Table 2

Torticollis rating scale: modified from TWSTRS (Consky and Lang⁴)

Severity items:
Rotation	0 None
	1 Mild (1/3 range)
	2 Moderate (1/3 to 2/3 range)
	3 Severe (>2/3 range)

Tilt	0 None
	1 Mild (<15 degrees)
	2 Moderate (16-35 degrees)
	3 Severe (>35 degrees)

Anterocollis or retrocollis:	Anterocollis:
	0 None
	1 Mild downward deviation
	2 Moderate (1/2 range)
	3 Severe: chin approximates chest

	Retrocollis:
	0 None
	1 Mild backward deviation
	2 Moderate deviation (1/2 range)
	3 Severe (full range)

Range of motion and effort (rate for plane of motion that appears most limited):
	0 Full range of motion, without obvious effort
	1 Can move head well past midline, or can achieve full range of motion only be exerting obvious effort
	2 Not able to move head past midline, or past midline only with great effort
	3 Barely able to move head past the abnormal posture, or moves past abnormal posture briefly only with great effort

Tremor and jerking	0 Absent
	1 Mild: occasional
	2 Moderate: often present
	3 Severe: almost always

Global assessment severity	0 None
	1 Mild
	2 Moderate
	3 Severe
Duration factor:^2-150
	0 Dystonia not present
	1 Occasional dystonia (<25% of the time), usually submaximal in severity
	2 Intermittent (<50% of time), usually submaximal or occasional (<25%) maximal dystonia
	3 Frequent (>50%), usually submaximal or intermittent maximal
	4 Constant dystonia or frequent maximal
	5 Constant maximal dystonia

↵2-150 Estimated duration of maximal dystonia as % of time dystonia is present during each video segment. This score is weighted ×2.
The maximum possible total score, combining severity items and the weighted duration factor (×2), is 28.