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