Hoehm and Yahr described stages of increasing disability in patients with Parkinson's Disease. The authors are from Columbia University and Columbia-Presbyterian Medical Center.
Patient selection: Parkinson's disease
Parameters:
(1) clinical features
(2) disability
Clinical Features
Disability
Stage
unilateral involvement only
none or minimal
I
bilateral or midline involvement; no balance impairment
minimal to mild
II
signs of impaired righting reflexes
mild to moderate; restricted activities but able to live independent life
III
incapacitated but still able to walk and stand unassisted; unable to leave homes unaided
severe
IV
confined to bed or wheelchair
severe, largely dependent
V
where:
• Signs of impaired righting reflexes: unsteadiness when turning; impaired response when pushed from standing equilibrium with feed together and eyes closed.
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