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SIMPSON-ANGUS SCALE (SAS)
SIMPSON-ANGUS SCALE
(SAS)
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SIMPSON-ANGUS SCALE (SAS)
1. GAIT:
The patient is examined as he walks into the examining room, his gait, the swing of his arms, his general posture, all
form the basis for an overall score for this item. This i s rated as follows:
0 = Normal
1 = Diminution in swing while the patient is walking
2 = Marked diminution in swing with obvious rigidity in the arm
3 = Stiff gait with arms held rigidly before the abdomen
4 = Stopped shuffling gait with propulsion and retropulsion
2. ARM DROPPING:
The patient and the examiner both raise their arms to shoulder height and let them fall to their sides.
In a normal subject, a stout slap is heard as the arms hit the sides. In the patient with extreme
Parkinsons syndrome, the arms fall very slowly:
0 = Normal, free fall with loud slap and rebound
1 = Fall slowed slightly with less audible contact and little rebound
2 = Fall slowed, no rebound
3 = Marked slowing, no slap at all
4 = Arms fall as though against resistance; as though through glue
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SIMPSON-ANGUS SCALE (SAS)
3. SHOULDER SHAKING:
The subjects arms are bent at a right angle at the elbow and are taken one at a time by the examiner
who grasps one hand and also clasps the other around the patients elbow. The subjects upper arm is
pushed to and fro and the humerus is externally rotated. The degree of resistance from normal to
extreme rigidity is scored as follows.
0 = Normal
1 = Slight stiffness and resistance
2 = Moderate stiffness and resistance
3 = Marked rigidity with difficulty in passive movement
4 = Extreme stiffness and rigidity with almost a frozen shoulder
4. ELBOW RIGIDITY:
The elbow joints are separately bent at right angles and passively
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