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How MS Disability Is Measured

January 25, 2016

Obviously a disease like multiple sclerosis is going to differently affect everybody, and it is going to progress in different manners as well. Scans and tests are great ways to measure MS, but they do not always tell the full story.

A neurologist will often administer tests that will create scales. Read about these scales below:

Expanded Disability Status Scale (EDSS): This scale focuses mainly on the patient’s physical ability, especially their ability to walk. It ranges from 0 to 10, with half points for greater specificity. Lower numbers indicate less severe disability. Higher numbers reflect a greater degree of disability, mostly in relation to mobility:

  • 0 = Normal
  • 1-1.5 = No disability, but some abnormal neurological signs
  • 2-2.5 = Minimal disability
  • 3-4.5 = Moderate disability, affecting daily activities, but you can still walk
  • 5-8 = More severe disability, impairing your daily activities and requiring assistance with walking
  • 8.5-9.5 = Very severe disability, restricting you to bed
  • 10 = Death

It's important to recognize that a one-point change at the lower end of the scale reflects more subtle changes than at the upper end of the scale.  The time of the exam ranges from 15-30 minutes, based on the condition of the patient and the skill of the administrator. All scores are at the administrator’s discretion.

Functional System Score (FSS): This scale measures how well a patient’s central nervous systems are working while also taking into account a patient’s gait and assistive devices used. The scoring goes from 0 to 6.

Disease Steps (DS): This is one of the more simple tests neurologists will perform. They will use it as a baseline test, determining whether a patient should begin therapy. This test is also simply known as the 25-foot walk. The scores range from 0-6, with 6 meaning the patient is unable to walk.

Multiple Sclerosis Functional Composite (MSFC): This newer system is sensitive to all changes, not just mobility. This test features:

  • Walking speed, using a timed 25-foot walk
  • Arm and hand dexterity, using a nine-hole peg test
  • Cognitive function, such as how well you can do math calculations, using the Paced Auditory Serial Additions Test (PASAT)