CHAPTER 9: SELF-ASSESSMENT PARKINSON’S DISEASE DISABILITY SCALE (SPDDS)

Description

The Self-Assessment Parkinson’s Disease Disability Scale (SPDDS) by Brown, MacCarthy, Jahanashi, and Marsden (1989) is a Parkinson’s disease (PD) specific questionnaire that consists of 24 items that address individual performance of activities of daily living (ADLs) and is administered either by proxy or as a self-assessment. During administration the individual is asked to quantify to what extent he or she is able to perform outlined ADLs without help and includes such items as inserting and removing an electric plug, pouring milk from a bottle or carton, getting up out of an armchair, getting out of bed, getting dressed, and picking up an object from the floor (Biemans, Dekker, & van der Woude, 2001). The assessment contains 24 items and uses a 5-point Likert scale (1 to 5) for each item outlined as follows: (1) able to do alone and without difficulty, (2) able to alone with a little effort, (3) able to do alone with a lot of effort or a little help, (4) able to do but only with a lot of help, or (5) unable to do at all (Stallibrass, Sissons, & Chalmers, 2002). Scores range from 24 to 120 with higher scores indicative of more severe impairment. The assessment can be completed in less than 10 minutes.

Psychometrics

To establish the validity of the SPDDS, 330 subjects with PD living at home were first asked to complete a self-assessment followed by one that was rater-administered among a subgroup of 30 subjects. Overall, results showed that the SPDDS had high internal consistency with a Cronbach’s alpha coefficient of α = 0.97 as well as excellent reliability (r = 0.97) suggesting good uni-dimensional hierarchy (Biemans et al., 2001). An examination of individual scores found that people had the least problems with washing and brushing their teeth while turning in bed, traveling by public transport, and writing letters were the most difficult (Biemans et al., 2001). Subgroup scores showed the relationship between self-report and skilled observation across 11 selected items was only moderately correlated at r = 0.66 with a range of 0.52 (using a telephone) to 0.82 (making cup of tea of coffee) implying only moderate to high associations (Biemans et al., 2001). A study by Stallibrass et al. (2002) of 93 persons with clinically confirmed idiopathic PD showed that pre- and post-intervention scores were statistically different at 33.3 (SD = 8.7) and 31.0 (SD = 7.9), respectively, thus indicating the assessments discriminant validity.

Advantages

The SPDDS is a relatively quick and simple outcome measure to administer and can be completed in less than 10 minutes either by proxy or as a self-report. No special training is needed and it can be a good tool to measure the effects of rehabilitative interventions over time. The assessment is also unique in that it is a PD ADLs specific.

Disadvantages

There is a limited amount of research in support of the SPDDS for use in clinical practice and access to the full standardized assessment may not be readily available.

Administration

During assessment the rater is asked to consider their own or the subject’s ability to engage in 24 common ADL and IADL tasks and then to rate that performance using the provided scale relative to the amount of independence or level of difficulty for successful performance.

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