Revised ALS Functional Rating Scale (ALSFRS-R)
Grades physical function in amyotrophic lateral sclerosis across 12 items.
Revised ALS Functional Rating Scale (ALSFRS-R) Cutting food and handling utensils
Use the gastrostomy sub-scale if a feeding tube is present; here the non-gastrostomy version is scored.
Turning in bed and adjusting bedclothes
Respiratory insufficiency
Result48 / 48
Higher scores indicate better preserved function. Serial totals and the rate of decline are commonly tracked over time.
- Total function score
- 48 / 48
When to use
- Measuring and following global physical function in amyotrophic lateral sclerosis in clinic and trials.
Formula
Sum of 12 items (bulbar, fine motor, gross motor, and respiratory), each scored 0 (no function) to 4 (normal). Range 0-48, higher being better.
Pearls and pitfalls
- The revised scale adds three respiratory items (dyspnea, orthopnea, respiratory insufficiency) to the original 10-item scale.
- Rate of decline in points per month is a widely used prognostic and trial endpoint.