Stages

In 1967, Hoehn & Yahr defined five stages of PD based on the level of clinical disability. The grading does justice to the motor symptoms but does not consider the non-motor symptoms of PD. This scale can be used for clinical purposes.

Patients mostly get diagnosed in Stage 1 or Stage 2

Stage 1:

Minimum symptoms are visible in this stage. The patients and family members start noticing some minor changes. But the patient is independent with minor difficulties.

  • Tremors on one side of the body.
  • Mild clumsiness.
  • Stiffness of posture and mask like face.
  • Slowed facial expression movement.

Stage 2:

  • Tremor, rigidity and other movement symptoms affect both sides of the body.
  • Walking, bathing and changing clothes take a longer time to complete.
  • The back muscles become stiff.

Stage 3:

  • Loss of balance and slowed movement.
  • Falls become more common.
  • Daily activities of living are hindered, but the patient is mostly still independent or needs mild supervision.

Stage 4:

  • Movement is limited.
  • Patients require assistive devices like walking cane or wheelchairs.
  • They need help with daily activities of living.

Stage 5:

  • Difficult or unable to stand.
  • Bed-ridden or requires a wheelchair to move about.
  • Difficulty Swallowing.
  • Continuous nursing care is required.