_id

683a164dc782e11e38d1b32b

id

10435

title

Abnormal Involuntary Movement Scale (AIMS)

full_title

Abnormal Involuntary Movement Scale (AIMS)

short_title

AIMS

med_description

Measures involuntary movements of tardive dyskinesia (TD).

short_description

Tardive dyskinesia (TD) movement measurement.

slug

abnormal-involuntary-movement-scale-aims

description

The Abnormal Involuntary Movement Scale (AIMS) measures involuntary movements of tardive dyskinesia (TD).

keywords

Abnormal Involuntary Movement Scale (AIMS), aims, abnormal movement, involuntary movement, movement scale, abnormal involuntary movement, tardive dyskinesia, td, involuntary movement measurement, abnormal movement measurement

complaint

[ "Agitation", "Altered Mental Status", "Anxious", "Depressed", "Excessive Crying", "Fatigue", "Weight Loss/Gain", "Involuntary Movements" ]

formula

Evidence of TD is determined according to the selected points: Additional questions included in the study:

evidence

measurements

[]

information

A rating of 2 or higher on any of the first seven questions is evidence of TD. If the patient has mild movements in two areas or moderate movements in one area, then they should be given a diagnosis of TD.

refrences

{ "Clinical Practice Guidelines": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/29742330/", "text": "Kane JM, Correll CU, Nierenberg AA, Caroff SN, Sajatovic M, Tardive Dyskinesia Assessment Working Group. Revisiting the abnormal involuntary movement scale: proceedings from the tardive dyskinesia assessment workshop. J Clin Psychiatry. 2018;79(3):17cs11959." } ], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/329329/", "text": "Chien CP, Jung K, Ross-Townsend A, Stearns B. The measurement of persistent dyskinesia by piezoelectric recording and clinical rating scales. Psychopharmacol Bull. 1977;13(3):34-36." } ], "Other References": [], "Outcomes": [], "Validation": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/6973337/", "text": "Rey JM, Hunt GE, Johnson GF. Assessment of tardive dyskinesia in psychiatric outpatients using a standardized rating scale. Aust N Z J Psychiatry. 1981;15(1):33-37." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/15913963/", "text": "Gharabawi GM, Bossie CA, Lasser RA, Turkoz I, Rodriguez S, Chouinard G. Abnormal involuntary movement scale (Aims) and extrapyramidal symptom rating scale (Esrs): cross-scale comparison in assessing tardive dyskinesia. Schizophr Res. 2005;77(2-3):119-128." } ], "Validations": [] }

pearls

• Scoring is not linear.
• The total score, while not included in the original literature, is widely utilized today.
• Note: Inputs in the Global Judgements section do not contribute to the overall score.
• Symptoms of tardive dyskinesia can be intermittent; a single assessment may miss mild or transient symptoms.

usecase

• May be used to monitor for and assess tardive dyskinesia (TD) in individuals with a history of antipsychotic therapy.
• Recommended by the American Psychiatric Association (APA):
  
  • If new or worsening movements are detected.
  • At least every 6 months in patients at high risk for TD.
  • At least every 12 months in other patients.

reasons

Provides a standardized method for assessing and quantifying the severity of TD. Aids in early detection, allowing for timely intervention to prevent progression. Supports clinical decision-making regarding the continuation, adjustment, or cessation of antipsychotic therapy.

next_advice

• If there is evidence of TD:
  
  • Evaluate the necessity of continued antipsychotic treatment and consider dose reduction or switching to a medication with a lower risk of TD.
  • Discuss the potential use of pharmacologic agents, such as vesicular monoamine transporter 2 (VMAT2) inhibitors, for symptomatic management.
  • Collaborate with neurology or psychiatry for complex cases or if symptoms are severe.
• If no evidence of TD:
  
  • Continue periodic monitoring to ensure early detection of potential movement disorders.
  • Reinforce patient and caregiver education on recognizing signs of involuntary movements.

• The APA notes:

  • There is no specific threshold score that suggests a need for intervention.

  • The same total score can be associated with different clinical manifestations and varying impacts on different patients.

• Therefore, the use of this tool should be combined with clinical judgment, a thorough clinical examination, and patient input.

• For more detailed management recommendations, refer to the APA practice guideline for the treatment of patients with schizophrenia.

next_actions

next_management

diseases

[ "Bipolar Disorder", "Schizophrenia" ]

