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neurology

ALS Functional Rating Scale (ALSFRS-R)

Assesses functional decline in ALS/MND across 12 domains. Serial scores track progression rate and guide intervention timing (PEG, NIV).

Score interpretation

Mild functional impairment

→ Continue MDT support; SLT; physiotherapy; nutritional review; respiratory monitoring (FVC); next clinic in 3 months

Moderate impairment — intervention planning

→ NIV consideration if FVC <65% or symptomatic; PEG/RIG if weight loss >10% or dysphagia; AAC devices; occupational therapy; carer support; ACP discussion

Advanced disease — urgent interventions

→ NIV if not started; consider palliative NIV; enteral feeding; 24h care; hospice referral; anticipatory prescribing; DNACPR discussion; carer bereavement support

Interpretation bands for the ALSFRS-R. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.