Medical Research Council (MRC) Dyspnoea Scale

Original Editor - Shreya Trivedi

Top Contributors - Shreya Trivedi and Vidya Acharya  

Introduction

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 dyspnoeaAssessment of dyspnoea is an integral and core component of Respiratory Assessment.

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.

The MRC (r = 0.59 to 0.66)(80) 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.

Medical Research Council (MRC) Dyspnoea Scale

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

Reliability and Validity

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.

Usefulness

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.

Advantages

• Easy to administer

Disadvantage

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

Resources

• MRC Dyspnoea Score / Scale for COPD in 75 seconds
• Patient-reported dyspnea in COPD reliability and association with stage of disease

Related articles

• https://www.pcrs-uk.org/mrc-dyspnoea-scale
• https://www.sciencedirect.com/science/article/pii/S0954611106003544
• https://www.youtube.com/watch?v=1QyQ3GrFlmI
• https://thorax.bmj.com/content/54/7/581