1998

THE AMYOTROPHIC LATERAL SCIEROSIS FUNCTIONAL RATING SCALE (ALSFRS)

A. SPEECH

4	NORMAL SPEECH PROCESSES
3	DETECTABLE SPEECH DISTURBANCES
2	INTELLIGIBLE WITH REPEATING
1	SPEECH COMBINED WITH NONVOCAL COMMUNICATION
0	LOSS OF USEFUL SPEECH

B. SALIVATION

4	NORMAL
3	SLIGHT BUT DEFINITE EXCESS OF SALIVA IN MOUTH; MAY HAVE NIGHTIME DROOLING
2	MODERATELY EXCESSIVE SALIVA; MAY HAVE MINIMAL DROOLING
1	MARKED EXCESS OF SALI VA WITH SOME DROOLING
0	MARKED DROOLING; REQUIRES CONSTANT TISSUE OR HANDKERCHIEF

C. SWALLOWING

4	NORMAL EATING HABITS
3	EARLY EATING PROBLEMS-OCCASIONAL CHOKING
2	DIETARY CONSISTENCY CHANGES
1	NEEDS SUPPLEMENTAL TUBE FEEDING
0	NPO (EXCLUSIVELY PARENTERAL OR ENTERAL FEEDING)

D. HANDWRITING

4	NORMAL
3	SLOW OR SLOPPY; ALL WORDS ARE LEGIBLE
2	NOT ALL WORDS ARE LEGIBLE
1	ABLE TO GRIP PEN BUT UNABLE TO WRITE
0	UNABLE TO GRIP PEN

E. CUTTING FOOD AND HANDLING UTENSILS (PATIENTS WITHOUT GASTROSTOMY-FEEDING TUBE)

4	NORMAL
3	SOMEWHAT SLOW AND CLUMSY BUT NO HELP NEEDED
2	CAN CUT MOST FOODS, ALTHOUGH CLUMSY AND SLOW ,SOME HELP NEEDED
1	FOOD MUST BE CUT BY SOMEONE, BUT CAN STILL FEED SLOWLY
0	NEEDS TO BE FED

CUTTING FOOD AND HANDLING UTENSILS (ALTERNATE SCALE FOR PATIENTS WITH GASTROSTOMY-FEEDING TUBE)

4	NORMAL
3	CLUMSY BUT ABLE TO PERFORM ALL MANIPULATIONS INDEPENDENTLY
2	SOME HELP NEEDED WITH CLOSURES AND FASTENERS
1	PROVIDES MINIMAL ASSISTANCE TO CAREGIVER
0	UNABLE TO PERFORM ANY ASPECT OF TASK

F. DRESSING AND HYGIENE

4	NORMAL FUNCTION
3	INDEPENDENT AND COMPLETE SELF-CARE WITH EFFORT OF DECREASED EFFICIENCY
2	INTERMITTENT ASSISTANCE OR SUBSTITUTE METHODS
1	NEEDS ATTENDANT FOR SELF-CARE
0	TOTAL DEPENDENCE

G. TURNING IN BED AND ADJUSTING BED CLOTHES

4	NORMAL
3	SOMEWHAT SLOW AND CLUMSY, BUT NO HELP NEEDED
2	CAN TURN ALONE AND ADJUST SHEETS, BUT WITH GREAT DIFFICULTY
1	CAN INITATE, BUT NOT TURN OR ADJUST SHEETS ALONE
0	HELPLESS

H. WALKING

4	NORMAL
3	EARLY AMBULATION DIFFICULTIES
2	WALKS WITH ASSISTANCE
1	NONAMBULATORY FUNCTIONAL MOVEMENT
0	NO PURPOSEFUL LEG MOVEMENT

I. CLIMBING STAIRS

4	NORMAL
3	SLOW
2	MILD UNSTEADINESS OR FATIGUE
1	NEEDS ASSISTANCE
0	CANNOT DO

J. BREATHING

4	*NORMAL*
3	SHORTNESS OF BREATH WIYH MINIMAL EXERTION (EG. WALKING TALKING)
2	SHORTNESS OF BREATH AT REST
1	INTERMITTEN (E.G. NOCTURNAL) VENTILATORYASSISTANCE
0	VENTILATOR DEPENDENT