MS Scales | Brigham Multiple Sclerosis Center

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<div class="drop-bg"></div> <div class="drop-menu for-patients" aria="hidden" data-cdrop="for-patients" style="" data-mwidth="0"> <div class="container-fluid p-0"> <div class="row row-eq-height"> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>MS Diagnosis & Symptoms</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/b63277ecb18a491a97c63ae847788385" href="/for-patients/about-ms#about-ms" title="MS Diagnosis & Symptoms | About MS" data-anchor="#about-ms">About MS</a></li> <li><a data-udi="umb://document/b63277ecb18a491a97c63ae847788385" href="/for-patients/about-ms#ms-world-distribution" title="MS Diagnosis & Symptoms | Distribution" data-anchor="#ms-world-distribution">Distribution</a></li> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#clinical-signs-and-symptoms" title="MS Diagnosis & Symptoms | Signs" data-anchor="#clinical-signs-and-symptoms">Signs</a></li> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#clinical-signs-and-symptoms" title="MS Diagnosis & Symptoms | Symptoms" data-anchor="#clinical-signs-and-symptoms">Symptoms</a></li> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#diagnosis" title="MS Diagnosis & Symptoms | Diagnosis" data-anchor="#diagnosis">Diagnosis</a></li> </ul> </div> </div> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>Treatment</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#treatment-overview" title="Treatment | Treatment Overview" data-anchor="#treatment-overview">Treatment Overview</a></li> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#disease-modifying-treatments" title="Treatment | Disease Modifying Treatments" data-anchor="#disease-modifying-treatments">Disease Modifying Treatments</a></li> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#symptoms-treatment" title="Treatment | Symptomatic Treatment" data-anchor="#symptoms-treatment">Symptomatic Treatment</a></li> </ul> </div> </div> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>Living with MS</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/f62b2e0d4c72482a902f32a030ee15a4" href="/for-patients/diagnosing-treating-ms#flu-shots" title="Living with MS | Flu Shots" data-anchor="#flu-shots">Flu Shots</a></li> <li><a data-udi="umb://document/08b1fe2aadeb4472a49ee295100c56fc" href="/for-patients/quality-of-life#support-groups" title="Living with MS | Support Groups" data-anchor="#support-groups">Support Groups</a></li> <li><a data-udi="umb://document/b63277ecb18a491a97c63ae847788385" href="/for-patients/about-ms#patient-resources" title="Living with MS | Patient Resources" data-anchor="#patient-resources">Patient Resources</a></li> <li><a data-udi="umb://document/08b1fe2aadeb4472a49ee295100c56fc" href="/for-patients/quality-of-life#diet" title="Living with MS | Nutrition" data-anchor="#diet">Nutrition</a></li> <li><a data-udi="umb://document/08b1fe2aadeb4472a49ee295100c56fc" href="/for-patients/quality-of-life#exercise" title="Living with MS | Exercise" data-anchor="#exercise">Exercise</a></li> <li><a data-udi="umb://document/08b1fe2aadeb4472a49ee295100c56fc" href="/for-patients/quality-of-life#positive-psychology" title="Living with MS | Positive Psychology for Individuals with MS" data-anchor="#positive-psychology">Positive Psychology for Individuals with MS</a></li> </ul> </div> </div> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>Other Neuroinflammatory Diseases</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/b63277ecb18a491a97c63ae847788385" href="/for-patients/about-ms#neuromyelitis-optica" title="Other Neuroinflammatory Diseases | NMO, MOGAD" data-anchor="#neuromyelitis-optica">NMO, MOGAD</a></li> </ul> </div> </div> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>COVID-19</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/e9db02dc492d488580298602faf5463a" href="/for-patients/covid-19" title="COVID-19 | COVID-19 & MS" data-anchor="#">COVID-19 & MS</a></li> <li><a data-udi="umb://document/15aba49ddf0643af84d22d385da8d53d" href="/for-patients/covid-19/covid-19-vaccines" title="COVID-19 | COVID-19 Vaccines" data-anchor="#">COVID-19 Vaccines</a></li> </ul> </div> </div> <div class="col-md-2 bg- pt-0 pb-0" style="" > <h5>Frequently Asked Questions</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/c29ff0e760204f8682438fcae61f2d77" href="/for-patients/faq" title="FAQ" data-anchor="#">FAQ</a></li> </ul> </div> </div> </div> </div> </div> <div class="drop-menu for-providers" aria="hidden" data-cdrop="for-providers" style="" data-mwidth="0"> <div class="container-fluid p-0"> <div class="row row-eq-height"> <div class="col-md-3 bg- pt-0 pb-0" style="" > <h5>Resources</h5> <div class="listNodesWidget"> <ul> <li><a data-udi="umb://document/52a840096bc14525a20d53f59cf8547a" href="/for-providers/ms-scales" title="MS Scales" data-anchor="#">MS Scales</a></li> </ul> </div> </div> </div> </div> </div> </div> </div> <script src="/_assets/js/custom-nav-drop.js" async