Multiple Sclerosis Functional Composite (MSFC)

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Purpose[edit | edit source]

The Multiple Sclerosis Functional Composite (MSFC) designed by "National MS Society's Clinical Outcome Assessment Task" and is a standardized tool used to quantify degree of disability in patients with multiple sclerosis (MS)[1]. Limitations in Expanded Disability Status Scale leads to development of MSFC in the early 1990's, to improve clinical assessment of patients with multiple sclerosis[2][3]. The traditional scales such as EDSS scale are inadequate in measuring some key aspects of MS for example cognitive function and have psychometric limitations as well[1].

Technique[edit | edit source]

MSFC covers three functional domains[3]:

  1. Ambulatory Function
  2. Hand Function
  3. Cognitive function

Performed with in 20 minutes.

Three Functional domains
Nine-Hole Peg Test Hand function is tested with the nine-hole peg test[3].
(PASAT)Paced auditory serial addition task PASAT was originally included to cover the cognitive dain. It measures processing speed and working memory, both of which are frequently affected functions in MS patients[3].
Timed 25-foot walk test (T25W) The ambulatory function is tested with the timed 25-foot walk test (T25W). The T25W is a reliable test for patients with more severe gait impairment, because it primarily assesses walking speed[3].


The results of the tests that assess these domains are depicted in an interval scale (seconds or number of correct responses) and can be converted to a Z score that is based on values of a reference population. An overall score can be calculated by averaging the Z score of the subtests[3].

Evidence[edit | edit source]

It has good intra- and inter-rater reliability and it results in a score on a continuous scale.

Resources[edit | edit source]

Guidebook

Scoring guideline

References[edit | edit source]

  1. 1.0 1.1 JS, RA, GR, SC. F Rudick, Cutter, Reingold. The Multiple Sclerosis Functional Composite measure (MSFC): an integrated approach to MS clinical outcome assessment. Multiple Sclerosis Journal [Internet]. 1999 [cited 2024 Mar 1];5(4):244–250.
  2. Cutter GR, Baier ML, Rudick RA, Cookfair DL, Fischer JS, Petkau J, . Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain [Internet]. 1999 [cited 2024 Mar 1];122(5):871–882.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Van Munster, C. E., & Uitdehaag, B. M. Outcome Measures in Clinical Trials for Multiple Sclerosis. CNS drugs. 2017;31(3):217–236.