The average Spearman correlation was 0.87, indicating very good consistency between the two videotapes, but correlations for Part A were somewhat better than for Part B. Interrater reliabilities were greater for Part A items (magnitude of tremor in different body parts) than for Part B items (tremor in writing and drawings) of the TRS. In the interrater reliability evaluation, modified Kappa statistics for seven tremor type composites ranged from 0.10 to 0.65 in the first videotape and 0.17 to 0.62 in the second videotape. Once the raters returned the videotape and completed the score sheet, they were mailed a second tape with the same recordings presented in a different order. Videotape recordings of 17 subjects with ET evaluated with the TRS were produced and sent to 59 raters. Proper treatment of ET is contingent upon correct assessment of the severity, loss of function, and disability related to tremor. The purpose of this study was to evaluate interrater and intrarater reliability of the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) in essential tremor (ET). Unable to do most dressing unless uses strategy such as using Velcro, buttoning shirt before putting it on or avoiding shoes with laces. Able to do everything but has difficulty due to tremor. Tremor is present but does not interfere with dressing. Cannot complete hygiene activities independently. Unable to do most fine tasks such as putting on lipstick or shaving unless changes strategy such as using two hands or using the less affected hand. Tremor is present but does not interfere with hygiene. Cannot drink from a glass or uses straw or sippy cup. Spills a lot or changes strategy to complete task such as using two hands or leaning over. Tremor is present but does not interfere with drinking from a glass. Tremor is present but does not interfere with feeding with a spoon. Feeding with a spoon 0 = Normal 1 = Slightly abnormal. 1 = Slight voice tremulousness, only when "nervous". Rate tremor's impact on activities of daily living (0-4 scoring).
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