OBJECTIVE RATINGS: (ratings by observer) | | | | |
I. Sitting | | | | |
1. Semipurposeful/purposeless leg/feet movement | 0 | 1 | 2 | 3 |
2. Semipurposeful hand/arm movements | 0 | 1 | 2 | 3 |
3. Shifting body position in chair | 0 | 1 | 2 | 3 |
4. Inability to remain seated | 0 | 1 | 2 | 3 |
II. Standing | | | | |
1. Purposeless/semipurposeless leg/feetmovements | 0 | 1 | 2 | 3 |
2. Shifting weight from foot-to-foot and/orwalking on spot | 0 | 1 | 2 | 3 |
3. Inability to remain standing on one spot(walking or pacing) | 0 | 1 | 2 | 3 |
Sum Score | | | | |
SUBJECTIVE RATINGS: (three questions were asked) | | | | |
1. Do you feel restless, or urge to move, especiallyin the legs? | 0 | 1 | 2 | 3 |
2. Are you unable to keep your legs still? | 0 | 1 | 2 | 3 |
3. Are you unable to remain still, standing orsitting? | 0 | 1 | 2 | 3 |
Key: 0–3: absent, mild, moderate, severe | | | | |
0—absent | | | | |
1—mild and present some of time | | | | |
2—mild and present most of the time or severe and present some of the time | | | | |
3—severe and present all the time | | | | |
Sum Score | | | | |
Total Score | | | | |