Barthel Index (BI)

Features

Objectives

• The Barthel Scale/Index (BI) is an ordinal scale used to measure performance in activities of daily living (ADL).

Intended population

• Patients with stroke, patients with other neuromuscular or musculoskeletal disorders, oncology patients (>18 years old).

Items and Scoring

• The Barthel includes 10 personal activities: feeding, personal toileting, bathing, dressing and undressing, getting on and off a toilet, controlling bladder, controlling bowel, moving from wheelchair to bed and returning, walking on level surface (or propelling a wheelchair if unable to walk) and ascending and descending stairs.
• Each item is rated in terms of whether the patient can perform the task independently, with some assistance, or is dependent on help based on observation (0=unable, 1=needs help, 2=independent). The final score is x 5 to get a number on a 100 point score

Training

• The MBI/BI is simple to administer.
• Requires training if administered by direct observation.

Time to administer

• -Self report: 2-5 minutes;
• Direct observation: 20 minutes.

Interpreting Barthel scores 

• 0-20: “total” dependency
• 21-60: “severe” dependency
• 61-90: “moderate” dependency
• 91-99: “slight” dependency
• Most studies apply the 60/61 cutting point. Note- the Barthel Index should not be used alone for predicting outcomes

YOU CAN USE THIS FORM BELOW TO ASSESS YOUR PATIENT AND PRINT IT OUT OR SAVE AS PDF FILE.

Original literature:

• Mahoney FI, Barthel D, Functional Evaluation: The Barthel Index, Maryland State Medical Journal 1965;14, 56-61

Other Sources:

• Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: a reliability study. Int Disabil Stud. 1988; 10(2):61-63.
• Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud. 1988;10(2):64-67.