Barthel Index 

Updated: Dec 09, 2014
  • Author: Buck Christensen; Chief Editor: Buck Christensen  more...
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Barthel Index

The Barthel Index is a scale that measures disability or dependence in activities of daily living in stroke patients. [1, 2, 3, 4]

Guidelines for use of the Barthel Index are as follows:

  • The index should be used as a record of what a patient does, not as a record of what a patient could do.
  • The main goal is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.
  • The need for supervision renders the patient not independent.
  • A patient's performance should be established using the best available evidence. The patient, friends/relatives, and nurses are usually asked for the information gathered, but direct observation and common sense are also important. However, direct testing is not needed.
  • Usually, the patient's performance over the preceding 24-48 hours is important, but longer periods are occasionally relevant.
  • Middle categories imply that the patient supplies over 50% of the effort.
  • Use of aids to be independent is allowed.

Table 1. Barthel Index (Open Table in a new window)

Feeding
Score  
0 Unable
5 Needs help cutting or spreading butter, etc, or requires modified diet
10 Independent
Bathing
Score  
0 Dependent
5 Independent (or in shower)
Grooming
Score  
0 Needs help with personal care
5 Independent face/hair/teeth/shaving (implements provided)
Dressing
Score  
0 Dependent
5 Needs help but can do about half unaided
10 Independent (including buttons, zips, laces, etc)
Bowels
Score  
0 Incontinent (or needs to be given enemas)
5 Occasional accident
10 Continent
Bladder
Score  
0 Incontinent or catheterized and unable to manage alone
5 Occasional accident
10 Continent
Toilet Use
Score  
0 Dependent
5 Needs some help, but can do something alone
10 Independent (on and off, dressing, wiping)
Transfers (Bed to Chair and Back)
Score  
0 Unable, no sitting balance
5 Needs major help (one or two people, physical), can sit
10 Minor help (verbal or physical)
15 Independent
Mobility (On level Surfaces)
Score  
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, e.g., stick) >50 yards
Stairs
Score  
0 Unable
5 Needs help (verbal, physical, carrying aid)
10 Independent