Task force report: scales for screening and evaluating tremor: critique and recommendations

Area of Science:

• Neurology
• Clinical Assessment
• Movement Disorders

Background:

• Tremor assessment relies on various rating scales and screening instruments.
• Standardized and validated tools are crucial for accurate diagnosis and treatment monitoring.
• Previous reviews have not comprehensively evaluated available tremor assessment scales.

Purpose of the Study:

• To systematically review and classify existing rating scales and screening instruments for tremor assessment.
• To identify recommended scales based on predefined criteria including availability, use, reliability, validity, and sensitivity to change.
• To guide future research and clinical practice in tremor assessment.

Main Methods:

• A systematic literature search of PubMed.gov was conducted to identify relevant scales.
• Seven tremor severity scales, six ADL/disability scales, four quality-of-life scales, and five screening instruments were identified.
• Scales were evaluated for availability, use, acceptability, reliability, validity, and sensitivity to change, and classified as recommended, suggested, or listed.

Main Results:

• Five tremor severity scales, one ADL/disability scale, one quality-of-life scale, and one screening instrument met the criteria for recommendation.
• Specific recommended scales include the Fahn-Tolosa-Marin Tremor Rating Scale and the Quality of Life in Essential Tremor Questionnaire.
• All reviewed scales require further comprehensive analysis, particularly regarding sensitivity to change.

Conclusions:

• Several validated scales are recommended for tremor assessment, but none are perfect.
• Further research should focus on refining existing recommended scales rather than developing new ones.
• Improved sensitivity to change analysis is needed to optimize scale utility in clinical trials and patient care.