Modified Medical Research Council (MMRC) Dyspnea Scale

The MMRC Dyspnea Scale Assesses a Patient's Level of Dyspnea

Patient consulting Doctor for breathing difficulties, Asthma
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Having an objective way to measure shortness of breath such as the MMRC dyspnea scale is helpful for describing a symptom that is largely subjective. 

The Symptom of Dyspnea

Dyspnea - or the sensation of shortness of breath - is almost a universal symptom for those dealing with chronic obstructive pulmonary diseases (COPD) such as emphysema or chronic bronchitis. In fact, one of the first symptoms your doctor will ask you at each visit, is "How is your breathing?"

The problem is that the sensation of dyspnea is very subjective. One person may feel relatively little shortness of breath with a certain activity while another may feel very winded.  Likewise, on one day you may feel more short of breath than another, even though your limitations on either day are the same.

So how can doctors properly assess the degree to which breathlessness is posing a problem in your life?. And how can they really know if you are better or worse, or just feeling better or worse on a particular day after completing rehab?

Measuring Dyspnea

Certainly, there are objective measures to monitor your COPD.  Tests such as pulmonary function tests, particularly spirometry, and pulse oximetry can give a number to put with your current condition.

Yet dyspnea - the sensation of shortness of breath - is still very important, as it plays a large role in what you can do in your day-to-day life.

  We want to treat people, not numbers.  We want to improve your quality of life, not what we can see on a printout. We want an objective way to see if an intervention such as pulmonary rehabilitation makes a difference, and is therefore, worth your time.

The Modified Medical Research Council Dyspnea Scale - MMRC

The Modified Medical Research Council Dyspnea Scale, or MMRC, uses a simple grading system to assess a patient's level of dyspnea -- shortness of breath.

This scale doesn't define the sensation of breathlessness per se, but rather the degree of disability that such breathlessness poses on day-to-day activities.

The scale measures a broad range of disability due to dyspnea, from only mild limitations, up to severe limitations, and is an easy and rapid test to do.

In general, this scale correlates fairly well with objective measures of breathing such as pulmonary function tests and walk tests.  It also tends to be stable over time which is good in having an objective measure.

Usefulness of the MMRC Dyspnea Scale

Now that we have a measure of dyspnea, what does this measure tell us?  The MMRC can be used to"

  • Assess the effects of interventions (treatments) such as medications and pulmonary rehabilitation
  • For research purposes and comparing treatments across different people
  • To predict survival - Most often the MMRC dyspnea scale is included with other measures as part of the BODE index (see below) when trying to predict survival.

MMRC Dyspnea Scale

GradeDescription of Breathlessness
0I only get breathless with strenuous exercise.
1I get short of breath when hurrying on level ground or walking up a slight hill.
2On level ground, I walk slower than people of the same age because of breathlessness or have to stop for breath when walking at my own pace.
3I stop for breath after walking about 100 yards or after a few minutes on level ground.
4I am too breathless to leave the house or I am breathless when dressing.

Using the Dyspnea Scale to Calculate the BODE Index

The MMRC is used to help calculate BODE Index

The BODE index can be used to predict the life expectancy of someone with COPD. While this can be helpful in some ways, it's important to remember that every person is different. Some people live much longer than expected while others do not live as long as would be expected.

Thankfully there are things people can do to improve their odds regardless of the MMRC dyspnea scale and BODE index results.  It's been found that not only is smoking cessation a good idea in people with COPD but that it can normalize the decline in lung function with the disease.

But raising your odds goes beyond smoking cessation.

Talk to your doctor about nutrition.  Being underweight is one of the risk factors that predicts poor survival. 

And finally, living with COPD is more than trying to live longer.  You can follow tips on how to break the dyspnea cycle to improve your life every day while living with the disease.


Chhabra, S., Gupta, A., and M. Khuma. Evaluation of three scales of dyspnea in chronic obstructive pulmonary disease. Annals of Thoracic Medicine. 2009. 4(3):128-32.

Dennis E. Doherty, MD, FCCP, Mark H. Belfer, DO, FAAFP, Stephen A. Brunton, MD Leonard Fromer, MD, Charlene M. Morris, MPAS, PA-C, Thomas C. Snader, PharmD, CGP, FASCP. Chronic Obstructive Pulmonary Disease: Consensus Recommendations for Early Diagnosis and Treatment. Journal of Family Practice, November 2006.

Perez, T., Burgel, P., Paillasseur, J. et al. Modified Medical Research Council scale vs Baseline Dyspnea Index to evaluate dyspnea in chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease. 2015. 10:1663-72.

Stenton, C. The MRC breathlessness scale. Occupational Medicine. 2008. 58(3):226-227.

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