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Expanded Standard Disability Status Scale (EDSS)

The EDSS scale extends from 0 (normal neurological examination) to 10 (death from MS complications) in 0.5 unit increments. EDSS 1.0 to 4.5 refers to patients who are fully ambulatory. The precise steps are denoted by functional scores which are graded from normal (0) to maximal impairment (5 or 6) for pyramidal, cerebellar, brain stem, sensory, bowel and bladder, visual, cerebral or mental, and other functions. EDSS 5.0 to 9.5 are defined by impairment to ambulation. The definitions for points 3 to 7 are given below:
3 Moderate disability in one functional score or mild disability in three or four functional scores, though fully ambulatory.
4 Fully ambulatory without aid; self-sufficient; up and about some 12 hours a day despite relatively severe disability consisting of one functional score grade 4 (others 0 or 1) or combinations of lesser grades exceeding limits of previous steps; able to walk 500 metres without aid or rest.
5 Ambulatory without aid or rest for about 200 metres; disability severe enough to impair full daily activities (unable to work a full day without special provision); usual functional scores are grade 5 alone (others 0 or 1) or a combination of lesser grades, usually exceeding those for step 4.0.
6 Intermittent or unilateral constant assistance (walking stick, crutch, brace) required to walk about 100 metres with or without resting; usual functional score equivalents are combinations of more than two functional scores grade 3+.
7 Unable to walk beyond about 5 metres even with aid; essentially restricted to a wheelchair; wheels self in standard wheelchair and transfers alone; up and about in wheelchair some 12 hours a day; usual functional score equivalents are combinations with more than one functional score grade 4+; very rarely, pyramidal grade 5 alone.