The Modified Fatigue Impact Scale (MFIS) is a tool that doctors use to evaluate how fatigue affects someone’s life.

Fatigue is a common and often frustrating symptom for up to 80 percent of people with multiple sclerosis (MS). Some people with MS find it hard to accurately describe their MS-related fatigue to their doctor. Others have difficulty communicating the full effect that fatigue has on their daily life.

The MFIS involves answering or evaluating a series of questions or statements about your physical, cognitive, and psychosocial health. It’s a quick process that can go a long way toward helping your doctor fully understand how fatigue affects you. This makes it easier to come up with an effective plan for managing it.

Read on to learn more about the MFIS, including the questions it covers and how it’s scored.

The MFIS is generally presented as a 21-item questionnaire, but there’s also a 5-question version. Most people fill it out on their own in a doctor’s office. Expect to spend anywhere from five to ten minutes circling your answers.

If you have vision problems or trouble writing, ask to go through the questionnaire orally. Your doctor or someone else in the office can read off the questions and note your answers. Don’t hesitate to ask for clarification if you don’t fully understand any of the questions.

Simply saying you’re fatigued usually doesn’t convey the reality of how you’re feeling. That’s why the MFIS questionnaire addresses several aspects of your daily life to paint a more complete picture.

Some of the statements focus on physical abilities:

  • I have been clumsy and uncoordinated.
  • I have to pace myself in my physical activities.
  • I have trouble maintaining physical effort for long periods.
  • My muscles feel weak.

Some statements address cognitive matters, such as memory, concentration, and decision-making:

  • I have been forgetful.
  • I have trouble concentrating.
  • I have difficulty making decisions.
  • I have trouble finishing tasks that require thinking.

Other statements reflect psychosocial aspects of your health, which refers to your moods, feelings, relationships, and coping strategies. Examples include:

  • I have been less motivated to participate in social activities.
  • I am limited in my ability to do things away from home.

You can find the full list of questions here.

You’ll be asked to describe how strongly each statement reflects your experiences in the last four weeks. All you have to do is circle one of these options on a scale of 0 to 4:

  • 0: never
  • 1: rarely
  • 2: sometimes
  • 3: often
  • 4: always

If you’re not sure how to answer, choose whatever seems closest to how you feel. There aren’t any wrong or right answers.

Each answer receives a score of 0 to 4. The total MFIS score has a range of 0 to 84, with three subscales as follows:

SubsetQuestions Subscale range
Physical4+6+7+10+13+14+17+20+210–36
Cognitive1+2+3+5+11+12+15+16+18+190–40
Psychosocial8+90–8

The sum of all the answers is your total MFIS score.

What the results mean

A higher score means fatigue is more significantly affecting your life. For example, someone with a score of 70 is affected by fatigue more than someone with a score of 30. The three subscales provide additional insight into how fatigue affects your day-to-day activities.

Together, these scores can help you and your doctor come up with a fatigue management plan that addresses your concerns. For example, if you score high on the psychosocial subscale range, your doctor might recommend psychotherapy, such as cognitive behavioral therapy. If you score high on the physical subscale range, they may instead focus on adjusting any medication you take.

Fatigue due to MS or any other condition can interfere with many aspects of your life. The MFIS is a tool that doctors use to get a better idea of how fatigue affects someone’s quality of life. If you have MS-related fatigue and feel like it’s not being properly addressed, consider asking your doctor about the MFIS questionnaire.