| 0 |
Normal neurological exam (all grade 0 in Functional Systems (FS); cerebral grade 1 acceptable). |
| 1 |
No disability, minimal signs in one FS (i.e., one grade 1 excluding cerebral grade 1). |
| 1.5 |
No disability, minimal signs in more than one FS (more than one grade 1 excluding cerebral grade 1). |
| 2.0 |
Minimal disability in one FS (one FS grade 2, others 0 or 1). |
| 2.5 |
Minimal disability in two FS (two FS grade 2, others 0 or 1). |
| 3.0 |
Moderate disability in one FS (one FS grade 3, others 0 or 1), or mild disability in three or four FS (three-four FS grade 2, others 0 or 1). |
| 3.5 |
Fully ambulatory but with moderate disability in one FS (one grade 3 and one or two FS grade 2) or two FS grade 3, others 0 or 1, or five FS grade 2, others 0 or 1. |
| 4.0 |
Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability consisting of one FS grade 4 (others 0 or 1), or combinations of lesser grades exceeding limits of previous steps. Able to walk without aid or rest some 500 meters. (0.3 miles) |
| 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; characterized by relatively severe disability, usually consisting of one FS grade 4 (others 0 or 1) or combinations of lesser grades exceeding limits of previous steps. Able to walk without aid or rest for some 300 meters. (975 ft) |
| 5.0 |
Ambulatory without aid or rest for about 200 meters (650 feet); disability severe enough to impaire full daily activities (e.g., to work full day without special provisions). (Usual FS equivalents are one grade 5 alone, others 0 or 1; or combinations of lesser grades usually exceeding specifications for step 4.0) |
| 5.5 |
Ambulatory without aid or rest for about 100 meters (325 ft); disability severe enough to impair full daily activities. (Usual FS equivalents are one grade 5 alone, others 0 or 1; or combinations of lesser grades usually exceeding specifications for step 4.0) |
| 6.0 |
Intermittent or constant unilateral assistance (cane, crutch, brace)required to walk about 100 meters (325 ft) with or without resting. (Usual FS equivalents are combinations with more than two FS grade 3+) |
| 6.5 |
Constant bilateral assistance (canes, crutches, braces) required to walk about 20 meters (65 ft). (Usual FS equivalents are combinations with more than two FS grade 3+) |
| 7.0 |
Unable to walk beyond about 5 meters (16 ft) even with aid, essentially restricted to wheelchair; wheels self in standard wheelchair a full day and transfers alone; up and about in wheelchair some 12 hours a day. Usual FS equivalents are combinations with more than one FS grade 4+; very rarely pyramidal grade 5 alone. |
| 7.5 |
Unable to take more than a few steps; restricted to wheelchair; may need aid in transfers, wheels self but cannot carry on in standard wheelchair a full day; may require motorized wheelchair; usual FS equivalents are combinations with more than one FS grade 4+ |
| 8.0 |
Essentially restricted to bed or chair or perambulated in wheelchair; but may be out of bed much of the day; retains many self-care functions; generally has effective use of arms. Usual FS equivalents are combinations, generally grade 4+ in several systems. |
| 8.5 |
Essentially restricted to bed for much of the day; has some effective use of arm(s); retains some self-care functions. Usual FS equivalents are combinations, generally grade 4+ in several systems. |
| 9.0 |
Helpless bed patient; can communicate and eat. Usual FS equivalents are combinations, mostly grade 4. |
| 9.5 |
Totally helpless bed patient; unable to communicate effectively or eat/swallow. Usual FS equivalents are combinations, almost all grade 4+ |
| 10 |
Death due to MS. |
