J Neurol Sci. Oct 31;() The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. Amyotrophic Lateral Sclerosis (ALS), is a neurodegenerative disease that typically affects The ALSFRS-R scale has some limitations though since it is not useful to compare scores of people who present with different onset. In ALS the main. Subscales of the ALS Functional Rating Scale (ALSFRS-R) as met El Escorial- Revised criteria for Possible, Probable or Definite ALS at.

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Invasive mechanical ventilation by intubation or tracheostomy. Does not routinely use more than two pillows Needs extra pillow in order to sleep more than two Can only sleep sitting up Unable to sleep Can only sleep sitting up.

Non-ambulatory functional movement only.

People diagnosed with ALS live on average 2—4 years after diagnosis due to the quick progression of the disease. A Systematic Review of the Published Literature”.

ALS Functional Rating Scale – Revised – Wikipedia

Marked drooling; requires constant tissue or handkerchief. Neurology Amyotrophic lateral sclerosis Rating systems. Occurs with one or more of the following: No purposeful leg movement. Orthopnea None Some difficulty sleeping at night due to shortness of breath.


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ALS Functional Rating Scale – Revised

Needs attendant for self-care. Menu “left menu navigation” Begins – Skip Menu. Slow or sloppy; all words are legible. Intermittent assistance or substitute methods. Continuous use of BiPAP during the night and day. Cutting food with gastrostomy.

ALS Functional Rating Scale

In ALS the main type of onset is bulbar, followed by limb-onset; which describes the region of motor neurons first affected. Able to grip pen but unable to write.

Speech combined with nonvocal communication. Handwriting Normal Slow or sloppy; all words are legible Not all words are legible Able to grip pen but unable to write Unable to grip pen 5. Mild unsteadiness or fatigue. Dyspnea None Occurs when walking Occurs with one or more of the following: By using this site, you agree to the Terms of Use and Privacy Policy.

Independent and complete self-care with effort or decreased efficiency. Cutting food with gastrostomy Normal Somewhat slow and clumsy, but no help needed Can cut most foods, although clumsy and slow; some help needed Food must be cut by someone, but can still feed slowly Needs to be fed Normal Clumsy but able to perform all manipulations independently Some help needed with closures and fasteners Provides minimal assistance to caregiver Unable to perform any aspect of task 6. Needs extra pillow in order to sleep more than two.


Questions 1 to 3 are related to bulbar onset, questions 4 to 9 are related to limb onset and questions are related to respiratory onset. Since there are three main pathways of progression, the questions are also divided in relation to the types of onset.

A score of 0 on a question would indicate no function while a score of 4 would indicate full function. A longitudinal and survival analysis of functional dimension subscores in amyotrophic lateral sclerosis”. Occurs at rest, difficulty breathing when either sitting or lying. J Neurol Neurosurg Psychiatry.

Significant difficulty, considering using mechanical respiratory support. Walking Normal Early ambulation difficulties Walks with assistance Non-ambulatory functional movement only No purposeful leg movement 9.

Needs supplemental tube feeding. Moderately excessive saliva; may have ufnctional drooling. NPO exclusively parenteral or enteral feeding.

A Journal of Neurology. This page was last edited on 3 Decemberat