ratings.^ 8. Ask client to protrude tongue. (Observe abnormalities of Scoring Procedure 9. Ask client to tap thumb with each fi 13. Have client walk a few paces, turn, and walk back to chair. 12. Ask client to extend both arms outstretched in front with Facial and Oral Movements^ 10. Flex and extend client’s left and right arms (one at a time). Rate highest severity observed. 11. Ask client to stand up. (Observe in profiInstructions: Complete examination procedure before making 1. Muscles of Facial Expression (e.g., movement of forehead, Code: 0 Noneareas again, hips included.)with left hand. (Observe facial and leg movements.)sible for 10 to 15 seconds; separately with right hand, then palms down. (Observe trunk, legs, and mouth.)(Observe hands and gait.) Do this twice. tongue movement.) Do this twice.(Note any rigidity.)eyebrows, periorbital area, cheeks; include frowning, 2 Mild 3 Moderate 4 Severe 1 Minimal, may be extreme normal nger as rapidly as pos- le. Observe all body APPENDIX R ●^629
2 2506_Appendix_R_628-630.indd 629 506 _AppendixR 628 - 630 Extremity Movements.indd 4. Tongue (Rate only increase in movement both in and out 2. Lips and Perioral Area (e.g., puckering, pouting, smacking) 3. Jaws (e.g., biting, clenching, chewing, mouth opening, lat- 5. Upper (arms, wrists, hands, fi 62 of mouth, NOT inability to sustain movement.)movements (i.e., rapid, objectively purposeless, irregular, spontaneous), athetoid movements (i.e., slow, irregular, complex, serpentine). Do NOT include tremor (i.e., re-petitive, regular, rhythmic).eral movement)blinking, smiling, grimacing) 9 0 1 2 3 4 0 1 2 3 4 0 1 2 3 4 0 1 2 3 4 0 1 2 3 4 ngers). Include choreic 1 10/1/10 9:32:34 AM 0 / 1 / 10 9 : 32 : 34 AM