What Is the Modified Rankin Scale?

Mary McMahon

The Modified Rankin Scale (MRS) is a rubric used to assess stroke patients. It provides information about the patient’s level of disability experienced as a result of stroke and can be useful in following up as well as making prognostic predictions. A score between one and six is assigned on the basis of the patient’s condition. Low scores indicate a high level of functioning, while high ones indicate severe disability or death as a result of a stroke.

Higher scores on the MRS indicate the need for more assistance with both medical and personal care.
Higher scores on the MRS indicate the need for more assistance with both medical and personal care.

A score of zero means the patient has no symptoms and appears to be entirely normal after a stroke. Patients with ones have some slight symptoms, but no significant disability. They may slur their speech slightly, for example, indicating that the stroke involved the speech centers of the brain, but they can still be clearly understood. They don’t have any trouble with performing tasks of daily living and may not need specific therapy or supportive care.

People who have had a stroke may have difficulty walking.
People who have had a stroke may have difficulty walking.

Twos are assigned to patients with slight disabilities caused by strokes. This score on the Modified Rankin Scale may mean that a patient has to curtail previous activities, but doesn’t need assistance. Threes are more serious. The patient may need help with some tasks, but can still walk independently. Rehabilitation may help the patient develop and retain independence and function.

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Patients who have had a stroke may require a cane to walk.
Patients who have had a stroke may require a cane to walk.

Higher scores on the Modified Rankin Scale indicate a more serious level of disability. A four is assigned if patients experience moderately severe disabilities like difficulty walking and inability to perform personal care. These patients may need aides or assistants to use the bathroom and bathe, for instance, and cannot walk without help. A five is a severe disability indicating the need for constant skilled nursing attention. The patient may need treatment to prevent bedsores and other complications caused by remaining in bed, and has low cognitive function.

The Modified Rankin Scale assesses the damage done by a stroke.
The Modified Rankin Scale assesses the damage done by a stroke.

Sixes are assigned to patients who are clinically dead. Providing a numeric score for death can allow hospitals and other facilities to use the Modified Rankin Scale to track patient outcomes and statistics more easily. The rubric is also used in clinical trials to quantify patient data and provide an accurate image of events during the trial. Statistical analysis performed in conjunction with clinical trials can be more accurate and helpful when the trial includes a clear numeric assessment tool for outcomes, rather than just a verbal one; the researchers can discuss findings and individual cases in more detail, but the Modified Rankin Scale provides a quick overview.

Stroke victims may require physical therapy.
Stroke victims may require physical therapy.

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