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The International Parkinson and Movement Disorder Society (MDS) commissioned the appraisal of the use and clinimetric properties of clinical measures of functional ability that have been applied in HD studies and trials to date, to make recommendations regarding their use based on standardized criteria. After a systematic literature search, we included a total of 29 clinical measures grouped into two categories: (1) performance\u2010based measures (e.g., balance, walking, and reaching\/grasping), and (2) rating scales. Three performance\u2010based measures are rated as \u201crecommended\u201d: the Tinetti Mobility Test for screening of fall risk and for severity assessment of mobility in patients with manifest HD (up to stage III); the Berg Balance Scale for severity of balance impairment; and the Six\u2010Minute Walk Test for assessment of walking endurance (severity) in HD subjects with preserved ambulation. No rating scale targeting functional ability reached a \u201crecommended\u201d status either for screening or severity measurement.<\/jats:p><jats:p>The main challenges identified in this review include applying widely accepted conceptual frameworks to the identified measures, the lack of validation of clinical measures to detect change over time, and absence of validated measures for upper limb function. Furthermore, measures of capacity or ability to perform activities of daily living had ceiling effects in people with early and pre\u2010manifest HD. We recommend that the MDS prioritize the development of new scales that capture small, but meaningful changes in function over time for outcome assessment in clinical trials, particularly in earlier stages of HD.<\/jats:p>","DOI":"10.1002\/mdc3.12617","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T02:20:57Z","timestamp":1523326857000},"page":"361-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Rating Scales and Performance\u2010based Measures for Assessment of Functional Ability in Huntington's Disease: Critique and Recommendations"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6973-7479","authenticated-orcid":false,"given":"Tiago A.","family":"Mestre","sequence":"first","affiliation":[{"name":"Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute University of Ottawa Brain and Mind Research Institute  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5331-5909","authenticated-orcid":false,"given":"Monica","family":"Busse","sequence":"additional","affiliation":[{"name":"Centre for Trials Research Cardiff University Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen M.","family":"Davis","sequence":"additional","affiliation":[{"name":"Krembil Research Institute, University Health Network and Institute of Health Policy, Management and Evaluation and Rehabilitation Institute University of Toronto  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Quinn","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Sciences, Teachers College Columbia University  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe B.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Huntington's Disease Centre, Institute of Neurology University College London, UK, Clinical Pharmacology Unit, Instituto de Medicina Molecular  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Marc","family":"Burgunder","sequence":"additional","affiliation":[{"name":"Swiss HD Center, Neuro Zentrum Siloah and Department of Neurology University of Bern  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle E.","family":"Carlozzi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Michigan  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Neurology Wake Forest School of Medicine  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen K.","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Psychology and Clinical Language Sciences University of Reading Reading UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Sampaio","sequence":"additional","affiliation":[{"name":"CHDI Foundation\/management  USA"},{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine University of Lisbon  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Goetz","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences Rush University Medical Center Chicago USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Cubo","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Universit\u00e1rio HermanosYag\u00fce Burgos Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Martinez\u2010Martin","sequence":"additional","affiliation":[{"name":"National Center of Epidemiology and CIBERNED Carlos III Institute of Health Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn T.","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences Rush University Medical Center Chicago USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Members of the MDS Committee on Rating Scales Development","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-4-79"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21333"},{"key":"e_1_2_9_4_1","unstructured":"Towards a Common Language for Functioning Disability and Health: ICF The International Classification of Functioning Disability and Health. 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