Introducing the ALSFRS-R
The ALSFRS-R Scale

ALSFRS-R: Quantifying disease progression in ALS Clinical Trials

The ALS Functional Rating Scale-Revised (ALSFRS-R) is a widely used test in clinical trials for measuring and evaluating decline in physical function over time in ALS patients.2

The ALSFRS-R is a validated, questionnaire-based instrument that3
ALS physical function
Measures physical function in carrying out activities of daily living (ADL)3
ALS test
Assesses bulbar, fine motor, gross motor, and respiratory functions3
ALS and disability
Correlates with objective measures of disease status and level of disability2
ALS clinical trials
Is frequently used in ALS clinical trials and recommended by experts3
Is a simple, convenient, and easily reproducible measure that can be administered online or over the phone2
The ALSFRS-R scale provides a comprehensive measure of physical function.2

How does the ALSFRS-R help determine disability progression?

The ALSFRS-R measures 12 aspects of physical function categorized within 4 functional domains (bulbar, fine motor, gross motor, and respiratory)3

Each aspect of function is scored from 4 (normal) to 0 (no ability). The maximum total score is 48, and the minimum total score is 0.
ALS types chart
Variability of

Each ALSFRS-R Score Is unique to the patient

The heterogeneity of disease spread and rate of progression mean that the ALSFRS-R score remains individual in nature. Two patients with similar overall scores can still exhibit very different symptoms.5

For example, while Patient A primarily experiences symptoms of the bulbar and cervical regions, Patient B experiences symptoms of the lumbar region and exhibits respiratory complications. Both have ALSFRS-R scores of 40.
ALSFRS-R scoring
ALSFRS score meaning
Understanding an individual’s unique course of disease will help you provide personalized care tailored to their specific needs.
REFERENCES: 1.ALS Society of Canada. A guide to ALS patient care for primary care physicians. Accessed August 2020 at: 2. Berry JD, Cudkowicz ME. New considerations in the design of clinical trials for amyotrophic lateral sclerosis. Clin Investig (Lond) 2011;1(10):1375-1389. 3. Cedarbaum JM, Stambler N, Malta E, et al. The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. J Neurol Sci 1999; 169(1-2):13-21. 4. ALS Society of Canada. A manual for people living with ALS. Accessed August 2020 at: 5. Simon NG, Turner MR, Vucic S, et al. Quantifying disease progression in amyotrophic lateral sclerosis. Ann Neurol 2014;76:643-657.