Modified Rankin Scale (mRS)

If you are dealing with a patient who had a stroke or some other neurological injury, you can use the Modified Rankin Scale (mRS) to assess their functional status! Learn more about the scale through this guide.

By Matt Olivares on Jul 15, 2024.

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Fact Checked by RJ Gumban.

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What is the Modified Rankin Scale (mRS)?

When a person, unfortunately, suffers from a stroke or another type of neurological problem, their functional status is impacted to varying degrees. Some are only mildly impacted, and some are so horribly impacted they can’t do what they usually do. To help assess the functional status of such people, the was developed.

The Modified Rankin Scale (mRS) assesses specifically the severity of their disability by checking if they can perform their activities of daily living (ADLs) as well as other activities that they normally do. Are they still able to do their activities of daily living and other things on their own? Can they still do them, but they need assistance from others? Or can they no longer do them and require someone to do things for them?

The answers to these questions will help determine the specific score the patient will get on the Modified Rankin Scale. The specifics of this scale will be discussed later on in this guide.

The score will determine what will go into a person’s care plan, and the scale can be used to monitor the patient from time to time.

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Modified Rankin Scale (mRS) Example

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How to use the Modified Rankin Scale (mRS)

The Modified Rankin Scale (mRS) is easy to use and doesn’t require much from the professional using it since the only thing that needs to be done when engaging with the sheet is to select a number rating.

Before selecting a rating, the professional must schedule an interview with the patient who suffered a stroke or a neurological problem. During the interview, the professional will ask the patient a series of questions, all related to how they are feeling and if they can perform activities of daily living. You should also observe some of them, too, if you can.

Here are some questions that you can ask them:

  • Are you able to bathe on your own?
  • Can you go to the toilet on your own and clean up after yourself?
  • Can you prepare your own meals?
  • Do you have trouble eating (not just chewing and swallowing food, but also if you can hold utensils without trouble)?
  • Can you dress?
  • Can you walk?

You can tweak the questions to ascertain if they can do these things but require the aid of something or someone or if they can’t do certain things at all.

Make sure to ask them about other things they do that are not necessarily activities of daily living, like their hobbies and recreational activities.

If they have difficulty communicating, you may have a caregiver or companion who supports them daily to help them answer for you.

Once you get all the information you need, you can give the rating using the scale.

How to score the Modified Rankin Scale (mRS)

The Modified Rankin Scale (mRS) is easy to score because you don’t really need to calculate anything. The score options are already set and you only have to pick one out of seven possible scores. The scores also have set descriptions, so you will know where your patient falls based on your interview with them.

Here are the options:

  • 0 = The patient has no symptoms at all.
  • 1 = The patient has no significant disability despite symptoms. They are able to carry out all their usual duties and activities.
  • 2 = The patient has a slight disability. They are unable to carry out all previous pre-stroke activities, but they are able to look after their own affairs without assistance.
  • 3 = The patient has a moderate disability. They also require some help, but they are able to walk without assistance.
  • 4 = The patient has a moderately severe disability. They are also unable to walk without assistance and they are unable to attend to their own bodily needs without assistance.
  • 5 = The patient has a severe disability. They are bedridden, incontinent, and they require constant nursing care and attention.
  • 6 = The patient is dead.

The score you assign should help you and your team determine what goes into the patient’s care plan.

When is it best to use the Modified Rankin Scale (mRS)?

The Modified Rankin Scale is best used after a person has suffered a stroke, traumatic brain damage, or some other neurological condition. The reason why this has to be used as early as possible is that the rating that you will give a patient who is dealing with a neurological condition, especially when they are in the stages of recovery, will help you and your team determine what exactly goes into the care plan for the patient.

Care plans may not necessarily be the same, and general care plans may not always apply, so the interview process of this scale is really important to tailor-fit the plan for them.

It’s important to use this scale as early as possible in order to get started with the necessary treatments immediately, especially if the patient has moderate to severe disabilities due to the impact of the neurological condition that they have.

