Abnormal Involuntary Movement Scale Form PDF Details

The Abnormal Involuntary Movement Scale Form (AIMS) is a rating scale used to measure the severity of involuntary movements. The AIMS can be helpful in diagnosing and managing movement disorders. The form is typically filled out by a doctor or other healthcare professional. Scores on the AIMS range from 0 to 4, with higher scores indicating more severe symptoms. The form is divided into four sections: facial grimacing, body rocking, limb chorea, and tongue protrusion. Each section includes five questions that should be answered separately for each side of the body (left and right). Scoring is based on the severity of symptoms present, not on how often they occur. Symptoms are rated from 0 (none) to 4 (

QuestionAnswer
Form NameAbnormal Involuntary Movement Scale Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesaims test pdf, abnormal involuntary movement scale aims pdf, aims pdf, scale aims pdf

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ABNORMAL INVOLUNTARY MOVEMENT SCALE (AIMS)

 

 

 

 

 

 

 

 

 

 

Public Health Service

 

NAME:__________________________________________

 

Alcohol, Drug Abuse, and Mental Health Administration

DATE: _____________________________

 

 

 

 

 

 

National Institute of Mental Health

 

Prescribing Practitioner: ___________________________

 

 

 

 

 

 

 

CODE:

0 = None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 = Minimal, may be extreme normal

 

 

INSTRUCTIONS:

 

 

 

 

 

 

 

 

2 = Mild

 

 

 

 

 

 

 

 

 

 

 

 

Complete Examination Procedure (attachment d.)

 

 

 

 

 

 

3 = Moderate

 

 

 

 

 

 

 

 

 

 

before making ratings

 

 

 

 

 

 

 

4 - Severe

 

 

 

 

 

 

 

 

 

 

 

 

MOVEMENT RATINGS: Rate highest severity observed. Rate

RATER

 

 

RATER

 

RATER

 

RATER

 

movements that occur upon activation one less than those observed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

spontaneously. Circle movement as well as code number that

 

Date

 

 

 

 

Date

 

 

 

Date

 

 

 

Date

 

 

 

applies.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Facial and

1.

Muscles of Facial Expression

 

0 1 2 3 4

 

0 1 2 3 4

0 1 2 3 4

0 1 2 3 4

Oral

 

e.g. movements of forehead, eyebrows

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Movements

 

periorbital area, cheeks, including frowning

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

blinking, smiling, grimacing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Lips and Perioral Area

 

 

0 1 2 3 4

 

0 1 2 3 4

0 1 2 3 4

0 1 2 3

4

 

 

e.g., puckering, pouting, smacking

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Jaw e.g. biting, clenching, chewing, mouth

0

1

2

3

4

 

0

1

2

3

4

0

1

2

3

4

0

1

2

3

4

 

 

opening, lateral movement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Tongue Rate only increases in movement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

both in and out of mouth. NOT inability to

0 1 2 3 4

 

0 1 2 3 4

0 1 2 3

4

O 1 2 3 4

 

 

sustain movement. Darting in and out of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

mouth.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Upper (arms, wrists,, hands, fingers)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Include choreic movements (i.e., rapid,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Extremity

 

objectively purposeless, irregular,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Movements

 

spontaneous) athetoid movements (i.e., slow,

0

1

2

3

4

 

0

1

2

3

4

0

1

2

3

4

0

1

2

3

4

 

 

irregular, complex, serpentine). DO NOT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCLUDE TREMOR (i.e., repetitive,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

regular, rhythmic)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Lower (legs, knees, ankles, toes)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e.g., lateral knee movement, foot tapping,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

heel dropping, foot squirming, inversion and

0

1

2

3

4

 

0

1

2

3

4

0

1

2

3

4

0

1

2

3

4

 

 

eversion of foot.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trunk

7.

Neck, shoulders, hips e.g., rocking,

 

0

1 2

3 4

 

0

1 2

3 4

0

1 2

3 4

0

1 2

3 4

Movements

 

twisting, squirming, pelvic gyrations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Severity of abnormal movements overall

0 1 2 3 4

 

0 1 2 3 4

0 1 2 3 4

0 1 2 3 4

Global

9.

Incapacitation due to abnormal

 

0 1 2 3 4

 

0 1 2 3 4

0 1 2 3 4

0 1 2 3 4

Judgments

 

movements

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

Patient’s awareness of abnormal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

movements. Rate only patient’s report

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No awareness

0

 

0

 

 

 

 

 

0

 

 

 

 

0

 

 

 

 

0

 

 

 

 

 

 

Aware, no distress

1

 

 

1

 

 

 

 

 

1

 

 

 

 

1

 

 

 

 

1

 

 

 

 

 

Aware, mild distress

2

 

 

 

2

 

 

 

 

 

2

 

 

 

 

 

2

 

 

 

2

 

 

 

 

Aware, moderate distress

3

 

 

 

 

3

 

 

 

 

 

3

 

 

 

 

 

3

 

 

 

3

 

 

 

Aware, severe distress

4

 

 

 

 

 

4

 

 

 

 

 

4

 

 

 

 

4

 

 

 

 

4

 

11.

Current problems with teeth and/or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dental Status

 

dentures

 

 

No

 

Yes

 

No

 

Yes

No

 

Yes

No

 

Yes

 

 

 

 

 

No

 

Yes

 

No

 

Yes

No

 

Yes

No

 

Yes

 

12.

Are dentures usually worn?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

Yes

 

No

 

Yes

No

 

Yes

No

 

Yes

 

13.

Edentia?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

Yes

 

No

 

Yes

No

 

Yes

No

 

Yes

 

14.

Do movements disappear in sleep?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Final: 9/2000

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