Neurology

Modified Rankin Scale (mRS) Calculator

Assessment of disability after stroke

Primary source: van Swieten JC et al. Stroke 1988; 19(5): 604-607

Aleksandr A. Aulov, MD, internal medicine Last clinical review: April 28, 2026

Online calculation

Patient functional status

About this score

The modified Rankin Scale (mRS) is a global measure of functional disability after stroke. Developed by J. Rankin (1957) and modified by C. Warlow (1988). Used to assess outcome in the first 30-90 days after stroke and at subsequent time points.

The scale has 7 grades (0-6): 0 — no symptoms; 1 — symptoms present but do not affect daily activities; 2 — slight disability (able to carry out daily activities without assistance); 3 — moderate disability (requires some help, walks independently); 4 — moderately severe disability (unable to walk without assistance, unable to manage self-care); 5 — severe disability (bedridden, requires constant care); 6 — death.

The mRS is the primary endpoint in nearly all stroke clinical trials. A "good outcome" is usually defined as mRS 0-2 at day 90. The ESO 2021 guidelines for ischemic stroke use the mRS as the standard measure for evaluating the efficacy of thrombolysis, thrombectomy, and rehabilitation.

When to use

At 30 and 90 days after stroke — the standard outcome assessment time points.
Before hospital discharge — to plan the rehabilitation pathway.
In clinical trials — as the primary endpoint.
When assessing baseline functional status before thrombolysis (baseline mRS > 2 is a relative contraindication).

Clinical example

Case

A 67-year-old woman, 90 days after an ischemic stroke in the left middle cerebral artery territory. Received thrombectomy 4 hours after symptom onset. At assessment: mild dysarthria, walks independently, cooks and cares for herself, but tires more easily than before and cannot go shopping alone (uses a taxi).

Calculation

Symptoms present and affect usual activities (needs help with shopping), but self-care is preserved and she walks independently → mRS 2.

Interpretation and management

Slight disability (mRS 2). This is a "good functional outcome" by accepted criteria. Recommendations: continue secondary prevention (antiplatelet therapy or anticoagulation for atrial fibrillation, statin, blood pressure control), outpatient neurorehabilitation, speech therapy if dysarthria persists.

Limitations and cautions

Subjectivity — the same patient may be scored differently by different examiners. Structured interviews (e.g., the mRS Structured Interview) are used to reduce this.
Does not capture cognitive or psychological consequences of stroke — additional scales (MMSE, MoCA) are needed.
Coarse grouping — mRS 2 includes a very heterogeneous group of patients.
Does not account for the etiology or severity of the initial stroke.

Related calculators

Frequently asked questions

Why is mRS 2 considered a "good outcome"?

Because the patient remains independent in self-care. mRS 0-2 is associated with quality of life close to pre-stroke levels and the ability to live at home without constant assistance.

How should mRS be assessed in an elderly patient with baseline disability?

Compare with premorbid status. If the patient had mRS 3 before the stroke (required help), a "good outcome" is a return to mRS 3, not achieving mRS 0.

Is mRS used in hemorrhagic stroke?

Yes, the scale is universal for all stroke types and for subarachnoid hemorrhage.

When should mRS first be assessed?

Premorbid mRS (before the stroke) is assessed on admission from history. Current mRS is assessed at discharge. Follow-up mRS is assessed at day 90. Many centers also assess at day 30 and at 1 year.

All clinical calculators in one place

Validated scores and formulas with full interpretation, clinical examples and source references. Open access, no registration required.

65+ calculators · scores and formulas · interpretation with management notes

Browse all calculators

АА

Aleksandr A. Aulov Physician, internal medicine, Sechenov School — independent medical education platform. Calculators are compiled from the original publications and current clinical guidelines. Interpretation thresholds follow the source study unless stated otherwise.

This calculator is intended for healthcare professionals. Do not use it for self-diagnosis or self-treatment. Management decisions are made by the treating clinician based on the full clinical picture of the individual patient.