Report Viewer

NINDS CDE Notice of Copyright
Pediatric Modified Rankin Scale (mRS)
Availability
Public access.
 
Click here for Bigi, et al version.
Click here for Cnossen, et al version.
Classification
Exploratory: Stroke
Short Description of Instrument
Purpose: To assess global neurological impairment following stroke in children
 
Overview: This is a modification of the adult Modified Rankin Scale (mRS) which takes into account age-related expectations of neurologic function. There are two published pediatric modifications of the mRS (Bigi, 2011; Cnossen, 2010). Neither version has been subjected to rigorous evaluation of inter-rater reliability or validity. The version published by Bigi is more comparable to the adult version of the mRS, and is the most widely used of the two versions. A comparison of the PSOM and pediatric mRS showed concordance of the two instruments in 88% of subjects when dichotomized into "good" vs "poor" outcomes (Bulger, 2011).
 
Time: 5 min (scored after completing a standard clinical neurologic examination)
Comments/Special Instructions
N/A
Scoring and Psychometric Properties
Scoring:
Pediatric mRS modification of Bigi, et al:
 
  1. No symptoms at all

  2. No significant disabilities despite symptoms; behavior appropriate to age and normal further development

  3. Slight disability; unable to carry out all previous activities, but same independence as other age- and sex-matched children, according to gross motor function scale (Palisano et al 1997)

  4. Moderate disability; requiring some help, but able to walk without assistance; in younger patients adequate motor development despite mild functional impairment, defined as reduction of 1 level on the gross motor function scale

  5. Moderately severe disability; unable to walk without assistance; in younger patients reduction of at least 2 levels on the gross motor function scale

  6. Severe disability; bedridden, requiring constant nursing care and attention

  7. Dead

Pediatric mRS, modification of Cnossen, et al:
  1. No residual disability; the child attends regular education and does not need remedial teaching

  2. Mild residual disability; the child is able to attend regular education but needs remedial teaching because of mild motor disturbances, mild learning disability, or both

  3. Severe residual disability; the child has a severe motor deficit (needs braces or wheelchair), severe learning disability, or both, attends a school for special education or is confined to a daily care center

  4. Dead

 
Psychometric Properties: N/A
References
Bigi S, Fischer U, Wehrli E, Mattle HP, Boltshauser E, Burki S, Jeannet P, Fluss J, Weber P, Nedeltchev K, El-Koussy M, Steinlin M, Arnold M Acute ischemic stroke in children versus young adults. Ann Neurol 2011;70(2): 245-254.
 
Bulder MM, Hellmann PM, van Nieuwenhuizen O, Kappelle LJ, Klijn CJ, Braun KP Measuring outcome after arterial ischemic stroke in childhood with two different instruments. Cerebrovasc Dis 2011;32(5):463-70.
 
Cnossen MH, Aarsen FK, Akker SLj, Danen R, Appel IM, Steyerberg EW, Catsman-Berrevoets CE. Paediatric arterial ischaemic stroke: functional outcome and risk factors. Dev Med Child Neurol. 2010;52(4):394-9.
 
Palisano R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997;39: 214-23.

 

Document last updated April 2020