MDS-UPDRS Part II – Motor Experiences of Daily Living
Patient-reported motor experiences of daily living in Parkinson’s disease. 13 items, total 0 to 52.
By Claire White
- 13 items, numbered 2.1 to 2.13, completed by the person. The investigator may review them for completeness and clarity.
- Each item is scored 0 for normal, 1 slight, 2 mild, 3 moderate, and 4 severe. Part II runs from 0 to 52.
- Covers speech, saliva and drooling, chewing and swallowing, eating tasks, dressing, hygiene, handwriting, hobbies and other activities, turning in bed, tremor, getting out of bed or a car or a deep chair, walking and balance, and freezing.
- Published by the International Parkinson and Movement Disorder Society.
Psychometrics
Cronbach's alpha for the Part II total, from Goetz et al. (2008). Higher is better.
What does MDS-UPDRS Part II measure?
Part II measures what Parkinson’s motor symptoms do to ordinary life, reported by the person living it. Its 13 items cover speech, saliva and drooling, chewing and swallowing, eating tasks, dressing, hygiene, handwriting, hobbies and other activities, turning in bed, tremor, getting out of bed or a car or a deep chair, walking and balance, and freezing. Each asks about the past week rather than the moment of the visit.
The scale is licensed, so this page describes what Part II covers rather than reproducing its wording. The official form, with the exact question text and the rating anchors, comes from the International Parkinson and Movement Disorder Society at movementdisorders.org.
What does an MDS-UPDRS Part II score mean?
Higher means more difficulty in daily life. A 2015 study of 452 people with Parkinson’s proposed three bands for the Part II total.
| Part II total | Severity |
|---|---|
| 0 to 12 | Mild |
| 13 to 29 | Moderate |
| 30 and above | Severe |
The band is reference information for the care team, tracked over time. Because Part II asks about a week and Part III examines a moment, the two can disagree, and the disagreement is usually informative rather than an error. Someone who scores well in clinic on medication can still report real difficulty at 6am before the first dose, and Part II is where that shows up.
How MDS-UPDRS Part II is administered
- Administered by
- The person, as a self-administered questionnaire. The investigator may review it for completeness and clarity.
- Time to administer
- About 30 minutes for all four parts. No separate published figure for Part II.
- Recall period
- The past week
- Equipment
- Pen and paper
- Cost
- Free to take here.
- Published by
- International Parkinson and Movement Disorder Society
- Permission
- Required for each use, through the permission request form at movementdisorders.org
- Training required
- The Movement Disorder Society runs a certificate program for raters
- Age range
- Adults
- Available languages
- Official translations in more than 25 languages
Which conditions is MDS-UPDRS Part II used for?
Related instruments
- MDS-UPDRS Part IIIThe clinician's examination of the same motor signs Part II asks you about
- MDS-UPDRS Part IThe non-motor half of daily living, covering mood, sleep, and thinking
- Parkinson's Disease Questionnaire (PDQ-39)Quality of life rather than function, also reported by the person
- Barthel IndexBasic activities of daily living, scored the same way across neurological conditions
MDS-UPDRS Part II questions, answered
How is MDS-UPDRS Part II scored?
You rate each of the 13 items from 0 to 4, where 0 is normal, 1 slight, 2 mild, 3 moderate, and 4 severe, and the 13 scores are added. Part II runs from 0 to 52. It is not folded into a total with the other three parts. A score of 2 on an item is the point at which a symptom is judged to affect function.
Who completes MDS-UPDRS Part II?
You do. Part II is a self-administered questionnaire, which the investigator may then review for completeness and clarity rather than re-rate. That makes it the part most easily filled in at home before a clinic visit.
What period does MDS-UPDRS Part II ask about?
The past week. It asks about your usual experience over those seven days rather than how you feel in the room, which is the main reason it can disagree with the examination done on the day.
What is the difference between MDS-UPDRS Part II and Part III?
Who reports and what is measured. Part II is your account of how motor symptoms affect ordinary tasks over the past week. Part III is the clinician's examination of motor signs at one moment, and it depends on medication state. They cover the same symptoms from two directions and are read together, not swapped for one another.
How long does MDS-UPDRS Part II take?
The Movement Disorder Society and the reference databases publish a time for the full four-part scale, about 30 minutes, rather than a figure for Part II on its own. It is 13 questions on paper.
Is MDS-UPDRS Part II free?
Yes. It is free to take here. The scale itself is published by the International Parkinson and Movement Disorder Society, which is who to approach about administering it in your own practice.
Evidence, psychometrics and provenance
Part II is one of the four parts of the MDS-UPDRS, published in 2008 by Goetz and colleagues for the International Parkinson and Movement Disorder Society. It replaced the original UPDRS activities of daily living section, keeping the same territory but putting every item on one 0 to 4 rating and asking the person rather than the examiner.
- Test-retest reliability
- ICC above 0.85 for each part's total (Martinez-Martin et al., 2013)
- Factor structure
- Comparative fit index above 0.90 for Part II (Goetz et al., 2008)
- Threshold for functional impact
- An item score of 2 is the point at which symptoms modestly affect function (Hauser et al., 2021)
References
- 1.Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23(15):2129-2170.
- 2.Martinez-Martin P, Rodriguez-Blazquez C, Alvarez-Sanchez M, et al. Expanded and independent validation of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). J Neurol. 2013;260(1):228-236.
- 3.Martinez-Martin P, Rodriguez-Blazquez C, Alvarez M, et al. Parkinson's disease severity levels and MDS-Unified Parkinson's Disease Rating Scale. Parkinsonism Relat Disord. 2015;21(1):50-54.
- 4.Hauser RA, Mehta SH, Kremens D, Chernick D, Formella AE. Effects of Gocovri (amantadine) extended-release capsules on motor aspects of experiences of daily living in people with Parkinson's disease and dyskinesia. Neurol Ther. 2021;10(2):739-751. (Source for the 13 Part II domains and the item-level rating anchors.)
- 5.Zou H, Goetz CG, Stebbins GT, Mestre TA, Luo S. Increasing sensitivity in patient-reported MDS-UPDRS items for predicting medication initiation in early PD. Mov Disord Clin Pract. 2025;12(2):148-156. (Source for the Part II item range and score range.)
- 6.International Parkinson and Movement Disorder Society. MDS-UPDRS: rating scale, permission request form, translations, and rater certificate program. movementdisorders.org.
- 7.Shirley Ryan AbilityLab. Rehabilitation Measures Database: MDS-UPDRS. Administration, cost, and per-part internal consistency, citing Goetz et al. (2008).
This assessment uses a validated instrument and is reference information, not a diagnosis. The MDS-UPDRS is copyright the International Parkinson and Movement Disorder Society. This page describes the scale and does not reproduce it. Permission for each use is requested at movementdisorders.org.