This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
After a stroke, the question that matters most to patients and families is how independent they will be. The modified Rankin Scale (mRS) answers it with a single grade from 0 (no symptoms) to 6 (death). First described by John Rankin in 1957 and modified in the late 1980s, it is now the main outcome measure of almost every stroke trial, usually assessed 90 days after the stroke.
The grades
| mRS | Description |
|---|---|
| 0 | no symptoms at all |
| 1 | no significant disability: symptoms, but able to carry out all usual activities |
| 2 | slight disability: unable to do all previous activities, but looks after own affairs without help |
| 3 | moderate disability: needs some help, but walks without assistance |
| 4 | moderately severe disability: unable to walk or attend to bodily needs without help |
| 5 | severe disability: bedridden, incontinent, needs constant nursing care |
| 6 | death |
How the calculator works
Rating the mRS from memory varies between assessors. Structured interviews reduce that variation by asking a fixed series of questions from the most severe to the least. The calculator follows the same logic: the first question answered “yes”, starting from the top, sets the grade. A person who has symptoms and has given up some hobbies but manages alone scores 2.
“Help” means another person’s help. Using a cane or a walker alone counts as walking without assistance.
Good and poor outcome
Trials often split the scale in two: 0 to 2 is a good outcome (functional independence) and 3 to 6 a poor one. Some trials use 0 to 1 as an excellent outcome, and many now analyze the whole scale.
Why the baseline matters
Ask about the situation before the stroke too. A person who already needed help with shopping had an mRS of 3 before the event, and the change matters as much as the final grade. Thrombolysis and thrombectomy decisions often consider the pre-stroke mRS.
Limits
The mRS is coarse: very different situations can share a grade, and it says little about mood, memory or quality of life. It also covers disability from any cause, not only from the stroke. Use it alongside the NIHSS for the neurological deficit and a fuller assessment of daily activities such as the Barthel index.