The Modified Fatigue Impact Scale (MFIS) is a tool that doctors use to evaluate how fatigue is affecting someone living with multiple sclerosis (MS).

Fatigue is a common and often frustrating symptom for up to 90 percent of people with MS. Some people find it hard to accurately describe their MS-related fatigue to their doctor, while others have difficulty communicating the full effect that fatigue has on their daily life.

The MFIS consists of a series of questions or statements about physical, cognitive, and psychosocial health. It’s a quick process that can go a long way toward helping your doctor fully understand how MS-related fatigue affects you, making 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 five-question version. Most people fill it out on their own in a doctor’s office.

It typically takes anywhere from 5 to 10 minutes to fill it out completely.

People with vision problems or who have trouble writing can ask to go through the questionnaire orally. Your doctor or someone else in the office can read off the questions and note your answers.

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.

In addition to the 21 questions, there’s a space to fill out just how strongly each question 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.

A few questions and their answer boxes are as follows:

I have been less alert01234
I have been unable to think clearly01234
My muscles have felt weak01234
I have limited my physical activities01234
I have been forgetful01234
I have trouble finishing tasks that require thinking01234
I have been physically uncomfortable01234
I have needed to rest more often or for longer periods01234

Some of the statements focus on physical abilities, while others address cognitive matters, such as memory, concentration, and decision-making.

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

You can find the full list of questions here.

The total MFIS score has a range of 0 to 84, with three subscales as follows:

SubsetQuestionsSubscale range

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 (CBT). 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.