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Modified Rankin Scale

Modified Rankin Scale

Measures the degree of disability or dependence after a stroke

Modified Rankin Scale

Modified Rankin Scale

Measures the degree of disability or dependence after a stroke

Is the patient dead?
Is the patient bedridden, incontinent, and requiring constant nursing care and attention?
Severe disability
Is the patient unable to walk without assistance and unable to attend to own bodily needs without assistance?
Moderately severe disability
Does the patient require some help but can walk without assistance?
Moderate disability
Is the patient unable to carry out all previous activities but able to look after own affairs without assistance?
Slight disability
Does the patient have symptoms but no significant disability, able to carry out all usual duties and activities?
Minor symptoms
Modified Rankin Scale
0/6 answered · tap options to update (0-6)

Instructions

Administer the mRS by asking patients (and caregivers if needed) about their ability to perform daily and instrumental activities. Use clear yes/no questions to evaluate independence in mobility, self-care, and managing routine responsibilities. Select the grade (0–6) that best matches the patient’s functional status at the time of assessment. Use structured interview guides for improved accuracy and consistency, and document the score as part of longitudinal follow-up after neurological events.

Overview
When to use
Why use
Evidences

Interpretation:

Scoring reflects the level of neurological disability or functional impairment.

Standardized interview for the mRS (Yes/No questions)

  • Are you currently experiencing any troubling or persistent symptoms?

  • Are you able to perform your daily work duties and routine activities as you did before?

  • Can you still participate in your usual hobbies or recreational activities?

  • Do you need help with basic daily tasks like cooking, cleaning, or managing finances?

  • Do you require assistance with errands such as grocery shopping or short-distance travel?

  • Do you rely on someone else to help you walk or move around safely?

  • Do you need support with personal care activities such as eating, bathing, toileting, or dressing?

  • Are you mostly confined to bed and dependent on full-time nursing or caregiver support?

mRS Score:

0 – No Symptoms
No signs of disability or residual symptoms.

1 – No Significant Disability
Minor symptoms may be present, but the person can perform all usual activities and duties independently.

2 – Slight Disability
Unable to complete all previous tasks or activities, but still manages personal affairs without assistance.

3 – Moderate Disability
Requires some help with daily activities but can walk unassisted.

4 – Moderately Severe Disability
Cannot walk or care for bodily needs without help from another person.

5 – Severe Disability
Bedridden, incontinent, and fully dependent on nursing care.

6 – Death
Patient has died.

mRS scores at discharge and at follow-up strongly predict patient functional status and longer-term outcomes after stroke. Inter-rater reliability in real clinical settings is moderate-to-good (kappa ~0.55–0.58), reflecting sufficient consistency for observational and registry studies. Structured interview guides can further improve scoring consistency.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10020493/

Use in clinical trials is robust for evaluating therapy effectiveness, with evidence supporting both ordinal and dichotomous scoring analyses. Ordinal analysis relates better to health, economic, and quality of life outcomes compared to dichotomous approaches.

https://www.neurology.org/doi/10.1212/WNL.0000000000006554

The mRS has validated utility-weighted versions for patient-centered outcome reporting and has been applied in studies across various neurological diseases, extending its value beyond stroke.

https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1539107/full

Overview
When to use
Why use
Evidences

The Modified Rankin Scale is a globally recognized tool to evaluate disability in individuals who have had a stroke or similar neurological event. It provides a single number that summarizes a patient's level of functional independence, making it easy for healthcare providers to track progress, evaluate therapy outcomes, and communicate prognosis.

Originally introduced in the 1950s and later revised, the mRS has become standard in stroke research and care. The score is particularly useful in assessing outcomes after thrombolytic therapy or mechanical thrombectomy, guiding rehabilitation decisions, and qualifying patients for specific clinical trials. 

Unlike tools focused on acute symptom severity (like the NIH Stroke Scale), the mRS focuses on long-term outcomes. It provides a clear picture of how much assistance a patient needs for daily life activities such as eating, dressing, walking, and managing personal finances.

Applications of the mRS include:

  • Measuring recovery progress after stroke

  • Assessing treatment effectiveness during clinical studies

  • Supporting decisions about in-home care or rehabilitation programs

  • Communicating prognosis with patients and families

Due to its simplicity and effectiveness, the mRS is used by neurologists, rehabilitation specialists, and primary care providers alike. Structured interview formats have improved its reliability, allowing better comparisons across healthcare teams and institutions.

Overview
When to use
Why use
Evidences

Interpretation:

Scoring reflects the level of neurological disability or functional impairment.

Standardized interview for the mRS (Yes/No questions)

  • Are you currently experiencing any troubling or persistent symptoms?

  • Are you able to perform your daily work duties and routine activities as you did before?

  • Can you still participate in your usual hobbies or recreational activities?

  • Do you need help with basic daily tasks like cooking, cleaning, or managing finances?

  • Do you require assistance with errands such as grocery shopping or short-distance travel?

  • Do you rely on someone else to help you walk or move around safely?

  • Do you need support with personal care activities such as eating, bathing, toileting, or dressing?

  • Are you mostly confined to bed and dependent on full-time nursing or caregiver support?

mRS Score:

0 – No Symptoms
No signs of disability or residual symptoms.

1 – No Significant Disability
Minor symptoms may be present, but the person can perform all usual activities and duties independently.

2 – Slight Disability
Unable to complete all previous tasks or activities, but still manages personal affairs without assistance.

3 – Moderate Disability
Requires some help with daily activities but can walk unassisted.

4 – Moderately Severe Disability
Cannot walk or care for bodily needs without help from another person.

5 – Severe Disability
Bedridden, incontinent, and fully dependent on nursing care.

6 – Death
Patient has died.

mRS scores at discharge and at follow-up strongly predict patient functional status and longer-term outcomes after stroke. Inter-rater reliability in real clinical settings is moderate-to-good (kappa ~0.55–0.58), reflecting sufficient consistency for observational and registry studies. Structured interview guides can further improve scoring consistency.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10020493/

Use in clinical trials is robust for evaluating therapy effectiveness, with evidence supporting both ordinal and dichotomous scoring analyses. Ordinal analysis relates better to health, economic, and quality of life outcomes compared to dichotomous approaches.

https://www.neurology.org/doi/10.1212/WNL.0000000000006554

The mRS has validated utility-weighted versions for patient-centered outcome reporting and has been applied in studies across various neurological diseases, extending its value beyond stroke.

https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1539107/full

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© 2025 DocScrib. All rights reserved.