The modified Rankin Scale (mRS) is a commonly used scale for measuring the degree of disability or dependence in the
daily activities of people who have suffered a
stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
or other causes of
neurological
Neurology (from , "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the s ...
disability. It has become the most widely used
clinical outcome measure for stroke
clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
s.
The scale was originally introduced in 1957 by Dr. John Rankin of
Stobhill Hospital,
Glasgow, Scotland
Glasgow is the Cities of Scotland, most populous city in Scotland, located on the banks of the River Clyde in Strathclyde, west central Scotland. It is the List of cities in the United Kingdom, third-most-populous city in the United Kingdom ...
as a 5-level scale ranging from 1 to 5. It was then modified by either van Swieten et al. or perhaps Prof. C. Warlow's group at
Western General Hospital in
Edinburgh
Edinburgh is the capital city of Scotland and one of its 32 Council areas of Scotland, council areas. The city is located in southeast Scotland and is bounded to the north by the Firth of Forth and to the south by the Pentland Hills. Edinburgh ...
for use in the UK-TIA study in the late 1980s to include the value '0' for patients who had no symptoms.
As late as 2005 the scale was still being reported as ranging from 0 to 5. Somewhere between 2005 and 2008 the final change was made to add the value '6' to designate patients who had died. The modern version of modified version differs from Rankin's original scale mainly in the addition of grade 0, indicating a lack of symptoms, and the addition of grade 6 indicating dead.
Interobserver reliability of the mRS can be improved by using a structured questionnaire during the interview process
and by having raters undergo a multimedia training process.
The multimedia mRS training system which was developed by Prof. K. Lees' group at the
University of Glasgow
The University of Glasgow (abbreviated as ''Glas.'' in Post-nominal letters, post-nominals; ) is a Public university, public research university in Glasgow, Scotland. Founded by papal bull in , it is the List of oldest universities in continuous ...
i
available online The mRS is frequently criticized for its subjective nature which is viewed as skewing results, but is used throughout hospital systems to assess rehabilitation needs and outpatient course. These criticisms were addressed by researchers creating structured interviews which ask simple questions both the patient and/or the caregiver can respond to.
More recently, several tools have been developed to more systematically determine the mRS, including the mRS-SI, the RFA,
and the mRS-9Q.
The mRS-9Q is in the
public domain
The public domain (PD) consists of all the creative work to which no Exclusive exclusive intellectual property rights apply. Those rights may have expired, been forfeited, expressly Waiver, waived, or may be inapplicable. Because no one holds ...
and free web calculators are available a
modifiedrankin.coman
mdcalc.com
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The Modified Rankin Scale (mRS)
The scale runs from 0–6, running from perfect health without symptoms to
death
Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
.
* 0 - No symptoms.
* 1 - No significant disability. Able to carry out all usual activities, despite some symptoms.
* 2 - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
* 3 - Moderate disability. Requires some help, but able to walk unassisted.
* 4 - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
* 5 - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
* 6 - Dead.
See also
*
Barthel scale
*
Glasgow outcome scale
strokecenter.org list of stroke assessment scales (external link)
References
{{reflist
Rehabilitation medicine
Medical scales