Ignacio Valdes Implementation Log/Episode23
Here are the custom template field definitions for this. I make the 0 option the default:
Field AIMS1 Combo Box 0 = None 1 = Minimal 2 = Mild 3 = Moderate 4 = Severe
Field AIMS2 Combo Box 0 = No Awareness 1 = Aware, no distress 2 = Aware, mild distress 3 = Aware, mod distress 4 = Aware, severe distr.
Field AIMS3 Combo Box 0 = No 1 = Yes
ABNORMAL INVOLUNTARY MOVEMENT SCALE (AIMS)
National Institute of Mental Health. (See Examination Procedure Below) Study: {FLD:63713 } Period: {FLD:63713 }
INSTRUCTIONS: Complete examination procedure before making ratings. MOVEMENT RATINGS: Rate highest severity observed. Rate movements that occur upon activation one less than those observed spontaneously. Circle movement as well as code number that applies. CODE:
0 = None 1 = Minimal, may be extreme normal 2 = Mild 3 = Moderate 4 - Severe
Facial and Oral Movements
1. Muscles of Facial Expression e.g. movements of {FLD:AIMS1}
forehead, eyebrows periorbital area, cheeks, including frowning blinking, smiling, grimacing.
2. Lips and Perioral Area e.g., puckering, pouting, {FLD:AIMS1}
smacking.
3. Jaw e.g. biting, clenching, chewing, mouth opening, {FLD:AIMS1}
lateral movement.
4. Tongue Rate only increases in movement both in and out {FLD:AIMS1}
of mouth. NOT inability to sustain movement.
Extremity Movements
5. Upper (arms, wrists,, hands, fingers) Include choreic {FLD:AIMS1}
movements (i.e., rapid, objectively purposeless, irregular, spontaneous) athetoid movements (i.e., slow, irregular, complex, serpentine). DO NOT INCLUDE TREMOR (i.e., repetitive, regular, rhythmic)
6. Lower (legs, knees, ankles, toes) e.g., lateral knee {FLD:AIMS1}
movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot.
Trunk Movements
7. Neck, shoulders, hips e.g., rocking, twisting, {FLD:AIMS1}
squirming, pelvic gyrations.
GLOBAL JUDGMENTS:
8. Severity of abnormal movements overall {FLD:AIMS1} 9. Incapacitation due to abnormal movements {FLD:AIMS1} 10. Patient's awareness of abnormal movements. Rate {FLD:AIMS2}
only patient's report
DENTAL STATUS:
11. Current problems with teeth and/or dentures. {FLD:AIMS3} 12. Are dentures usually worn? {FLD:AIMS3}
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EXAMINATION PROCEDURE Abnormal Involuntary Movement Scale (AIMS)
Either before or after completing the Examination Procedure, observe the patient unobtrusively, at rest (e.g. in waiting room). The chair to be used in this examination should be a hard, firm one without arms.
1. Ask patient to remove shoes and socks. 2. Ask patient whether there is anything in his/her mouth (i.e., gum, candy, etc.) And if there is, to remove it. 3. Ask patient about the current condition of his/her teeth. Ask patient if he/she wears dentures. Do teeth or dentures bother patient now? 4. Ask patient whether he/she notices any movements in mouth, face, hands, or feet. If yes, ask to describe and to what extent they currently bother patient or interfere with his/her activities. 5. Have patient sit in chair with both hands on knees, legs slightly apart, and fee flat on floor. (Look at entire body for movements while in this position.) 6. Ask patient to sit with hands hanging unsupported. If male, between legs, if female and wearing a dress, hanging over knees. (Observe hands and other body areas.) 7. Ask patient to open mouth. (Observe tongue at rest within mouth.) Do this twice. 8. Ask patient to protrude tongue. (Observe abnormalities of tongue movement.) Do this twice. 9. Ask patient to tap thumb with each finger as rapidly as possible for 10- 15 seconds; separately with right hand, then with left hand. (Observe facial and leg movements.) 10. Flex and extend patient=s left and right arms (one at a time). (Note any rigidity.) 11. Ask patient to stand up. (Observe in profile. Observe all body areas again, hips included.) 12. Ask patient to extend both arms outstretched in front with palms down. (Observe trunk, legs, and mouth.) 13. Have patient walk a few paces, turn, and walk back to chair. (Observe hands and gait.) Do this twice.
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