Schmitz-Hubsch et al developed a simple scale for the assessment and rating of ataxia (SARA). This can be used both for initial assessment and for monitoring change over time. The authors are from multiple universities in Europe.
Parameters:
(1) gait
(2) stance (tandem, feet together, natural)
(3) sitting
(4) speech
(5) finger chase, left side
(6) finger chase, right side
(7) nose-finger test, left side
(8) nose-finger test, right side
(9) fast alternating hand movements, left side
(10) fast alternating hand movements, right side
(11) heel-shin slide, left side
(12) heel-shin slide, right side
|
Parameter |
Finding |
Points |
|---|---|---|
|
gait |
normal |
0 |
|
|
slight difficulty |
1 |
|
|
abnormal |
2 |
|
|
considerable staggering |
3 |
|
|
marked staggering |
4 |
|
|
severe staggering |
5 |
|
|
needs strong support to walk > 10 meters |
6 |
|
|
can walk < 10 meters with strong support |
7 |
|
|
unable to walk even if supported |
8 |
|
stance |
normal; able to stand with feed in tandem for > 10 seconds |
0 |
|
|
can stand with feet together without sway but cannot stand with feet in tandem for > 10 seconds |
1 |
|
|
sways while standing with feet together |
2 |
|
|
can stand in natural position without support for > 10 seconds but not with feet together |
3 |
|
|
requires intermittent support to stand in a natural position for > 10 seconds |
4 |
|
|
requires constant support to stand in a natural position for > 10 seconds |
5 |
|
|
unable to stand even with constant support |
6 |
|
sitting |
normal |
0 |
|
|
intermittent sway, slight difficulty |
1 |
|
|
constant sway but can sit for more than 10 seconds without support |
2 |
|
|
requires intermittent support to sit for > 10 seconds |
3 |
|
|
requires constant support to sit for > 10 seconds |
4 |
|
speech |
normal |
0 |
|
|
minimal disturbance |
1 |
|
|
impaired but easily understood |
2 |
|
|
occasional words are hard to understand |
3 |
|
|
many words are hard to understand |
4 |
|
|
few words can be understood |
5 |
|
|
unintelligible |
6 |
|
finger chase |
normal |
0 |
|
|
under or overshooting target < 5 cm |
1 |
|
|
under or overshooting target 5-15 cm |
2 |
|
|
under or overshooting target > 15 cm |
3 |
|
|
unable to perform 5 pointing movements |
4 |
|
nose-finger test |
no tremor |
0 |
|
|
tremor with amplitude < 2 cm |
1 |
|
|
tremor with amplitude 2-5 cm |
2 |
|
|
tremor with amplitude > 5 cm |
3 |
|
|
unable to perform 5 pointing movements |
4 |
|
fast-alternating hand movements |
normal |
0 |
|
|
slightly irregular |
1 |
|
|
irregular |
2 |
|
|
markedly irregular |
3 |
|
|
unable to complete 10 cycles |
4 |
|
heel-shin slide |
normal |
0 |
|
|
slightly abnormal |
1 |
|
|
abnormal |
2 |
|
|
markedly abnormal |
3 |
|
|
unable to perform |
4 |
where:
• Support for walking may be one or two walking sticks, support of one arm, use of a stroller or active lifting by a companion.
• An abnormal finger chase with under or overshooting is called dysmetria.
points for finger chase =
= ((points for left side) + (points for right side)) / 2
points for nose-finger test =
= ((points for left side) + (points for right side)) / 2
points for fast-alternating hand movements =
= ((points for left side) + (points for right side)) / 2
points for heel-shin slide test =
= ((points for left side) + (points for right side)) / 2
total score =
= SUM(points for gait, stance, sitting and speech) + SUM(points for finger chase, nose-finger, alternating hand and heel-shin slide)
Interpretation:
• minimum score: 0
• maximum score: 40
• The higher the score the more severe the ataxia
Specialty: Neurology
