German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Department of Neurology, University Hospital Bonn, Bonn, Germany.
Mov Disord. 2021 May;36(5):1242-1246. doi: 10.1002/mds.28478. Epub 2021 Jan 12.
Clinical scales such as the Scale for the Assessment and Rating of Ataxia (SARA) cannot be used to study ataxia at home or to assess daily fluctuations. The objective of the current study was to develop a video-based instrument, SARA , for measuring ataxia severity easily and independently at home.
Based on feasibility of self-application, we selected 5 SARA items (gait, stance, speech, nose-finger test, fast alternating hand movements) for SARA (range, 0-28). We compared SARA items with total SARA scores in 526 patients with spinocerebellar ataxia types 1, 2, 3, and 6 from the EUROSCA natural history study. To prospectively validate the SARA , we directly compared the self-applied SARA and the conventional SARA in 50 ataxia patients. To demonstrate feasibility of independent home recordings in a pilot study, 12 ataxia patients were instructed to obtain a video each morning and evening over a period of 14 days. All videos were rated offline by a trained rater.
SARA extracted from the EUROSCA baseline data was highly correlated with conventional SARA (r = 0.9854, P < 0.0001). In the prospective validation study, the SARA was highly correlated with the conventional SARA (r = 0.9254, P < 0.0001). Five of 12 participants of the pilot study obtained a complete set of 28 evaluable videos. Seven participants obtained 13-27 videos. The intraindividual differences between the lowest and highest SARA scores ranged from 1 to 5.5.
The SARA and the conventional SARA are highly correlated. Application at home is feasible. There was a considerable degree of intraindividual variability of the SARA scores. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
临床量表，如共济失调评定量表（SARA），不能用于在家中研究共济失调或评估日常波动。本研究的目的是开发一种基于视频的仪器 SARA，以便在家中轻松、独立地测量共济失调的严重程度。
基于自我应用的可行性，我们选择了 SARA 的 5 个项目（步态、站位、言语、指鼻试验、快速交替手运动），范围为 0-28 分。我们将 SARA 项目与 EUROSCA 自然史研究中 526 例脊髓小脑性共济失调 1、2、3 和 6 型患者的总 SARA 评分进行了比较。为了前瞻性验证 SARA，我们直接比较了 50 例共济失调患者的自我应用 SARA 和常规 SARA。在一项试点研究中，为了证明在家中独立记录的可行性，我们指导 12 例共济失调患者在 14 天内每天早晚各获得一段视频。所有视频均由一名经过培训的评分员离线评分。
从 EUROSCA 基线数据中提取的 SARA 与常规 SARA 高度相关（r=0.9854，P<0.0001）。在前瞻性验证研究中，SARA 与常规 SARA 高度相关（r=0.9254，P<0.0001）。试点研究的 12 名参与者中，有 5 名获得了完整的 28 个可评估视频。有 7 名参与者获得了 13-27 个视频。最低和最高 SARA 评分之间的个体内差异范围为 1 至 5.5。
SARA 与常规 SARA 高度相关。在家中应用是可行的。SARA 评分的个体内差异较大。© 2021 作者。运动障碍由 Wiley Periodicals LLC 代表国际帕金森病和运动障碍协会出版。
