Schwab & England ADL (SEADL)

Another well-known staging tool is that developed by Hoehn and Yahr, which has been used since the late 1960s.¹ The Hoehn & Yahr scale originally allocated the degree of impairment experienced by the patient to five stages (although these have since been expanded to include two more) ranging from ‘no symptoms’ to a wheelchair- or bed-bound state.^1,2

While the Hoehn & Yahr scale is particularly useful for comparing populations of patients with PD, it is relatively insensitive to changes in clinical state over time and so tends not to be used for monitoring the responses of individual patients to therapy.²

References:
1.Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology 1967; 17 (5): 427–442.

2.Jankovic J. Pathophysiology and assessment of parkinsonian symptoms and signs. In: Pahwa R, Lyons K, Koller WC (eds). Handbook of Parkinson’s Disease, 3rd edition. Boca Raton: CRC Press, 2003.

3.Goetz CG, Poewe W, Rascol O, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord 2004; 19 (9): 1020–1028.

4.Simuni T, Chahine LM, Poston K, et al. A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research. Lancet Neurol 2024; 23 (2): 178–190.