Barthel Index

Authors Florence I. Mahoney, MD. & Dorothea W. Barthel, BA, PT Purpose The purpose of the Barthel Index in to assess the level of functional independence/dependence for ten Activities of Daily Living (ADLs) primarily related to personal care and mobility in a clinical setting.1 Target Population Originally designed for in-patient patients with paralysis and chronically ill patients, now it is used commonly for stroke, Parkinsons disease, and the aging process. What it Tests It tests ten ADLs including the ability to independently feed oneself, bathe, groom oneself, control of bowels and bladder, toilet use, transfers, mobility on level surfaces and stairs. It has a point value for each section. A higher score means the patient is more independent. Psychometric Characteristics The reliability of the Barthel Index is rated high when assessing patients who had a stroke. The test-retest reliability was found to be 0.989, and inter-rater reliability was 0.994.2 The validity of the Barthel Index when used for patients with stroke was shown to be high also. When compared to another ADLs scale the Cronbachs alpha was 0.935 and Spearmans correlation coefficient was -0.912.2 Administration of Test The Barthel Index is a survey/point scale that a clinician fills out based on ten tasks they have the patient perform. Most of these tasks are a part of the patients daily life anyway, so the clinician only needs to observe to see how well the patient can perform them, or how much help the clinician needs to provide for the patient to complete the task. Time Required to Administer the Test

If the patient simply fills out the survey, they can complete it in two to five minutes. A clinician can observe all tasks and fill out form in about twenty minutes. Advantages It seems very simple to administer and can be completed by the patient himself/herself. It seems very reliable and valid, at least for patients who have had a stroke, and does not cost any extra money to administer. Limitations The total point value is one hundred, and much of the actual scoring is up to the clinicians or patients discretion. Just like a numeric pain scale, one person may give a certain score, and someone else may give a different score for the same level of competency. However, since the reliability is high this does not seem to be a big problem. References
1. Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Maryland State

Medical Journal 1965; 14:56-61.

2. Oveisgharan, S, et al. Barthel Index in a Middle-East country: translation, validity

and reliability. Cerebrovascular Disease, 2006; 22:350-354. Acquisition Information One way to get a copy of the Barthel Index is to use the following link: http://www.strokecenter.org/trials/scales/barthel.pdf

Appraised by: Matt Bugnet

Date appraised: 8/1/08