Medical Research Council (MRC) Dyspnoea Scale

Original Editor - Shreya Trivedi

Top Contributors - Shreya Trivedi and Vidya Acharya  

Objective[edit | edit source]

To measure the amount of dyspnoea in patient with various condition like.

Intended Population[edit | edit source]

The MRC Scale can be used to measure dyspnoea in various conditions like COPD, Bronchial asthma, Restrictive disease, pulmonary fibrosis, occupational lung disease, various heart conditions such as heart failure.

Method of Use[edit | edit source]

It is a questionnaire in which patient has to understand the activity when he feels dyspnoea and based on that patient has to grade the dyspnoea. The MRC breathlessness scale comprises five statements that describe almost the entire range of respiratory disability from none (Grade 1) to almost complete incapacity (Grade 5). It can be self-administered by asking subjects to choose a phrase that best describes their condition, e.g. ‘I only get breathless with strenuous exertion’ (Grade 1) or ‘I am too breathless to leave the house’ (Grade 5). Alternatively, it can be administered by an interviewer with the statements framed as questions, e.g. ‘Are you short of breath when hurrying on the level or walking up a slight incline’ (Grade 2). The score is the number that best fits to the patient’s level of activity. All the questions relate to everyday activities and are generally easily understood by patients. A score can usually be obtained in a few seconds.[1]

Medical Research Council (MRC) Dyspnoea Scale[edit | edit source]

Grade Degree of breathlessness related to activities
1 Not troubled by breathlessness except on

strenuous exercise

2 Short of breath when hurrying on the level or

walking up a slight hill

3 Walks slower than most people on the level,

stops after a mile or so, or stops after 15

minutes walking at own pace

4 Stops for breath after walking about 100 yds or

after a few minutes on level ground

5 Too breathless to leave the house, or breathless

when undressing

Evidence[edit | edit source]

1. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease

2. Measurement of breathlessness in advanced disease: A systematic review.

3. The Medical Research council Dyspnoea Scale.

Reliability and Validity[edit | edit source]

Based on various researcher it was found that MRC scale is valid and reliable tool to measure dsypnea in various condition. It also gives and idea about the functional status of the patient and predicts severity[2]. [3][4]

Responsiveness[edit | edit source]

The MRC Dypnoea scale is highly responsive to exertional dyspnoea.[5]

Miscellaneous[edit | edit source]

Dyspnoea is one of the most common symptom of majority of respiratory conditions such as COPD, Bronchial Asthma, and Restrictive lung disease. Though dyspnoea(widely known as breathlessness) is subjective and difficult to quantify its plays a major role in decision-making about diagnosis and treatment so it is important to measure the amount of dyspnoea.[6] The Assessment of dyspnoea is an integral and core component of Respiratory Assessment.[7]

There are various tools available to measure the dyspnoea as an outcome, such as Borg Scale, St George’s Respiratory Questionnaire (SGRQ) and Chronic Respiratory Questionnaire (CRQ) etc, The MRC breathlessness scale does not quantify breathlessness itself. Other tools such as the Borg scale or visual analogue scales are used for that Rather, it quantifies the disability associated with breathlessness by identifying that breathlessness occurs when it should not (Grades 1 and 2) or by quantifying the associated exercise limitation (Grades 3–5).There is up to 98% agreement between observers recording MRC breathlessness scores The score correlates well with the results of other breathlessness scales,lung function measurements and with direct measures of disability such as walking distance.[7]

Advantages[edit | edit source]

  • Easy to administer
  • self administer[7]

Disadvantage[edit | edit source]

  • Because of its subjectivity score may vary from patient to patient
  • Therapist have to rely on patient for result[1]

Links[edit | edit source]

  • Video: MRC Dyspnoea Score / Scale for COPD in 75 seconds In the video its nicely explained how to administer the MRC scale to assess the dyspnoea. the patient have to choose which statement suits the best to describe their dyspnoea. The patient has to select the grade/statement describing their level of dyspnoea based on the amount of dyspnoea they are perceiving during the various activities from wide range like difficult activity such as walking for 1 mile to simple activity like dressing/undressing.
  • Patient-reported Dyspnoea in COPD reliability and association with stage of disease

In the above research mainly two purpose were fulfilled. first was to examine the test-retest reliability of three widely used dyspnoea instruments and second was to compare dyspnoea scores at different stages of disease.89 of these patients were tested. At each visit, patients rated dyspnoea with three instruments presented in random order and then performed post-bronchodilator therapy lung function tests. Medical Research Council scale, San Diego Shortness of Breath Questionnaire results, Baseline dyspnoea index are the tool which were used for the research. in the conclusion it was found that Test-retest reliability was acceptable for patient-reported dyspnea scores using three clinical instruments at baseline and at the 3-month follow-up. Additionally it was also noted that for the first time that patient-reported dyspnea ratings are related to the stage of disease severity.

References[edit | edit source]

  1. 1.0 1.1 Paladini L, Hodder R, Cecchini I, Bellia V, Incalzi RA. The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients. Respir Med. 2010 Jul;104(7):1027-34. doi: 10.1016/j.rmed.2009.12.012. PMID: 20116231.
  2. Bestall, J C, et al. “Usefulness of the Medical Research Council (MRC) Dyspnoea Scale as a Measure of Disability in Patients with Chronic Obstructive Pulmonary Disease.” Thorax, vol. 54, no. 7, 1 July 1999, pp. 581–586,, 10.1136/thx.54.7.581.
  3. Manali, Effrosyni D, et al. “MRC Chronic Dyspnea Scale: Relationships with Cardiopulmonary Exercise Testing and 6-Minute Walk Test in Idiopathic Pulmonary Fibrosis Patients: A Prospective Study.” BMC Pulmonary Medicine, vol. 10, no. 1, 28 May 2010, 10.1186/1471-2466-10-32. Accessed 10 Aug. 2021.
  4. Marciniuk, Darcy D, et al. “Managing Dyspnea in Patients with Advanced Chronic Obstructive Pulmonary Disease: A Canadian Thoracic Society Clinical Practice Guideline.Canadian Respiratory Journal : Journal of the Canadian Thoracic Society, vol. 18, no. 2, 2011, pp. 69–78,
  5. Nouraei, S.A.R., et al. “Sensitivity and Responsiveness of the Medical Research Council Dyspnoea Scale to the Presence and Treatment of Adult Laryngotracheal Stenosis.” Clinical Otolaryngology, vol. 33, no. 6, Dec. 2008, pp. 575–580, 10.1111/j.1749-4486.2008.01832.x. Accessed 27 Nov. 2021.
  6. Gruenberger JB, Vietri J, Keininger DL, Mahler DA. Greater dyspnea is associated with lower health-related quality of life among European patients with COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:937-944. Published 2017 Mar 20. doi:10.2147/COPD.S123744
  7. 7.0 7.1 7.2 Stenton, C. “The MRC Breathlessness Scale.” Occupational Medicine, vol. 58, no. 3, 1 May 2008, pp. 226–227, 10.1093/occmed/kqm162. Accessed 27 Nov. 2021.