Urdu Version of the Unified PARKINSON Disease Rating Scale
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Observational

Summary: 
      The Unified Parkinson's Disease Rating Scale version 3.0 (UPDRS), published in 1987, was
      developed to provide a comprehensive instrument for the evaluation of impairment and
      disability related to PD. The primary objectives of this research were to translate, validate
      and generate data on the UPDRS for using among Urdu speaking residents of Pakistan. UPDRS
      questionnaire will be first translated into Urdu and then apply on Parkinson's Disease
      patients to check the validity and reliability of this scale . Instrument will be first
      translated from English to Urdu by two experts. Both these experts were fluent in English and
      Urdu language.

      One expert belongs to allied health care profession and other expert will be junior life
      scientist. The third expert compares the initial to Urdu translation and formulated the first
      draft of UPDRS. Content validity of UPDRS Questionnaire was established by committee method.
      10 experts from physical therapy field rate the all items of the UPDRS on content validity
      index . They rate each item of UPDRS Questionnaire for its relevance, clarity, simplicity,
      and ambiguity on four point ordinal likert scale. Data will be analyzed using SPSS v 25.
      Intra class correlation coefficient, chronbach alpha and factor analysis will be used to
      analyses the data.
    

Detailed description: 
      Parkinson's disease (PD) is a complex disorder with a combination of characteristic motor
      signs and non-motor symptoms. The natural course of PD is modified by the effect of
      treatments, and over time, these treatments can also be associated with both motor and
      non-motor complications. At present, there is no biomarker or other gold standard index to
      determine the severity of PD as a whole. Therefore, measurement of the different aspects of
      PD and their severities relies on clinically based rating scales.

      The Unified Parkinson's Disease Rating Scale version 3.0 (UPDRS), published in 1987, was
      developed to provide a comprehensive instrument for the evaluation of impairment and
      disability related to PD. Further, the scale attempted to utilize the most clinically
      relevant aspects of several earlier scales that were already familiar to clinicians and
      researchers, though poorly validated clinimetrically. The development of this "unified" scale
      was aimed to provide a single scale so that outcomes among different clinical trials could be
      directly compared. For two decades, the UPDRS was the most used scale for assessment of PD
      patients and became the reference scale for development of other measures and for the United
      States and European regulatory agencies.

      In 2002, the Movement Disorder Society sponsored Task Force for Rating Scales in PD carried
      out a review and critique of the UPDRS. Several weaknesses, including ambiguities in wording,
      the absence of uniform instructions for raters, some metric flaws, and the lack of
      assessments for many important non-motor symptoms were evident. Therefore, a modified UPDRS,
      named the Movement Disorder Society-UPDRS (MDS-UPDRS), was proposed to overcome the
      identified shortcomings. In 2008, the official MDS-UPDRS English version was published along
      with satisfactory clinimetric results on its performance in a series of over 800 native
      English-speaking patients and raters. As a result, the MDS-UPDRS has been proposed as the
      official benchmark scale for PD.

      Given the content and structure of the MDS-UPDRS, with inclusion of symptoms impossible to
      assess objectively (e.g., fatigue, pain, dizziness), a questionnaire for self-evaluation, and
      a wide body of instructions for raters, the scale has to be cross-culturally adapted and
      validated. A detailed plan for obtaining equivalent and locally validated non-English
      versions of the MDS-UPDRS was established by the Steering Committee of the Movement Disorder
      Society Task Force and Spanish, Italian and Estonian official versions are now available.
    

Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Subjects were at least 50 years of age and were at Hoehn and Yahr stage 3.0 or less. The
        diagnosis of PD was made by a movement disorders specialist based on the presence of at
        least two of the three cardinal signs of PD (resting tremor, rigidity, or bradykinesia)
        without a known or suspected alternative cause of parkinsonism.
      
Keywords: Parkinson's disease; Validity; Reliability; UPDRS