHAB). Appendix 8Hoehn and Yahr stages. Front Biosci (Landmark Ed). Mar 1; Hoehn and Yahr staging of Parkinson’s disease in relation to neuropsychological measures. Modestino.

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Intellectual function, moodbehavior Forgetfulnessdisorientation in time and space Vivid dreaming Hallucinations Delusions and paranoia Depressed mood Anxious mood Apathy Features of dopamine dysregulation syndrome Nighttime sleep problems Daytime sleepiness Pain and other sensations Urinary problems Constipation problems Lightheadedness on standing Fatigue Part 2: Parkinson’s disease Medical scales.

Diagnosis may be easy at this stage if the patient has a tremor, however, if stage one was missed and the only symptoms of stage ayhr are slowness or lack of spontaneous movement, PD could be misinterpreted as only advancing age. A patient at Stage II can become almost normal with adequate therapy; a patient at Stage IV will have residual symptoms, and improvement is never as marked or dramatic.

Sometimes the disease must evolve over many years before a diagnosis can be made with certainty. These scores are tallied to indicate the severity of the disease, with points being the worst and total disability and 0 meaning no disability.

Years of education had a significant negative relationship with H-Y score. The Hoehn and Yahr scale The Hoehn and Yahr scale, named for its authors, was published in and was the first rating scale to describe the progression of PD. Severe disability, still able to walk and to stand stagint. General Information info parkinsonsresource.


Balance is compromised by the inability to make the rapid, automatic, and involuntary adjustments necessary to prevent falling, and falls are common at this stage. Wheelchair bound or bedridden unless aided. Symptoms of PD in stage two may include the loss of facial expression on both sides of the face and decreased blinking.

Symptoms at stage one may include tremorrigidityor slowness of movement in the arm or leg on one side of the body, or one side of the face may be affected, impacting staving expression. People with PD may also never experience some of the above symptoms.

Five Stages of Parkinson’s · Parkinson’s Resource Organization

Most doctors worry about a stroke parkinxon tumor — which they should. February Learn how and when to remove this template message. A typical example of diagnosis using this method of staging would be: All other aspects of Parkinsonism are evident and usually diagnosis is not in doubt. Since then, a modified Hoehn and Yahr scale was proposed with the addition of ;arkinson 1.

Others may have mild disturbance of balance for many years without losing independence. Show details Health Technology Assessment, No. National Center for Biotechnology InformationU.

The Hoehn and Yahr scale, named for its authors, was published in and was the first rating scale to describe the progression of PD. When abd necessary tests show nothing, one must wait and observe. However, the most important factor identifying Stage III as opposed to stage IV is that the patient is still fully independent in all activities of daily living dressing, hygiene, eating, etc.

Hoehn and Yahr scale

Fill out my Wufoo form! Sign up here instead. People with stage five Staginv may be unable to rise from a chair or get out of bed without help, they may have a tendency to fall when standing or turning, and they may freeze or stumble when walking. For example, even in Stage II, Parkinsonism may be interpreted as only advancing age. This article needs more links to other articles to help integrate it into the encyclopedia.


The Hoehn and Yahr scale is a commonly used system for describing how the symptoms of Parkinson’s disease progress.

Hoehn and Yahr staging of Parkinson’s disease in relation to neuropsychological measures.

We never sell dtaging share your email address. Views Read Parkisnon View history. Appendix 8, Hoehn and Yahr stages. Motor examination Speech — volume, diction Reduced facial expressions Rigidity Finger tapping Slowed hand movements Rapid alternating movements of hands pronation-supination Toe tapping Leg agility — when tapping heel on the ground, is it slowed, early fatiguing Arising from a chair — degree of difficulty Gait — shuffling, walking with difficulty Freezing of gait Postural stability — difficulty recovering balance Posture — stooped Global spontaneity of movement body bradykinesia — slowness of movement, lack of movement Tremor at rest Part 4: Stage two may develop months or years after stage one.

Applications for commercial reproduction should be diseaee to: As H-Y stage significantly increased, so did age and levodopa equivalency dose of medications, both independent of one another.

It now includes the following sections: In addition, there are treatments available that can help at every stage of the disease. In spite of these drawbacks, this method of grading severity has proved practical over many years. Eventually Stage II may emerge. Twitter Created with Sketch.