Barthel Index
Updated: Jun 10, 2022
Author: Buck Christensen; Chief Editor: Buck Christensen
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.
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 |