Abnormal Involuntary Movement Scale
Info
Muscles of Facial Expression None Minimal, may be extreme normal Mild Moderate Severe
Lips and Perioral Area None Minimal, may be extreme normal Mild Moderate Severe
Jaw (Definitions- Biting, clenching, chewing, mouth opening, lateral movement) None Minimal, may be extreme normal Mild Moderate Severe
Tongue (Definition- Darting in and out of mouth (rate only increases in movement both in and out of mouth NOT inability to sustain movement) None Minimal, may be extreme normal Mild Moderate Severe
Upper Extremities (arms, wrists,, hands, fingers)(DO NOT INCLUDE TREMOR (i.e., repetitive, regular, rhythmic)) None Minimal, may be extreme normal Mild Moderate Severe
Lower Extremities (legs, knees, ankles, toes) None Minimal, may be extreme normal Mild Moderate Severe
Trunk (Neck, shoulders, hips) None Minimal, may be extreme normal Mild Moderate Severe
Severity of abnormal movements overall None Minimal, may be extreme normal Mild Moderate Severe
Incapacitation due to abnormal movements None Minimal, may be extreme normal Mild Moderate Severe
Patient's awareness of abnormal movements (rate only patient's report) No awareness Aware, no distress Aware, mild distress Aware, moderate distress Aware, severe distress
Are there any current problems with teeth or dentures? Yes No
Does the patient usually wear dentures? Yes No
R e s u l t s
---
 
Facial and Oral Movements
 
Extremity Movements
 
Trunk Movements
 
Global Judgements
 
Dental Status
 
Total Score
 
Show Results
Info
Abnormal Involuntary Movement Scale

The Abnormal Involuntary Movement Scale (AIMS) is a 12 item clinician rating scale to assess for abnormal involuntary movements (tardive dyskinesia) in patients taking antipsychotic medications.

There are 2 components to this scale. The first is the Examination Procedure and the Second is the Scoring.

Examination

Either before or after completing the examination procedure, observe the patient unobtrusively at rest (e.g., in the waiting room).

The chair to be used in this examination should be a hard, firm one without arms.

  1. Ask the patient whether there is anything in his or her mouth (such as gum or candy) and, if so, to remove it.
  2. Ask about the current condition of the patient's teeth. Ask if he or she wears dentures. Ask whether teeth or dentures bother the patient now.
  3. Ask whether the patient notices any movements in his or her mouth, face, hands, or feet. If yes, ask the patient to describe them and to indicate to what extent they currently bother the patient or interfere with activities.
  4. Have the patient sit in chair with hands on knees, legs slightly apart, and feet flat on floor (look at the entire body for movements while the patient is in this position).
  5. Ask the patient to sit with hands hanging unsupported [if male, between his legs, if female and wearing a dress, hanging over her knees (Observe hands and other body areas)].
  6. Ask the patient to open his or her mouth (Observe the tongue at rest within the mouth), do this twice.
  7. Ask the patient to protrude his or her tongue (Observe abnormalities of tongue movement), do this twice.
  8. Ask the patient to tap his or her thumb with each finger as rapidly as possible for 10 to 15 seconds, first with right hand, then with left hand (Observe facial and leg movements). [±activated]
  9. Flex and extend the patient's left and right arms, one at a time.
  10. Ask the patient to stand up (Observe the patient in profile; Observe all body areas again, hips included).
  11. Ask the patient to extend both arms out in front, palms down (Observe trunk, legs, and mouth).
  12. Have the patient walk a few paces, turn, and walk back to the chair (Observe hands and gait). do this twice.

Scoring

The Examination procedure is to be completed before the scoring is to be made.

The Abnormal Involuntary Movement Scale (AIMS)

Each item is scored:

  • None [0 pt]
  • Minimal, may be extreme normal [1 pt]
  • Mild [2 pts]
  • Moderate [3 pts]
  • Severe [4 pts]

The clinician is to rate the highest severity observed; with movements that occur upon activation being rated one LESS than those observed spontaneously.

Facial and Oral Movements:

  1. Muscles of Facial Expression e.g. Movements of forehead, eyebrows, periorbital area, cheeks, including frowning, blinking, smiling, grimacing
  2. Lips and Perioral Area e.g. Puckering, pouting, smacking
  3. Jaw e.g. Biting, clenching, chewing, mouth opening, lateral movement
  4. Tongue e.g. Darting in and out of mouth (rate only increases in movement both in and out of mouth NOT inability to sustain movement)

Extremity Movements:

  1. Upper Extremities (arms, wrists, hands, fingers)
    Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous) or athetoid movements (i.e., slow, irregular, complex, serpentine). DO NOT INCLUDE TREMOR (i.e., repetitive, regular, rhythmic)
  2. Lower Extremities (legs, knees, ankles, toes) e.g. Include lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot

Trunk Movements:

  1. Trunk (Neck, shoulders, hips) e.g. Rocking, twisting, squirming, pelvic gyrations. Include diaphragmatic movements.

Global Judgements:

  1. Severity of abnormal movements overall
  2. Incapacitation due to abnormal movements
  3. Patient's awareness of abnormal movements (rate only patient's report)
    • No awareness [0 pt]
    • Aware, no distress [1 pt]
    • Aware, mild distress [2 pts]
    • Aware, moderate distress [3 pts]
    • Aware, severe distress [4 pts]

Dental Status:

  1. Current problems with teeth and/or dentures?
    • Yes [1 pts]
    • No [0 pt]
  2. Are dentures usually worn?
    • Yes [1 pts]
    • No [0 pt]

References:

  1. Guy W. ECDEU Assessment Manual for Psychopharmacology: Revised (DHEW publication number ADM 76-338). Rockville, MD, US Department of Health, Education and Welfare, Public Health Service, Alcohol, Drug Abuse and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs. 1976:534-7.
  2. Lane RD, Glazer WM, Hansen TE, et al. Assessment of tardive dyskinesia using the Abnormal Involuntary Movement Scale. J Nerv Ment Dis . 1985;173(6):353-7.
  3. Munetz MR, Benjamin S. How to examine patients using the Abnormal Involuntary Movement Scale. Hospital and Community Psychiatry. Hosp Community Psychiatry. 1988;39(11):1172-7.