type="text/javascript"></script> <div class="allbutnav"> <header class="outermost stripheaderimage stripHeaderGridManual gradient-header stellarprops bg- text- vh-60" style="background-repeat: no-repeat; background-size: cover; " data-stellar-background-ratio="0.8" data-stellar-horizontal-offset="0"> <div class="container-fluid mt-0 mb-0 pt-0 pb-0 vh-60 "> <div class="row align-items-center "> <div class="col-md-12 bg- align-items-center col-lg-10 col-xl-7 mr-xl-9 text-white mt-auto pt-0 pb-0" style=""> <div class="header-content"> <h1 class="display-2">MS Scales</h1> </div> </div> </div> </div> </header> <style type="text/css"> .stripHeaderGridManual { background-image: url(https://cdn.asdfinc.io/media/25082/adobestock_483995742.jpeg?anchor=center&mode=crop&width=1600&height=1200&rnd=133021965570000000&quality=80); background-position: center center; } @media (min-width: 480px) { .stripHeaderGridManual { background-image: url(https://cdn.asdfinc.io/media/25082/adobestock_483995742.jpeg?anchor=center&mode=crop&width=1600&height=900&rnd=133021965570000000&quality=80); background-position: center center; } } @media (min-width: 992px) { .stripHeaderGridManual { background-image: url(https://cdn.asdfinc.io/media/25082/adobestock_483995742.jpeg?anchor=center&mode=crop&width=1920&height=1080&rnd=133021965570000000&quality=80); background-position: center center; } } </style> <div class="main-content Content parent-Content"> <section id="ms-scales"> <div class="outermost astrip stripGridManual stripGrid2Cell bg-white text- " style="" > <div class="container mt-0 mb-0 pt-7 pb-3 " > <div class="row justify-content-center "> <div class="col-md-8 bg- pt-0 pb-0" style="" > <div class="text-center pb-4"> <h2>MS Scales</h2> </div> <div class="accordion collapsiblePanelsWidget card-collapsible-panels" id="accordion74614e20-5e50-48c8-8bb0-7d18eeeb99b1"> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b10" id="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b10" aria-expanded="false" aria-controls="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b10"> The Expanded Disability Status Scale (EDSS) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b10" class="collapse" aria-labelledby="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b10" data-parent="#accordion74614e20-5e50-48c8-8bb0-7d18eeeb99b1"> <div class="card-body"> <div> <p>The EDSS is the most commonly used scale. The EDSS can help physicians monitor changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with MS. The EDSS focuses mainly on your ability to walk. In general, the EDSS can be broken down like this:</p> <p>0 = Normal.</p> <p>1-1.5 = No disability, but some abnormal neurological signs.</p> <p>2-2.5 = Minimal disability.</p> <p>3-4.5 = Moderate disability, affecting daily activities, but a patient can still walk.</p> <p>5-8 = More severe disability, impairing one’s daily activities and requiring assistance with walking.</p> <p>8.5-9.5 = Very severe disability, restricting a patient to bed.</p> <p>10 = Death.</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b11" id="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b11" aria-expanded="false" aria-controls="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b11"> Ambulation Index (AI) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b11" class="collapse" aria-labelledby="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b11" data-parent="#accordion74614e20-5e50-48c8-8bb0-7d18eeeb99b1"> <div class="card-body"> <div> <p>MS doctors may also assess a patient's AI.</p> <p>0 = Asymptomatic; fully active.</p> <p>1 = Walks normally but reports fatigue which interferes with athletic or other demanding activities.</p> <p>2 = Abnormal gait or episodic imbalance; gait disorder is noticeable to family and friends. Able to walk 25 feet in 10 seconds or less.</p> <p>3 = Walks independently; able to walk 25 feet in between 11-20 seconds.</p> <p>4 = Requires unilateral support (cane, single crutch) to walk. Walks 25 feet in 20 seconds or less.</p> <p>5 = Requires unilateral support but walks 25 feet in greater than 20 seconds or requires bilateral support (canes, crutches, walker) and walks 25 feet in 20 seconds or less.</p> <p>6 = Requires bilateral support and walks 25 feet in greater than 20 seconds. (May use wheelchair on occasion)*</p> <p>7 = Walking limited to several steps with bilateral support; unable to walk 25 feet. (May use wheelchair most of the time)</p> <p>8 = Restricted to wheelchair; able to transfer independently.</p> <p>9 = Restricted to wheelchair; unable to transfer independently.</p> <p>10 = Bedridden.</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b12" id="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b12" aria-expanded="false" aria-controls="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b12"> Disease Steps <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b12" class="collapse" aria-labelledby="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b12" data-parent="#accordion74614e20-5e50-48c8-8bb0-7d18eeeb99b1"> <div class="card-body"> <div> <p>MS Doctors also think of the overall disease step and how this evolves over time.