Arm Dystonia Disability Scale
Objective[edit | edit source]
Fahn[1] created the Arm Dystonia Disability Scale (ADDS) to be more sensitive to focal dystonia of the arm. It extends the Fugl-Meyer Assessment (FMA) scale with ordinal grading of motor function difficulties in performing seven specific tasks using the arm, one of which is playing a musical instrument.
Intended Population[edit | edit source]
People with a genetic predisposition who experience repetitive stress in the form of frequent complex motor tasks and people diagnosed with arm dystonia.
Method of Use[edit | edit source]
The Arm Dystonia Impairment Scale (ADDS) is intended to assess disability on a scale of 0 to 100%, with 100% representing no disability. It is computed as follows:
If functional activities are restricted, the next section is completed. Score the difficulty of executing each action in the list below as follows:
0 - None (or not applicable, i.e. patient does not perform the activity)
1 - Mild
2 - Moderate
3 - Marked
Activities[edit | edit source]
The subject is made to perform the following tasks and is scored on a scale of 0-3 as listed above.
- Writing
- Playing a musical instrument
- Buttoning
- Handling utensils and feeding
- Hygiene (e.g. shaving, brushing teeth)
- Grasping objects
- Housework or outside job
Result[edit | edit source]
The final score is reduced by this amount proportional to the maximum possible, i.e.:
Final score = N % - [N% x (total score / 21)]
Variations[edit | edit source]
Variations in text[edit | edit source]
For three of the seven activities, Walter et al[2]. utilise somewhat different wordings:
"eating" (instead of "handling utensils and feeding") "shaving/teeth brushing" (rather than "hygiene (for example, shaving, cleaning teeth)" ”gardening” (instead of "housework or outside job")
Variation in Score Conventions[edit | edit source]
In some uses of the ADDS[3][4][5][6][7][8][2], the scores are given not in the canonical 0-100% ability range, but in a 0-3 range.
Variation in Scale Nomenclature[edit | edit source]
In some studies that appear to use the ADDS, the scale is not referred to as such, but rather as one of the following:
- "Fahn Arm Dystonia Scale" is referred to as Stinear 2004 EBR[10]
- "Fahn dystonia disability scale" is referred to as Garraux 2004 Ann Neurol[11]
- "Fahn dystonia scale" is referred to as Zeuner 2005 Mov Dis[12]
- "severity from Fahn" is referred to as Lim 2003 Mov Dis[13]
- “severity scale” is referred to as Wu 2010 JNNP[14]
- “Global Disability Score” is referred to as Schmidt 2006 Neurol[7]
References[edit | edit source]
- ↑ Fahn S. Assessment of the primary dystonias. In: Munsat TL, ed. Quantification of neurologic deficit: Butterworths, 1989: 241-270
- ↑ 2.0 2.1 Walter U, Buttkus F, Benecke R, Grossmann A, Dressler D, Altenmüller E. Sonographic alteration of lenticular nucleus in focal task-specific dystonia of musicians. Neurodegenerative diseases 2012;9:99-103.
- ↑ Lie-Nemeth TJ. Focal dystonia in musicians. Phys Med Rehabil Clin N Am 2006;17:781-787
- ↑ Jabusch HC, Vauth H, Altenmüller E. Quantification of focal dystonia in pianists using scale analysis. Mov Disord 2004;19:171-180.
- ↑ Sakai N. Slow down exercise for the treatment of focal hand dystonia in pianists. Med Probl Perform Artist 2006;21:25-28.
- ↑ Buttkus F, Weidenmüller M, Schneider S, et al. Failure of cathodal direct current stimulation to improve fine motor control in musician's dystonia. Mov Disord 2010;25:389-393.
- ↑ 7.0 7.1 Schmidt A, Jabusch HC, Altenmüller E, et al. Dominantly transmitted focal dystonia in families of patients with musician's cramp. Neurology 2006;67:691-693.
- ↑ Berque P, Gray H, Harkness C, McFadyen A. A combination of constraint-induced therapy and motor control retraining in the treatment of focal hand dystonia in musicians. Med Probl Perform Artist 2010;25:149-161
- ↑ A graph depicting a variation on the score convention suggested by Fahn
- ↑ Stinear CM, Byblow WD. Impaired inhibition of a pre-planned response in focal hand dystonia. Exp Brain Res 2004;158:207-212.
- ↑ Garraux G, Bauer A, Hanakawa T, Wu T, Kansaku K, Hallett M. Changes in brain anatomy in focal hand dystonia. Ann Neurol 2004;55:736-739.
- ↑ Zeuner KE, Shill HA, Sohn YH, et al. Motor training as treatment in focal hand dystonia. Mov Disord 2005;20:335-341.
- ↑ Lim VK, Bradshaw JL, Nicholls MER, Altenmüller E. Perceptual differences in sequential stimuli across patients with musician's and writer's cramp. Mov Disord 2003;18:1286-1293.
- ↑ Wu CC, Fairhall SL, McNair NA, et al. Impaired sensorimotor integration in focal hand dystonia patients in the absence of symptoms. J Neurol Neurosurg Psychiatry 2010;81:659-665