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, 5, 6]
Guidelines for use of the Barthel Index are as follows:
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The index should be used as a record of what a patient does, not as a record of what a patient could do.
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The need for supervision renders the patient not independent.
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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.
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Usually, the patient's performance over the preceding 24-48 hours is important, but longer periods are occasionally relevant.
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Middle categories imply that the patient supplies over 50% of the effort.
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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 |