Barthel Index

 

What is the Barthel Index?

The Barthel Index consists of 10 items that measure a person's daily functioning specifically the activities of daily living and mobility. The items include feeding, moving from wheelchair to bed and return, grooming, transferring to and from a toilet, bathing, walking on level surface, going up and down stairs, dressing, continence of bowels and bladder.

How is the Barthel Index used?

The assessment can be used to determine a baseline level of functioning and can be used to monitor improvement in activities of daily living over time. The items are weighted according to a scheme developed by the authors. The person receives a score based on whether they have received help while doing the task. The scores for each of the items are summed to create a total score. The higher the score the more "independent" the person. Independence means that the person needs no assistance at any part of the task.   If a persons does about 50% independently then the "middle" score would apply.

In the United Kingdom quite frequently the 5, 10 and 15 scores are substituted by 1, 2, and 3.  This gives a potential maximum of 20 rather than 100.


Example form:

Patient Name:  __________________   Rater: ____________________  Date:      /     /              :      

Activity

Score

Feeding
0 = unable
5 = needs help cutting, spreading butter, etc., or requires modified diet
10 = independent

0     5    10

Bathing
0 = dependent
5 = independent (or in shower)

0        5

Grooming
0 = needs to help with personal care
5 = independent face/hair/teeth/shaving (implements provided)

0     5

Dressing
0 = dependent
5 = needs help but can do about half unaided
10 = independent (including buttons, zips, laces, etc.)

0     5     10

Bowels
0 = incontinent (or needs to be given enemas)
5 = occasional accident
10 = continent

0     5    10

Bladder
0 = incontinent, or catheterized and unable to manage alone
5 = occasional accident
10 = continent

0     5    10

Toilet Use
0 = dependent
5 = needs some help, but can do something alone
10 = independent (on and off, dressing, wiping)

0     5    10

Transfers (bed to chair and back)
0 = unable, no sitting balance
5 = major help (one or two people, physical), can sit
10 = minor help (verbal or physical)
15 = independent

0      5    10    15

Mobility (on level surfaces)
0 = immobile or < 50 yards
5 = wheelchair independent, including corners, > 50 yards
10 = walks with help of one person (verbal or physical) > 50 yards
15 = independent (but may use any aid; for example, stick) > 50 yards

0      5    10    15

Stairs
0 = unable
5 = needs help (verbal, physical, carrying aid)
10 = independent

0     5     10

TOTAL  (0 - 100)

________

 

 

References:

Mahoney Fl, Barthel DW:Functional evaluation: the Barthel Index. Md State Med J 14:2, 1965.

van der Putten JJMF, Hobart JC; Freeman JA, Thompson AJ. (1999) Measuring the change indisability after inpatient rehabilitation; comparison of the responsiveness of the Barthel Index and Functional Independence Measure. Journal of Neurology, Neurosurgery, and Psychiatry, 66(4), 480-484. PubMed Link to abstract