input_schema

[ { "inct": null, "option_fhir_rules": null, "subheading": "Facial and Oral Movements", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": 0, "label_en": "<p>Muscles of facial expression</p>", "mdcalc_info_concept": null, "name": "face", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "e.g. movements of forehead, eyebrows, periorbital area, cheeks, including, frowning, blinking, smiling, grimacing", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p>Lips and perioral area</p>", "mdcalc_info_concept": null, "name": "lips", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "e.g. puckering, pouting, smacking", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p>Jaw</p>", "mdcalc_info_concept": null, "name": "jaw", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "e.g. biting, clenching, chewing, mouth opening, lateral movement", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p>Tongue</p>", "mdcalc_info_concept": null, "name": "tongue", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "Rate only increases in movement both in and out of mouth. NOT inability to sustain movement. Darting in and out of mouth.", "type": "radio" }, { "inct": null, "option_fhir_rules": null, "subheading": "Extremity Movements", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": 0, "label_en": "<p>Upper (arms, wrists, hands, fingers)</p>", "mdcalc_info_concept": null, "name": "upper", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous) and athetoid movements (i.e., slow, irregular, complex, serpentine). DO NOT include tremor (i.e., repetitive, regular, rhythmic).", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p>Lower (legs, knees, ankles, toes)</p>", "mdcalc_info_concept": null, "name": "lower", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "e.g. lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot", "type": "radio" }, { "inct": null, "option_fhir_rules": null, "subheading": "Trunk Movements", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": 0, "label_en": "<p>Neck, shoulders, hips</p>", "mdcalc_info_concept": null, "name": "trunk", "option_fhir_rules": null, "optional": false, "options": [ { "label": "None", "value": 0 }, { "label": "Minimal, may be extreme normal", "value": 1 }, { "label": "Mild", "value": 2 }, { "label": "Moderate", "value": 3 }, { "label": "Severe", "value": 4 } ], "show_points": true, "tips_en": "e.g. rocking, twisting, squirming, pelvic gyrations", "type": "radio" }, { "inct": null, "option_fhir_rules": null, "subheading": "Global Judgements", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": null, "label_en": "<p>Severity of abnormal movements overall</p>", "mdcalc_info_concept": null, "name": "overall", "option_fhir_rules": null, "optional": true, "options": [ { "label": "None", "value": 1 }, { "label": "Minimal, may be extreme normal", "value": 2 }, { "label": "Mild", "value": 3 }, { "label": "Moderate", "value": 4 }, { "label": "Severe", "value": 5 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": null, "label_en": "<p>Incapacitation due to abnormal movements</p>", "mdcalc_info_concept": null, "name": "incap", "option_fhir_rules": null, "optional": true, "options": [ { "label": "None", "value": 1 }, { "label": "Minimal, may be extreme normal", "value": 2 }, { "label": "Mild", "value": 3 }, { "label": "Moderate", "value": 4 }, { "label": "Severe", "value": 5 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": null, "label_en": "<p>Patient's awareness of abnormal movements</p>", "mdcalc_info_concept": null, "name": "aware", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No awareness", "value": 1 }, { "label": "Aware, no distress", "value": 2 }, { "label": "Aware, mild distress", "value": 3 }, { "label": "Aware, moderate distress", "value": 4 }, { "label": "Aware, severe distress", "value": 5 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "inct": null, "option_fhir_rules": null, "subheading": "Dental Status", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": null, "label_en": "<p>Current problems with teeth and/or dentures?</p>", "mdcalc_info_concept": null, "name": "problems", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No", "value": 1 }, { "label": "Yes", "value": 2 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": null, "label_en": "<p>Are dentures usually worn?</p>", "mdcalc_info_concept": null, "name": "dentures", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No", "value": 1 }, { "label": "Yes", "value": 2 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": null, "label_en": "<p>Edentia?</p>", "mdcalc_info_concept": null, "name": "edentia", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No", "value": 1 }, { "label": "Yes", "value": 2 } ], "show_points": false, "tips_en": "", "type": "radio" }, { "inct": null, "option_fhir_rules": null, "subheading": "Other", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": null, "label_en": "<p>Do movements disappear in sleep?</p>", "mdcalc_info_concept": null, "name": "sleep", "option_fhir_rules": null, "optional": true, "options": [ { "label": "No", "value": 1 }, { "label": "Yes", "value": 2 } ], "show_points": false, "tips_en": "", "type": "radio" } ]

instructions

• Rate highest severity observed. Rate movements that occur upon activation one less than those observed spontaneously.
• Complete the examination procedure prior to making ratings. Note that the total AIMS score is not reported to the patient.

published

2022-08-09T16:52:03.696Z

purpose

[ "Diagnosis", "Prognosis" ]

search_terms

[ "Abnormal Involuntary Movement Scale (AIMS)", "aims", "abnormal movement", "involuntary movement", "movement scale", "abnormal involuntary movement", "tardive dyskinesia", "td", "involuntary movement measurement", "abnormal movement measurement" ]

seo

{ "keywords_en": "Abnormal Involuntary Movement Scale (AIMS), aims, abnormal movement, involuntary movement, movement scale, abnormal involuntary movement, tardive dyskinesia, td, involuntary movement measurement, abnormal movement measurement", "meta_description_en": "The Abnormal Involuntary Movement Scale (AIMS) measures involuntary movements of tardive dyskinesia (TD)." }

specialty

[ "Neurology", "Psychiatry" ]

departments

[ "Neurologic", "Psychiatric" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 3979, "short_title_en": "Trunk Impairment Scale", "slug": "trunk-impairment-scale" }, { "calcId": 10414, "short_title_en": "PANSS for Schizophrenia", "slug": "positive-negative-syndrome-scale-panss-schizophrenia" }, { "calcId": 10566, "short_title_en": "GDS-15", "slug": "geriatric-depression-scale-gds-15" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "neurology", "psychiatry" ]

cleaned_use

[ "May be used to monitor for and assess tardive dyskinesia (TD) in individuals with a history of antipsychotic therapy.", "Recommended by the American Psychiatric Association (APA):If new or worsening movements are detected.At least every 6 months in patients at high risk for TD.At least every 12 months in other patients.", "If new or worsening movements are detected.", "At least every 6 months in patients at high risk for TD.", "At least every 12 months in other patients." ]

pub

false