</p> <p>0 = Normal – Functionally normal; no limitations on activity or lifestyle; RR; EDSS=0-1.5; AI=0; may have minor abnormality on exam (eg nystagmus, extensor plantar); attack frequency <1/year; return to baseline with/without treatment and generally not treated.</p> <p>1 = Mild Disability – Minor, but noticeable signs and/or symptoms (eg. sensory symptoms, minor bladder problems, fatigue); RR or very early CP; EDSS=2-2.5; AI=0-1 (ie-no visible abnormality of gait); attack frequency=1-2/year.</p> <p>2 = Moderate Disability – Main feature=abnormality of gait; AI=2-3; EDSS=2-4.5; able to work full day, but may find athletic activities difficult; RR-P or early CP; may need cane with attack but recover to independent ambulation.</p> <p>3 = Early Cane – EDSS=6; RR-P or CP; AI=2-3; may use a cane/unilateral support (eg spouse's arm) outside for greater distances, but can walk 25 feet in 20 seconds or less without a cane.</p> <p>4 = Late Cane – EDSS=6; RR-P or CP; AI=4-5; unable to walk 25 ft. without a cane/unilateral support(eg may hang on to furniture inside home or touch wall in clinic; use cane outside; may need a scooter for greater distances (eg in malls).</p> <p>5 = Bilateral Support – EDSS=6.5; AI=5-6; require bilateral support to walk 25 feet (eg 2 canes or crutches or walker); may use a scooter for greater distances.</p> <p>6 = Wheelchair – EDSS > 7; AI > 7; confined to wheelchair; may be able to take 1 or 2 steps, but cannot ambulate 25 feet even with bilateral support; may have further progression including problems with use of hands, inability to transfer.</p> <p>U = Unclassifiable – Used for patients who do not fit above classification; eg-significant cognitive or visual impairment.</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b13" id="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b13" aria-expanded="false" aria-controls="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b13"> MS Progression: Multiple Sclerosis Functional Composite (MSFC) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse74614e20-5e50-48c8-8bb0-7d18eeeb99b13" class="collapse" aria-labelledby="heading74614e20-5e50-48c8-8bb0-7d18eeeb99b13" data-parent="#accordion74614e20-5e50-48c8-8bb0-7d18eeeb99b1"> <div class="card-body"> <div> <p>The MSFC is a newer measurement system. It is sensitive to changes other than mobility. The MSFC often takes a bit more time to complete, so it is currently used less in clinic and more in clinical trials.</p> <p>The MSFC measures the following:</p> <ul> <li>Walking speed, using a timed 25-foot walk</li> <li>Arm and hand dexterity, using a nine-hole peg test</li> <li>Cognitive function, such as how well a patient can do math calculations, using the Paced Auditory Serial Additions Test (PASAT)</li> </ul> </div> </div> </div> </div> </div> </div> </div> </div> </div> </section> <section id="functional-status"> <div class="outermost astrip stripGridManual stripGrid2Cell bg-white text- " style="" > <div class="container mt-0 mb-0 pt-7 pb-7 " > <div class="row justify-content-center "> <div class="col-md-8 bg- pt-0 pb-4" style="" > <div class="text-center"> <h2>Functional Status</h2> </div> </div> <div class="col-md-8 bg- pt-0 pb-0" style="" > <div class="accordion collapsiblePanelsWidget card-collapsible-panels" id="accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd30" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd30" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd30"> Pyramidal Function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd30" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd30" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Abnormal signs without disability</p> <p>2<br />Minimal disability</p> <p>3<br />Mild or moderate paraparesis or hemiparesis; severe monoparesis</p> <p>4<br />Marked paraparesis or hemiparesis; moderate quadriparesis; or monoplegia</p> <p>5<br />Paraplegia, hemiplegia, or marked quadriparesis</p> <p>6<br />Quadriplegia</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd31" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd31" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd31"> Cerebellar function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd31" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd31" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Abnormal signs without disability</p> <p>2<br />Mild ataxia</p> <p>3<br />Moderate truncal or limb ataxia</p> <p>4<br />Severe ataxia all limbs</p> <p>5<br />Unable to do coordinated movements due to ataxia</p> <p>X<br />Is used after each number when weakness (grade 3 or more on pyramidal) interferes with testing</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd32" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd32" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd32"> Brainstem