Modified Rankin Scale (mRS)

A 7-point global disability scale measuring functional independence after stroke.

Clinician-assessed in a structured interview; 5 to 10 minutes.
7 grades: 0 (no symptoms) to 5 (severe disability) and 6 (death).
Favourable outcome typically defined as mRS 0 to 2.

What it measures

The mRS grades global disability and dependence on a single 7-point scale. Grade 0 indicates no symptoms. Grades 1 and 2 indicate minor or slight disability with independence. Grades 3 to 5 indicate moderate to severe disability requiring help from others. Grade 6 is death. The structured interview format, with an 11-item questionnaire, improves reliability.

What the result tells you

The mRS is the primary endpoint in most acute stroke and stroke prevention trials. A shift of one grade up the scale is clinically meaningful. Favourable outcome (0 to 2) is the most common binary outcome in trials. Serial assessment tracks disability trajectory over months to years after stroke.

Used for

Stroke

Evidence, psychometrics and provenance

Psychometrics

Inter-rater reliability (unstructured)κ 0.56–0.78

Inter-rater reliability (structured interview)κ > 0.80

Inter-rater agreement (kappa); a structured interview raises it.

References

1.van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19(5):604-607.

This assessment uses a validated instrument and is reference information, not a diagnosis.