Once a care plan has been developed and implemented, the Modified Rankin Scale (mRS) can be used as a monitoring tool during routine check-ups! This is so you can see if the patient is getting better. For example, you rated them a 4 the first time you used this scale. Then, after two routine check-ups, they scored a 3. That means they are getting better and that your care plan seems to be working. If they are not getting better or are getting worse, then it’s likely that your care plan isn’t working, and you may have to adjust things or overhaul it.

Who can use the Modified Rankin Scale (mRS)?

Since the Modified Rankin Scale (mRS) was designed to assess the functional status of patients who are suffering from neurological conditions, the following healthcare professionals can definitely use this for their work:

  • Neurologists
  • Physiotherapists
  • Physical Therapists
  • Occupational Therapists
  • Physicians
  • Nurses

So long as the person is highly trained and experienced when it comes to dealing with, assessing, and treating patients who have neurological problems, they are more than welcome to use this scale. The reason why not just anyone can use this is that this requires observing the patient in terms of how they are currently as well as what they can or can’t do. If the person using it is highly trained and experienced, their number ratings can be trusted. The score will guide treatment and interventions, after all.

If you wonder if this can be used as a self-assessment, the answer is no. The reason for this is that the scale requires an assessor who will not simply ask questions about activities of daily living and how the patient feels, but it also requires them to observe the patient when they can to make a well-informed rating. So, under no circumstance should this be used as a self-assessment scale.

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What are the benefits of the Modified Rankin Scale (mRS)?

It’s a time-saving tool!

If you and your team are part of a busy hospital and you have a lot of patients to look after, then you will definitely love this tool because you don’t really have to do much when you engage with it. You will pick a single number that will serve as the score for your patient’s functional status. That’s it. While it may take a few minutes (don’t be surprised if it reaches an hour) to interview your patient and observe them, it should only take you between one to five minutes to accomplish the scale!

It can help educate the loved ones and friends of the patient.

The scale primarily focuses on the patient’s disabilities and if they can carry out their activities of daily living as well as other things that they normally do. This is also the key concern of the patient, their loved ones, and their friends. By using this scale, the rating you give will help all of them understand what the patient’s functional status is and what kind of support they need.

The Additional Comments box is here to help with that because it can serve as your opportunity to elaborate on things that the patient, their loved ones, and friends need to know.

It can guide treatment plans and interventions as well as monitor the patient.

As we mentioned earlier, the Modified Rankin Scale (mRS), specifically the rating that you selected for the patient, will help guide the treatment plan. Through the rating and the additional comments box, you can communicate the relevant information with your team, the patient, and the patient’s loved ones.

Other members of your team can conduct the tests that they feel are important when it comes to the aspects of the person that have been impacted by their neurological condition. Then, they can determine what should go into the patient’s care plan based on the results!

Physical therapists on your team can conduct routine physical therapy tests to help rehab whichever extremities have been affected. If they have slurred speech, speech therapists can play a role in the care plan to get them back to a state where they can speak clearly again. These are just some kinds of treatment that can be included in a care plan!

Eventually, you can use this as a monitoring tool to assess the patient’s recovery progress and how effective your team’s care plan is.

Is this scale primarily used for stroke patients?
Is this scale primarily used for stroke patients?

Commonly asked questions

Is this scale primarily used for stroke patients?

It’s commonly used to assess stroke patients, but this can also be used to assess patients with traumatic brain injury, cerebral palsy, and multiple sclerosis.

How long will it take to accomplish the scale?

Depends on how you look at it. If you’re asking this in terms of just filling up the scale, it can only take you a second because you’re simply picking a number. But it can take you up to ten minutes if you take your time to weigh the information you got from interviewing your patient/patient’s companion and from observing the patient. If you take into account the interview and the observation parts, well, the amount of time you will spend on both will vary from patient to patient. Just don’t be surprised if it takes you an hour. You are dealing with a patient impacted by a neurological problem, after all.

How often should I use this to monitor a patient?

That depends on your team’s care plan. You can go with monthly, quarterly, every half-year, or annually. Weekly might not be the best way to go about it because one thing that you can expect is that it might take a while for progress to show.

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