How are ALS Functional Rating Scale (ALSFRS) scores interpreted in the assessment of amyotrophic lateral sclerosis (ALS)?

Updated: Jun 14, 2018
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Total scores reflect the impact of ALS, as follows:

  • >40 (minimal to mild)

  • 39-30 (mild to moderate)

  • < 30 (moderate to severe)

  • < 20 (advanced disease)

For an individual patient, loss of only 8-10 points on the ALSFRS-R may have severe implications; eg, if respiratory or bulbar function bears the brunt of the losses. A minor limitation of the scale is that it has a floor effect in terms of measuring disease progression in quadriparetic, ventilator-dependent patients.


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