AIMS - Abnormal Involuntary Movement Scale
The AIMS is a 12-item clinician-rated scale to assess severity of dyskinesias (specifically, orofacial movements and extremity and truncal movements) in patients taking neuroleptic medications. Additional items assess the overall severity, incapacitation, and the patient’s level of awareness of the movements, and distress associated with them.
The AIMS has been used extensively to assess tardive dyskinesia in clinical trials of antipsychotic medications. Due to its simple design and short assessment time, the AIMS can easily be integrated into a routine clinical evaluation by the clinician or another trained rater.
Because it is a provider-administered measure, when assigned it will not appear in the patient's Patient Portal. Instead, it will be queued up for you to fill out when you start your next note for that patient.
- Score the highest amplitude or frequency in a movement of the 0-4 scale, not the average.
- Some versions recommend scoring movements that occur upon activation one less than those observed spontaneously.
- Observe patient unobtrusively at rest (e.g. in waiting room) either before or after completing the examination. Use a hard, firm chair without arms for the exam.
- Ask the patient whether there is anything in his or her mouth (such as gum or candy) and, if so, to remove it.
- 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.
- 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.
- 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.)
- 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).
- Ask the patient to open his or her mouth. (Observe the tongue at rest within the mouth.) Do this twice.
- Ask the patient to protrude his or her tongue. (Observe abnormalities of tongue movement.) Do this twice.
- 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.)
- Flex and extend the patient’s left and right arms, one at a time.
- Ask the patient to stand up. (Observe the patient in profile. Observe all body areas again, hips included.)
- Ask the patient to extend both arms out in front, palms down. (Observe trunk, legs, and mouth.)
- Have the patient walk a few paces, turn, and walk back to the chair. (Observe hands and gait.) Do this twice.
A positive AIMS examination is as follows:
- A score of 2 in two or more movements, OR
- A score of 3 or 4 in a single movement
- 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
- Munetz MR, Benjamin S. How to Examine Patients Using the Abnormal Involuntary Movement Scale. Hosp Commun Psych. 1988;39:1172-117