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:

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.^{[7, 8]}
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.

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

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Table 1. Barthel Index

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

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