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    Modified Rankin Scale for Neurologic Disability

    Measures the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability.
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    Why Use

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

    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.

    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.

    No symptoms at all
    0
    No significant disability despite symptoms; able to carry out all usual duties and activities
    +1
    Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
    +2
    Moderate disability; requiring some help, but able to walk without assistance
    +3
    Moderately severe disability; unable to walk and attend to bodily needs without assistance
    +4
    Severe disability; bedridden, incontinent and requiring constant nursing care and attention
    +5
    Dead
    +6
    A standardized interview also exists to try to reduce subjectivity or variability in score assignments. See the “About” section for more information.

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    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.

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    Dr. John van Swieten
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