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A New Assessment Tool for Ataxia Syndromes: The "STAND" (Scale To Assess Ataxia and Neurologic Dysfunction)
American Academy of Neurology Annual Meeting (AAN) (2013)
  • Theresa A. Zesiewicz, University of South Florida
  • Jessica D. Shaw, University of South Florida
  • Israt Jahan, University of South Florida
  • Kelly L. Sullivan, University of South Florida
  • Kevin G. Allison, University of South Florida
  • Joseph F. Staffetti, University of South Florida
  • Patricia E. Greenstein, Phillips Beth Israel School of Nursing
  • Clifton Gooch, University of South Florida
  • Tuan Vu, University of South Florida
Objective: To evaluate a new ataxia rating scale, the STAND (Scale To assess Ataxia and Neurologic Dysfunction).

Background: Neurodegenerative ataxias, such as spinocerebellar ataxia (SCA) may include non-ataxic symptoms. There is a need for an assessment tool to better evaluate non-ataxic symptoms in patients suffering from neurodegenertive ataxias. The Scale for the Assessment and Rating of Ataxia (SARA) is a valid scale, but does not assess these symptoms. The “INAS” (Inventory of Non-Ataxia Symptoms) “counts” nonataxia symptoms, but does not rate them. We conducted a pilot evaluation of a new assessment tool called the “STAND” to better evaluate non-ataxic and ataxic symptoms.

Design/Methods: The STAND is a semi-quantitative 109 point scale that tests gait, balance, speech, coordination, tone, peripheral motor, and sensory function. Two movement disorders neurologists administered the SARA and the STAND during one visit and a neuromuscular expert performed nerve conduction studies (NCS) in SCA and Friedreich's ataxia patients. Interrater reliability was examined using intraclass correlation coefficients (ICC). Correlation between STAND and SARA totals and sub-scores were tested using Spearman's correlation test. Internal consistency was assessed by Cronbach's α.

Results: Thirty-seven ataxic patients participated in the study to evaluate the scale, and 25 patients received NCS. The scale showed good internal consistency (Cronbach's α=88). Ataxia components of the STAND were strongly correlated with the SARA (r for total ataxia score = 0.88). Interrater reliability for the overall scale was excellent (ICC=0.97) and was similar for sub-scales (gait and balance ICC=0.99; speech ICC=0.84; limb coordination ICC=0.91; tone ICC=0.76; peripheral motor system ICC=0.78; peripheral sensory ICC=0.87). Peripheral sensory scores correlated with the presence and degree of abnormalities noted by NCS (r=0.75).

Conclusions: The STAND's quantification of non-ataxic neurologic symptoms should provide greater diagnostic and prognostic utility than scales that assess ataxic symptoms alone.
  • New assessment tool,
  • Ataxia syndromes,
  • STAND,
  • Scale To Assess Ataxia and Neurologic Dysfunction
Publication Date
April 17, 2013
San Diego, CA
Citation Information
Theresa A. Zesiewicz, Jessica D. Shaw, Israt Jahan, Kelly L. Sullivan, et al.. "A New Assessment Tool for Ataxia Syndromes: The "STAND" (Scale To Assess Ataxia and Neurologic Dysfunction)" American Academy of Neurology Annual Meeting (AAN) (2013)
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