Page 385

Appendix D

Kurtzke's Expanded Disability Status Scale (EDSS)

0

Normal neurologic exam

1.0

No disability, minimal signs in one functional system

1.5

No disability, minimal signs in more than one functional system

2.0

Minimal disability in one functional system

2.5

Minimal disability in two functional systems

3.0

Moderate disability in one functional system, or mild disability in three or four functional systems though fully ambulatory

3.5

Fully ambulatory but with moderate disability in three or four functional systems

4.0

Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability. Able to walk without aid or rest some 500 meters

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. Able to walk without aid or rest for some 300 meters

5.0

Ambulatory without aid or rest for about 200 meters; disability severe enough to preclude full daily activities (e.g. to work full day without special provisions)



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OCR for page 385
Page 385 Appendix D Kurtzke's Expanded Disability Status Scale (EDSS) 0 Normal neurologic exam 1.0 No disability, minimal signs in one functional system 1.5 No disability, minimal signs in more than one functional system 2.0 Minimal disability in one functional system 2.5 Minimal disability in two functional systems 3.0 Moderate disability in one functional system, or mild disability in three or four functional systems though fully ambulatory 3.5 Fully ambulatory but with moderate disability in three or four functional systems 4.0 Fully ambulatory without aid, self-sufficient, up and about some 12 hours a day despite relatively severe disability. Able to walk without aid or rest some 500 meters 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. Able to walk without aid or rest for some 300 meters 5.0 Ambulatory without aid or rest for about 200 meters; disability severe enough to preclude full daily activities (e.g. to work full day without special provisions)

OCR for page 385
Page 386 5.5 Ambulatory without aid or rest for about 100 meters; disability severe enough to preclude full daily activities 6.0 Intermittent or unilateral constant assistance (cane, crutch, or brace) required to walk about 100 meters with or without resting 6.5 Constant bilateral assistance (canes, crutches, or braces) required to walk about 20 meters without resting 7.0 Unable to walk beyond about 5 meters even with aid. Essentially restricted to a wheelchair. Wheels self in standard wheelchair and transfers alone. Active in wheelchair about 12 hours a day 7.5 Unable to take more than a few steps. Restricted to wheelchair. May need aid to transfer. Wheels self but cannot carry on in standard wheelchair a full day. May require a motorized wheelchair 8.0 Unable to walk at all, essentially restricted to bed, chair or wheelchair but may be out of bed much of the day. Retains many self-care functions. Generally has effective use of the arms 8.5 Essentially restricted to bed much of the day. Has some effective use of arm(s). Retains some self-care functions 9.0 Helpless bed patient. Can communicate and eat 9.5 Totally helpless bed patient. Unable to communicate effectively or eat/ swallow 10 Death due to Multiple Sclerosis SOURCE: Kurtzke JF. 1983. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology.;33:1444-52.