Performance Scales(PS) uses a single question to assess each of eleven domains (mobility, hand function, vision, fatigue, cognition, bladder/bowel, sensory, spasticity, pain, depression and tremor/coordination). All of the subscales are scored ordinally as follows 0 (normal), 1 (minimal),2 (mild), 3 (moderate), 4 (severe), or 5 (total disability), except mobility which is scored from 0 to 6; total scores range from 0 to 41.

With validated DeltaQuest copyrighted translations available in 18 language versions in addition to the United States English version, the measure is amenable as a clinical research tool in many contexts and countries (www.deltaquest.org).

  • Marrie RA, Goldman M. Validity of performance scales for disability assessment in multiple sclerosis. Mult Scler 2007;13:1176-82.

The FSMC is an assessment of MS-related cognitive and motor fatigue. A Likert-type 5-point scale (ranging from ‘does not apply at all’ to ‘applies completely’) produces a score between 1 and 5 for each scored question. Thus minimum value is 20 (no fatigue at all) and maximum value is 100 (severest grade of fatigue). Two subscales (mental and physical fatigue) can be made. Items included in the subscale mental are 1-4-7-8-11-13-15-17-18-20 and items included in the subscale physical are 2-3-5-6-9-10-12-14-16-19. Copyrighted translations © Penner et al., 2005 are available.

  • Penner IK, Raselli C, Stocklin M, Opwis K, Kappos L, Calabrese P. The Fatigue Scale for Motor and Cognitive Functions (FSMC): validation of a new instrument to assess multiple sclerosis-related fatigue. Multiple Sclerosis 2009;15:1509-17.


The MSIS-29 is a 29-item self-report measure with 20 items associated with a physical scale and 9 items with a psychological scale. Items ask about the impact of MS on day-to-day life in the past two weeks. All items have 5 response options: 1 “not at all” to 5”extremely”. Each of the two scales are scored by summing the responses across items, then converting to a 0-100 scale where 100 indicates greater impact of disease on daily function (worse health).

The physical impact score is computed by summing items number 1-20 inclusive. This score can then be transformed to a score on a scale of 0 -100 using the formula below:

(100*(observed score-20))

The psychological impact score is computed by summing items number 21-29 inclusive. This score can then be transformed to a score on a scale of 0 -100 using the formula below:

(100*(observed score-9))

For respondents with missing data, but where at least 50% of the items in a scale have been completed, a respondent–specific mean score computed from the completed items can be computed.

For example, consider person X who has completed 15 items in the physical scale. Sum the completed items and divide by 15 to get person X’s respondent–specific mean score. Then use this value as the score for EACH of the missing 5 items. Then generate a total score as usual by summing the values of the 15 completed items and the 5 imputed items.
Note: respondents MUST have completed a minimum of 10 items in the physical scale, or 5 items in the psychological scale to use this imputing process.

It is copyrighted, ‘© 2006 University of Plymouth, University College London and Plymouth Hospitals NHS Trust. All Rights Reserved.’ Available in many languages.

  • Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A. The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain 2001;124:962-73.


The EQ-5D-5L is a standardized measure of health status developed by the Euroqol group in order to provide a simple, generic measure of health for clinical and economic appraisal, by a simple descriptive profile and a single index value for health status. The EQ-5D has been translated in more than 100 languages and is used worldwide.
More information can be find on http://www.euroqol.org/

  • Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011;20:1727-36.


The ABILHAND is a self-reported measure of perceived ease or difficulty that a persons may experience when performing bilateral ADL tasks in the last 3 months. During a semi-structured interview, persons are asked to rate 23 bilateral ADL tasks using a 3-point ordinal scale. The score of the different tasks are summed up and transformed using a Rasch-derived conversion table. This is currently available in English, Dutch, French but will be much expanded in near future.
More information can be found on www.rehab-scales.org.

  • Barrett L, Cano S, Zajicek J, Hobart J. Can the ABILHAND handle manual ability in MS? Mult Scler 2013;19:806-15..

The Edingburgh Handedness Inventory defines hand dominance by asking preference in hand use on 10 activities.

