International Cooperative Ataxia Rating Scale

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The International Cooperative Ataxia Rating Scale (ICARS) is an outcome measure that was created in 1997 by the Committee of the World Federation of Neurology with the goal of standardizing the quantification of impairment due to cerebellar ataxia. The scale is scored out of 100 with 19 items and 4 subscales of postural and gait disturbances, limb ataxia, dysarthria, and oculomotor disorders. Higher scores indicate higher levels of impairment.

Subscale Items Weight
Postural and gait disturbances 7 34 (12 for gain, 22 for stance)
Limb ataxia 7 52
Dysarthria 2 8
Oculomotor disorders 3 6

The ICARS has been validated for use in patients with focal cerebellar lesions [1] and hereditary spinocerebellar and Friedrich's ataxia.[2][3] More recently, two shorter ataxia scales based upon the ICARS have been created and validated, the Scale for the Assessment and Rating of Ataxia (SARA)[4] and the Brief Ataxia Rating Scale (BARS).[5] The SARA is a shorter, 8 item, 40 point scale which has been validated in ataxia patients.[6] The BARS was developed in 2009 in an attempt to both reduce redundancies of the ICARS, but also to shorten and simplify the administration of ataxia outcome measures.


  1. ^ Schoch, B; et al. (Nov 2007). "Reliability and validity of ICARS in focal cerebellar lesions". Movement Disorders. 22 (15): 2162–2169. doi:10.1002/mds.21543. PMID 17712842. 
  2. ^ Schmitz-Hubsch, T; et al. (May 2006). "Reliability and validity of the International Cooperative Ataxia Rating Scale: a study in 156 spinocerebellar ataxia patients". Movement Disorders. 21 (5): 699–704. doi:10.1002/mds.20781. PMID 16450347. 
  3. ^ Storey, E; Tuck, K.; Hester, R.; Hughes, A.; Churchyard, A. (Feb 2004). "Inter-rater reliability of the International Cooperative Ataxia Rating Scale (ICARS)". Movement Disorders. 19 (2): 190–192. doi:10.1002/mds.10657. PMID 14978674. 
  4. ^ Subramony, SH (Mar 2007). "SARA - a new clinical scale for the assessment and rating of ataxia". Nature Clinical Practice Neurology. 3 (3): 136–137. doi:10.1038/ncpneuro0426. PMID 17290240. 
  5. ^ Schmahmann, Jeremy D.; Raquel Gardner; Jason MacMore; Mark G. Vangel (2009). "Development of a Brief Ataxia Rating Scale (BARS) based on a modified form of the ICARS". Movement Disorders. 24 (12): 1820–1828. doi:10.1002/mds.22681. PMID 19562773. 
  6. ^ Weyer, A; et al. (Aug 2007). "Reliability and validity of the scale for the assessment and rating of ataxia: a study in 64 ataxia patients". Movement Disorders. 22 (11): 1633–1637. doi:10.1002/mds.21544. PMID 17516493.