Function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd32" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd32" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Signs only</p> <p>2<br />Moderate nystagmus, or other mild disability</p> <p>3<br />Severe nystagmus, marked extraocular weakness, or moderate disability of other cranial nerves</p> <p>4<br />Marked dysarthria or other marked disability</p> <p>5<br />Inability to swallow or speak</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd33" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd33" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd33"> Sensory function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd33" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd33" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal vibration (VIB)/position sense (PS)</p> <p>1<br />Mild l VIB in 1 or 2 limbs; PS normal</p> <p>2<br />Moderate l VIB &/or mild l PS in 1 or 2 limbs OR mild l VIB in 3 or 4 limbs; PS normal</p> <p>3<br />Lost VIB &/or moderate l PS in 1 or 2 limbs OR moderate l PS in 3 or 4 limbs</p> <p>4<br />Lost PS in 1 or 2 limbs OR severe l PS in 3 or 4 limbs</p> <p>5<br />Lost PS in 3 or 4 limbs</p> <p>6<br />Sensation lost below the head</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd34" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd34" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd34"> Bowel and bladder function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd34" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd34" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Mild hesitancy, urgency, or retention</p> <p>2<br />Moderate hesitancy, urgency, or retention, or rare urinary incontinence</p> <p>3<br />Frequent incontinence</p> <p>4<br />In need of almost constant catheterization</p> <p>5<br />Loss of bladder control</p> <p>6<br />Loss of bowel and bladder control</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd35" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd35" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd35"> Visual function (best corrected) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd35" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd35" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Scotoma with acuity better than 20/30</p> <p>2<br />Worse eye=20/30-20/59</p> <p>3<br />Worse eye=20/60-20/99</p> <p>4<br />Worse eye=20/100-20/200 OR #3 + better eye worse than or=to 20/60</p> <p>5<br />Worse eye less than 20/200 OR #4 + better eye worse than or=to 20/60</p> <p>6<br />#5 + better eye worse than or=to 20/60</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd36" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd36" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd36"> Mental Function <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd36" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd36" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Mood alteration only (does not affect EDSS score)</p> <p>2<br />Mild decrease in mentation</p> <p>3<br />Moderate decrease in mentation</p> <p>4<br />Marked decrease in mentation</p> <p>5<br />Dementia – severe or incompetent</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd37" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd37" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd37"> Right Hand Function (not included in EDSS) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd37" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd37" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Mild-minor problems with coordinated tasks</p> <p>2<br />Moderate-unable to write clearly</p> <p>3<br />Severe-unable to feed self</p> </div> </div> </div> </div> <div class="card">  <a class="card-header" data-toggle="collapse" data-target="#collapse4ff75f7c-3056-476d-b6eb-dfe013198fd38" id="heading4ff75f7c-3056-476d-b6eb-dfe013198fd38" aria-expanded="false" aria-controls="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd38"> Left Hand Function (not included in EDSS) <span class="card-block-toggle-icon align-self-right"><i class="fa fa-chevron-down"></i></span> </a> <div id="collapse4ff75f7c-3056-476d-b6eb-dfe013198fd38" class="collapse" aria-labelledby="heading4ff75f7c-3056-476d-b6eb-dfe013198fd38" data-parent="#accordion4ff75f7c-3056-476d-b6eb-dfe013198fd3"> <div class="card-body"> <div> <p>0<br />Normal</p> <p>1<br />Mild-minor problems with coordinated tasks</p> <p>2<br />Moderate-unable to write clearly</p> <p>3<br />Severe-unable to feed self</p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </section> </div> <footer class=""> <div > <div class="outermost astrip stripGridManual text-light bg-tertiary-darker text-center text-md-left stripGrid2Cell bg- text- " style="" > <div class="container-fluid mt-0 mb-0 pt-5 pb-5 " > <div class="row "> <div class="col-md bg- pt-0 pb-0" style="" > <a href="/" class="widget 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