📈Function tracker (ALSFRS-R)

Track how you're doing over time using the Revised ALS Functional Rating Scale. Higher is better (max 48). A self-tracking aid to share with your care team — not a diagnosis.

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0/12 · score 0

1. Speech

4 — Normal speech3 — Detectable speech disturbance2 — Intelligible with repeating1 — Speech combined with non-vocal communication0 — Loss of useful speech

2. Salivation

4 — Normal3 — Slight but definite excess of saliva; may have nighttime drooling2 — Moderately excessive saliva; may have minimal drooling1 — Marked excess of saliva with some drooling0 — Marked drooling; requires constant tissue or handkerchief

3. Swallowing

4 — Normal eating habits3 — Early eating problems — occasional choking2 — Dietary consistency changes1 — Needs supplemental tube feeding0 — Nothing by mouth (exclusively tube/parenteral feeding)

4. Handwriting

5. Cutting food and handling utensils

4 — Normal3 — Somewhat slow and clumsy, but no help needed2 — Can cut most foods, although clumsy and slow; some help needed1 — Food must be cut by someone, but can still feed slowly0 — Needs to be fed

6. Dressing and hygiene

4 — Normal function3 — Independent and complete self-care with effort or decreased efficiency2 — Intermittent assistance or substitute methods1 — Needs attendant for self-care0 — Total dependence

7. Turning in bed and adjusting bed clothes

4 — Normal3 — Somewhat slow and clumsy, but no help needed2 — Can turn alone or adjust sheets, but with great difficulty1 — Can initiate, but not turn or adjust sheets alone0 — Helpless

8. Walking

4 — Normal3 — Early ambulation difficulties2 — Walks with assistance1 — Non-ambulatory functional movement only0 — No purposeful leg movement

9. Climbing stairs

10. Dyspnea (breathlessness)

4 — None3 — Occurs when walking2 — Occurs with one or more of: eating, bathing, dressing1 — Occurs at rest, difficulty breathing when sitting or lying0 — Significant difficulty; considering mechanical support

11. Orthopnea (breathing when lying down)

4 — None3 — Some difficulty sleeping at night due to shortness of breath; does not routinely use more than two pillows2 — Needs extra pillows to sleep (more than two)1 — Can only sleep sitting up0 — Unable to sleep without mechanical assistance

12. Respiratory insufficiency

4 — None3 — Intermittent use of BiPAP2 — Continuous use of BiPAP during the night1 — Continuous use of BiPAP during night and day0 — Invasive mechanical ventilation by intubation or tracheostomy

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