Modified Rankin Scale for Neurologic Disability

Why Use

There are nearly 800,000 cases of acute stroke in the United States every year, with 130,000 associated deaths (4th leading cause of death in Americans). The mRS is a widely used measure to assess the functional outcomes for patients who have suffered a stroke. It can also provide a common language for describing the degree of disability.

When to Use

The mRS can help users determine the degree of disability in patients who have suffered a stroke.

Formula

Pearls / Pitfalls

The Modified Rankin Scale (mRS) assesses disability in patients who have suffered a stroke and is compared over time to check for recovery and degree of continued disability. A score of 0 is no disability, 5 is disability requiring constant care for all needs; 6 is death. The mRS has been used in clinical research for over 30 years and is a common standard for assessing functional outcomes in patients with stroke. Multiple studies have shown that the mRS correlates with physiological indicators such as stroke type, lesion size and neurological impairment as assessed by other stroke evaluation scales. Points to keep in mind: There is criticism that the mRS contains subject components that results in variability and bias that lowers the score’s reliability. The use of structured interviews when assessing the mRS appears to result in improved interrater reliability though this effect is not completely consistent.

Management

Decisions about further medical management, the need for PT/OT therapy and the degree of care that a patient requires can be partially informed by the mRS, but final determinations should be made on an individual basis.

Critical Actions

The mRS is used to evaluate the degree of disability in patients who have suffered a stroke, but individual quality of life and independence are influenced by a wide variety of factors including the presence of comorbidities and socioeconomic status. The use of a structured interview may lead to increased reliability among those conducting assessments using the mRS.

More Information

Standardized Interview for the mRS: Ask these Yes/No Questions: Do you have any symptoms that are bothering you? Are you able to do the same work as before? Are you able to keep up with your hobbies? Have you maintained your ties to friends and family? Do you need help making a simple meal, doing household chores, or balancing a checkbook? Do you need help with shopping or traveling close to home? Do you need another person to help you walk? Do you need help with eating, going to the toilet, or bathing? Do you stay in bed most of the day and need constant nursing care?