Medical Research Council (MRC) 
Scale for Muscle Strength

EFFORT                                                                                                               0-5 

Muscle contracts against full resistance                                                                5 

Strength reduced, but contraction can still move joint against resistance             4

 Strength further reduced such that joint can be moved 
only against gravity     with examiner's resistance completely removed.                3                            

Muscle can onlly move if resistance of gravity is removed.                                    2 

Only a trace or flicker of movement is seen or felt,                          
or fasciculations are observed,                                                                              1                                             

No movement                                                                                                         0


 Reference:

  1. Medical Research Council. Aids to the examination of the peripheral nervous system, Memorandum no. 45, Her Majesty's Stationery Office, London, 1981.
  2. Hahn AF, Bolton CF, Pillay N, et al. Plasma exchange therapy in chronic inflammatory
    demyelinating polyneuropathy. A double-blind, sham controlled, cross-over study.
    Brain 1996;119:1055–66. [Medline]
  3. Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuhfried O, Vacariu G, Mittermaier C, Bittner C, Fialka-Moser V. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med. 2008 Aug;40(8):665-71. [Medline]





 CLINICAL GRADING (FUNCTIONAL ASSESSMENTS)                      0-10 SCALE

Normal                                                                                                                0


No disability; minor sensory signs or areflexia                                                    1


mild disability; ambulatory >200 m; mild weakness
 in >=1 limb and sensory impairment                                                                  2


Requires support to walk >50m without stick; 
moderate weakness MRC Grade 4 and sensory impairment                                 3


Severe disability; able to walk >10m without support of stick,
 motor weakness MRC Grade 4 and sensory impairment                                      4


Requires support to walk 5m; marked motor and sensory signs                           5


Cannot walk 5m; able to stand without support and to transfer to wheelchair;
 able to feed independently                                                                                   6


Bedridden; severe quadriparesis; max strength MRC Grade 3                               7


Respirator [sic] and/or severe quadriparesis; max strength MRC Grade 2              8


Respirator [sic] and quadriplegia                                                                          9


Dead                                                                                                                    10



(1) Hahn AF, Bolton CF, Pillay N et al., Plasma Exchange ... Brain 1996; 119:1055-66