Modified Hoehn and Yahr Scale

Updated: Jan 13, 2023
  • Author: Ryan O Stephenson, DO; Chief Editor: Buck Christensen  more...
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Modified Hoehn and Yahr Scale

The Hoehn and Yahr scale is used to describe the symptom progression of Parkinson disease. [1, 2, 3] The scale originally was described in 1967 and included stages 1 through 5. [4] It has since been modified with the addition of stages 1.5 and 2.5 to account for the intermediate course of Parkinson disease. It was designed to be a descriptive staging scale to evaluate  both disability and impairment related to clinical disease progression.

The modified Hoehn and Yahr scale is as follows [5] :

  • Stage 0: No signs of disease
  • Stage 1.0: Symptoms are very mild; unilateral involvement only
  • Stage 1.5: Unilateral and axial involvement
  • Stage 2: Bilateral involvement without impairment of balance
  • Stage 2.5: Mild bilateral disease with recovery on pull test
  • Stage 3: Mild to moderate bilateral disease; some postural instability; physically independent
  • Stage 4: Severe disability; still able to walk or stand unassisted
  • Stage 5: Wheelchair bound or bedridden unless aided

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