  • Oldfield RC. The assessment and analysis of handedness: The edinburgh inventory. Neuropsychologia. 1971;9:97-113


The Manual Ability Measurement (MAM-36) is a questionnaire on perceived ease or difficulty that a persons may experience when performing unilateral and bilateral ADL tasks. During a semi-structured interview, the persons are asked to rate 36 unilateral and bilateral ADL tasks using a 4-point scale. The score of the different tasks are summed up and transformed using a Rasch-derived conversion table.

SOP, Item 11: a towel many also be washcloth, floor cloth, cleaning cloth, …

  • Chen CC, Bode RK. Psychometric validation of the Manual Ability Measure-36 (MAM-36) in patients with neurologic and musculoskeletal disorders. Arch Phys Med Rehabil 2010;91:414-20.


The ABC is a 16-item self-report questionnaire that asks people to rate their balance confidence in performing everyday activities on a numeric rating scale (range, 0-100). A score of zero represents no confidence and a score of 100 represents complete confidence in performing the activity. The overall score is calculated by dividing the sum of the item scores by the total number of items.

  • Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci 1995; 50A(1):M28-M34


The International physical activity questionnaire (IPAQ) is used to subjectively assess physical activity undertaken across a comprehensive set of domains (leisure time physical activity, domestic and gardening (yard) activities, work-related physical activity and transport-related physical activity).

This physical activity questionnaire is publically available, it is open access, and no permissions are required to use it. Information about the use of the questionnaire and links to the questionnaire itself, in multiple languages can be found on the website www.ipaq.ki.se. Here you can find translations in Czech and Serbian.

  • Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine and science in sports and exercise. 2003;35:1381-1395


The Multiple Sclerosis Walking Scale is a self-assessment scale which measures the impact of MS on walking. It consists of 12 questions concerning the limitations to walking due to MS during the past 2 weeks. Each item can be answered with 5 options, with 1 meaning no limitation and 5 extreme limitation.

A total score can be generated and transformed to a 0 to 100 scale by subtracting the minimum score possible (12) from the patient’s score, dividing by the maximum score possible minus the minimum possible (60-12 or 48), and multiplying the result by 100. Walking improvement on the MSWS-12 is indicated by negative change scores.

This questionnaire (original English version and all diverse translated versions) is copyrighted, ‘© 2006 University of Plymouth, University College London and Plymouth Hospitals NHS Trust. All Rights Reserved.’ No part of the translated PRO’s may be used for profit or commercial purposes without prior approval from the University of Plymouth, University College London and Plymouth Hospitals NHS Trust and RIMS.

  • Hobart JC, Riazi A, Lamping DL, Fitzpatrick R, Thompson AJ. Measuring the impact of ms on walking ability: The 12-item ms walking scale (msws-12). Neurology. 2003;60:31-36


The Rivermead Mobility Index1 is a measuring instrument for functional loss related to body mobility. It measures the patient’s ability to move her or his own body. It does not measure how the patient manages in a wheelchair, or the patient’s functional ability when needing personal aid. The patient is asked the following 15 questions and observed (for item 5). A score of 1 is given for each ‘yes’ answer. Note that most require independence from personal help, but method is otherwise unimportant.

This questionnaire is copyrighted,  OCE 2015. Reproduce freely, but acknowledge source and do not sell.

The use of 0-1 scoring above a score range of 0-1-2-3 is recommended and one should avoid the modified RMI as this is less valid and less sensitive2.

It has been used in postal versions, and over the telephone and in other ways. It is very robust.


  • When asking for stairs patients living in single-storey accommodation were asked whether they could climb stairs if the need arose (for example, when visiting friends).
  • ‘Standby help’ means that the patient can perform safely without the therapist/other person to interfere (eg catch when falling, …). The need for ‘supervision’ for safety reasons should be due to objective danger that is posed, rather than ‘just in case’.
  1. Collen FM, Wade DT, Robb GF, Bradshaw CM. The rivermead mobility index: A further development of the rivermead motor assessment. Int.Disabil.Stud. 1991;13:50-54
  2. Rossier P, Wade DT. Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment. Archives of physical medicine and rehabilitation. 2001;82:9-13