Expanded Disability Status Scale: Difference between revisions

Latest revision as of 16:27, 16 February 2025

Expanded Disability Status Scale[edit]

The Expanded Disability Status Scale (EDSS) is a method of quantifying disability in multiple sclerosis (MS) and monitoring changes in the level of disability over time. The scale was developed by John F. Kurtzke in 1983 and is widely used in clinical trials and in the assessment of patients with MS.

Description[edit]

The EDSS quantifies disability in eight Functional Systems (FS) and allows neurologists to assign a Functional System Score (FSS) in each of these. The FS include:

Pyramidal (motor function)
Cerebellar (coordination)
Brainstem (speech and swallowing)
Sensory (touch and pain)
Bowel and bladder function
Visual function
Cerebral (mental) function
Other

The EDSS score ranges from 0 to 10 in 0.5 increments, with 0 being normal neurological examination and 10 being death due to MS. Scores from 1.0 to 4.5 refer to people with MS who are fully ambulatory, while scores from 5.0 to 9.5 are defined by the impairment to ambulation.

Scoring[edit]

The scoring is based on a neurological examination and the patient's ability to walk. The scale is heavily weighted towards ambulation, with higher scores indicating greater disability:

0.0: Normal neurological exam
1.0-1.5: No disability, minimal signs in one FS
2.0-2.5: Minimal disability in one FS
3.0-3.5: Moderate disability in one FS
4.0-4.5: Significant disability but able to walk without aid
5.0-5.5: Disability severe enough to impair full daily activities
6.0-6.5: Requires a walking aid
7.0-7.5: Restricted to wheelchair
8.0-8.5: Restricted to bed or chair
9.0-9.5: Confined to bed, unable to communicate effectively
10.0: Death due to MS

Limitations[edit]

The EDSS is criticized for its emphasis on ambulation and its insensitivity to changes in other areas of disability, such as cognitive function. It may not fully capture the impact of MS on a patient's quality of life. Despite these limitations, it remains a standard tool in both clinical practice and research.

Related pages[edit]

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-'''Expanded Disability Status Scale''' (EDSS) is a method of quantifying disability in [[Multiple Sclerosis]] and monitoring changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with MS.
+== Expanded Disability Status Scale ==
-== Overview ==
+[[File:Kurtzke_scale.jpg|thumb|right|Diagram of the Expanded Disability Status Scale]]
-The EDSS scale ranges from 0 to 10 in 0.5 unit increments that represent higher levels of disability. Scoring is based on an examination by a neurologist.
+The '''Expanded Disability Status Scale''' ('''EDSS''') is a method of quantifying disability in [[multiple sclerosis]] (MS) and monitoring changes in the level of disability over time. The scale was developed by [[John F. Kurtzke]] in 1983 and is widely used in clinical trials and in the assessment of patients with MS.
-== Scale ==
+== Description ==
-* 0.0 - Normal neurological exam (all [[neurological]] tests are passed successfully).
+The EDSS quantifies disability in eight Functional Systems (FS) and allows neurologists to assign a Functional System Score (FSS) in each of these. The FS include:
-* 1.0 - No disability, minimal signs in one [[Functional System]] (FS).
-* 1.5 - No disability, minimal signs in more than one FS.
-* 2.0 - Minimal disability in one FS.
-* 2.5 - Minimal disability in two FS.
-* 3.0 - Moderate disability in one FS, or mild disability in three or four FS. Fully ambulatory.
-* 3.5 - Fully ambulatory but with moderate disability in one FS and more than minimal disability in several others.
-* 4.0 - Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability.
-* 4.5 - Fully ambulatory without aid, up and about much of the day, able to work a full day, may otherwise have some limitation of full activity or require minimal assistance.
-* 5.0 - Ambulatory without aid or rest for about 200 meters.
-* 5.5 - Ambulatory for about 100 meters without aid or rest.
-* 6.0 - Requires a cane, crutch or brace to walk about 100 meters with or without resting.
-* 6.5 - Requires two canes, crutches or braces to walk about 20 meters without resting.
-* 7.0 - Unable to walk beyond approximately 5 meters even with aid, essentially restricted to wheelchair.
-* 7.5 - Restricted to wheelchair, but able to transfer and self-care.
-* 8.0 - Essentially restricted to bed or wheelchair.
-* 8.5 - Essentially restricted to bed much of day, has some effective use of arms.
-* 9.0 - Helpless bed patient.
-* 9.5 - Totally helpless bed patient.
-* 10.0 - Death due to MS.
-== See also ==
+* Pyramidal (motor function)
+* Cerebellar (coordination)
+* Brainstem (speech and swallowing)
+* Sensory (touch and pain)
+* Bowel and bladder function
+* Visual function
+* Cerebral (mental) function
+* Other
-* [[Multiple Sclerosis]]
+The EDSS score ranges from 0 to 10 in 0.5 increments, with 0 being normal neurological examination and 10 being death due to MS. Scores from 1.0 to 4.5 refer to people with MS who are fully ambulatory, while scores from 5.0 to 9.5 are defined by the impairment to ambulation.
-* [[Functional System]]
-* [[Neurological Examination]]
-[[Category:Medical scales]]
+== Scoring ==
+The scoring is based on a neurological examination and the patient's ability to walk. The scale is heavily weighted towards ambulation, with higher scores indicating greater disability:
+* 0.0: Normal neurological exam
+* 1.0-1.5: No disability, minimal signs in one FS
+* 2.0-2.5: Minimal disability in one FS
+* 3.0-3.5: Moderate disability in one FS
+* 4.0-4.5: Significant disability but able to walk without aid
+* 5.0-5.5: Disability severe enough to impair full daily activities
+* 6.0-6.5: Requires a walking aid
+* 7.0-7.5: Restricted to wheelchair
+* 8.0-8.5: Restricted to bed or chair
+* 9.0-9.5: Confined to bed, unable to communicate effectively
+* 10.0: Death due to MS
+== Limitations ==
+The EDSS is criticized for its emphasis on ambulation and its insensitivity to changes in other areas of disability, such as cognitive function. It may not fully capture the impact of MS on a patient's quality of life. Despite these limitations, it remains a standard tool in both clinical practice and research.
+== Related pages ==
+* [[Multiple sclerosis]]
+* [[John F. Kurtzke]]
+* [[Functional Systems]]
+{{Multiple sclerosis}}
+[[Category:Neurology]]
 [[Category:Multiple sclerosis]]
-[[Category:Neurology]]
-{{stub}}
-{{dictionary-stub1}}