Spasmodic Torticollis
Rating Scale (TWSTRS)
11
Toronto Western
Spasmodic
Torticollis
Rating Scale
(TWSTRS)11
PRESENTED BY WE MOVE | 2002
Presented by we move
phone: 800-437-mov2 (6682)
e-mail: wemove@wemove.org
WE MOVE 2002
1. Consky ES, Lang AE. Clinical assessments of patients with cervical dystonia. In: Jankovic J, Hallett M, eds. Therapy with Botulinum Toxin. New York, NY: Marcel Dekker, Inc.:1994;211-237.
Patient
Chart No.
Date
|
month
|
day
Time
am pm
year
WE MOVE 2002
Rate maximum amplitude of excursion asking patient not to oppose the abnormal movement; examiner may use
distracting or aggavating maneuvers. When degree of deviation is between scores, choose the higher of the two.
1. Rotation
2. Laterocollis
3. Anterocollis or Retrocollis
a. Anterocollis
b. Retrocollis
0
0
1
1
2
2
3
3
4. Lateral shift
5. Sagittal shift
B. Duration Factor
1
(x 2)
2
(x 2)
3
(x 2)
E. Range of Motion
F. Time
(Weighted x 2)
4
(x 2)
5
(x 2)
SUBTOTAL SEVERITY
C. Driving
D. Reading
E. Television
SUBTOTAL DISABILITY
Best ____
Worst ____
Usual ____
B. Duration of Pain
SUBTOTAL PAIN
T O TA
TA L T W S T R S S C O R E
physicians signature
SCORE
Chart No.
Date
|
month
Agent Injected:
Time
day
am pm
year
WE MOVE 2002
Units
Injected
Muscle Injected
Volume
Injected
Semispinalis capitis m.
Scalene muscles:
Anterior
Middle
Posterior
Levator scapulae m.
Total
Units
Electromyography Utilized?
Total
Volume
Yes
No
Semispinalis capitis m.
Splenius capitis m.
Sternocleidomastoid m.
Number of
Injections
Splenius capitis m.
Spinal accessory nerve
Levator scapulae m.
Trapezius m.
Trapezius m.
Brachial plexus
Sternocleidomastoid m.
Scalene muscles:
Anterior
Middle
Posterior
Brachial plexus
m. = muscle
Splenius capitis m.
Levator scapulae m.
Trapezius m.
Rhomboideus minor m.
Rhomboideus major m.
Deltoid m.
Semispinalis m.
Splenius capitis m.
Sternocleidomastoid m.
Supraspinatus m.
Splenius cervicalis m.
Infraspinatus m.
Longissimus capitis m.
Trapezius m.
Levator scapulae m.
Rhomboid minor m.
Teres major m.
Rhomboid major m.
Teres minor m.
Latissimus
dorsi m.
Serratus anterior m.
Serratus posterior
inferior m.
Oblique internus m.
Erector spinae m.
physicians signature
Toronto Western Spasmodic Torticollis Rating Scale (twstrs)