Key facts
- Score direction
- Lower is better
- Meaningful change
- Change scores of approximately 8 points on the physical subscale and approximately 6 points on the psychological subscale have shown moderate to high sensitivity and specificity for detecting whether patients have improved.
- Scoring
- The MSIS-29 has 29 items, each rated on a 5-point scale (1 = Not at all, 2 = A little, 3 = Moderately, 4 = Quite a bit, 5 = Extremely) with a recall period of the past two weeks. PHYSICAL IMPACT (items 1-20): sum the 20 …
- Time to complete
- 10 min
- Licensing
- Licensed instrument - check copyright terms before clinical use
About the Multiple Sclerosis Impact Scale (MSIS-29)
The Multiple Sclerosis Impact Scale (MSIS-29) is a validated, patient-reported outcome measure that captures the impact of multiple sclerosis from the patient's perspective. It comprises two subscales - a 20-item physical impact scale and a 9-item psychological impact scale - and is widely used in clinical practice and research to monitor disease impact over time and to evaluate response to treatment.
Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
The MSIS-29 was developed by Jeremy Hobart and colleagues at the Institute of Neurology, University College London, and published in Brain in 2001. It was created through a standardised psychometric process using patient interviews and field testing.
Copyright & Licensing
The MSIS-29 is copyrighted. It is freely available for non-commercial clinical and research use, but permission should be sought from the developers / Royal Free and University College Medical School for commercial use. Validated translations should be used for non-English speaking populations.
Administration Instructions
The following questions ask about the impact of MS on your day-to-day life during the past two weeks. For each statement, please select the one response that best describes your situation.
Scoring Methodology
The MSIS-29 has 29 items, each rated on a 5-point scale (1 = Not at all, 2 = A little, 3 = Moderately, 4 = Quite a bit, 5 = Extremely) with a recall period of the past two weeks. PHYSICAL IMPACT (items 1-20): sum the 20 item responses (raw range 20-100). PSYCHOLOGICAL IMPACT (items 21-29): sum the 9 item responses (raw range 9-45). Each subscale is transformed to a 0-100 scale using: (100 * (observed score - minimum score)) / (maximum score - minimum score), which is equivalent to (mean of answered items - 1) * 25. SCORING REQUIREMENTS: a subscale score can be computed when at least 10 of 20 physical items, or at least 5 of 9 psychological items, are answered (mean imputation across answered items). Higher scores indicate a greater impact of MS on daily life (worse health). The two subscales are reported separately; there is no combined total score.
Meaningful Change Threshold
Change scores of approximately 8 points on the physical subscale and approximately 6 points on the psychological subscale have shown moderate to high sensitivity and specificity for detecting whether patients have improved.
Score Interpretation
Understanding what your score means
minimal
0 - 25Minimal impact of MS on daily life.
mild
26 - 50Mild impact of MS on daily life.
moderate
51 - 75Moderate impact of MS on daily life.
severe
76 - 100Severe impact of MS on daily life.
Subscales
This questionnaire measures multiple dimensions
Physical Impact(0-100)
Impact of MS on physical functioning and day-to-day physical activities.
Psychological Impact(0-100)
Impact of MS on emotional and psychological wellbeing.
Clinical Limitations & Considerations
The MSIS-29 captures the physical and psychological impact of MS but does not assess all dimensions of the condition (e.g. cognition or specific symptoms in detail). It is self-reported and may be influenced by mood, expectations, and external factors. Scores cannot be calculated reliably when too many items are missing (fewer than 10 physical or 5 psychological items answered). The two subscales should be reported separately and not summed into a single total.
Supporting Literature
Key validation and development studies for the Multiple Sclerosis Impact Scale (MSIS-29)
- 1
The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure
Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A
Brain, 2001
Used in Literature
Studies and publications that have used the Multiple Sclerosis Impact Scale (MSIS-29)
- 1
The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure
Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A
Brain, 2001
Frequently asked questions
What does a mild Multiple Sclerosis Impact Scale (MSIS-29) score mean?
A Multiple Sclerosis Impact Scale (MSIS-29) score of 26 to 50 is classified as mild. Mild impact of MS on daily life.
What does a severe Multiple Sclerosis Impact Scale (MSIS-29) score mean?
A Multiple Sclerosis Impact Scale (MSIS-29) score of 76 to 100 is classified as severe. Severe impact of MS on daily life.
What does a minimal Multiple Sclerosis Impact Scale (MSIS-29) score mean?
A Multiple Sclerosis Impact Scale (MSIS-29) score of 0 to 25 is classified as minimal. Minimal impact of MS on daily life.
What does a moderate Multiple Sclerosis Impact Scale (MSIS-29) score mean?
A Multiple Sclerosis Impact Scale (MSIS-29) score of 51 to 75 is classified as moderate. Moderate impact of MS on daily life.
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