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{{Short description|Ordinal scale used to measure performance in activities of daily living (ADL)}}
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The '''Barthel scale''' or '''Barthel ADL index''' is a scale used to measure performance in basic Activities of Daily Living. The Barthel Index is an [[ordinal scale]]. Each performance item is rated on this ordinal scale with a given number of points assigned to each level or ranking.<ref name="O'Sullivan">{{cite book|last=O'Sullivan|first=Susan B|title=Physical Rehabilitation, Fifth Edition|year=2007|publisher=F.A. Davis Company|location=Philadelphia, PA|pages=385|coauthors=Schmitz, Thomas J}}</ref>It uses ten variables describing [[activities of daily living]] (ADL) and mobility. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence following discharge from hospital. The amount of time and physical assistance required to perform each item are used in determining the assigned va lue of each item. External factors within the environment effects the score of each item. If adaptations outside the standard home environment are met during [[assessment]], the participant’s score will be lower if these conditions are not available. If adaptations to the environment are made, they should be described in detail and attached to the Barthel Index. <ref>{{cite web|last=Carroll|first=Douglas|title=Functional Evaluation: The Barthel Index|url=http://www.strokecenter.org/trials/scales/barthel_reprint.pdf|accessdate=12 May 2011}}</ref>
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| synonyms = '''Barthel ADL index'''
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The '''Barthel scale''' is an [[ordinal scale]] used to measure performance in [[activities of daily living]] (ADL). Each performance item is rated on this scale with a given number of points assigned to each level or ranking.<ref name="O'Sullivan">{{cite book|last=O'Sullivan|first=Susan B|title=Physical Rehabilitation, Fifth Edition|year=2007|publisher=F.A. Davis Company|location=Philadelphia, PA|pages=385|author2=Schmitz, Thomas J}}</ref> It uses ten variables describing ADL and mobility. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence following discharge from a hospital. The amount of time and physical assistance required to perform each item are used in determining the assigned value of each item. External factors within the environment affect the score of each item. If adaptations outside the standard home environment are met during [[wikt:assessment|assessment]], the participant's score will be lower if these conditions are not available. If adaptations to the environment are made, they should be described in detail and attached to the Barthel index.<ref>{{cite web|last=Carroll |first=Douglas |title=Functional Evaluation: The Barthel Index |url=http://www.strokecenter.org/trials/scales/barthel_reprint.pdf |accessdate=12 May 2011 |url-status=dead |archiveurl=https://web.archive.org/web/20110928032514/http://www.strokecenter.org/trials/scales/barthel_reprint.pdf |archivedate=28 September 2011 }}</ref>


The scale was introduced in 1965,<ref name=MahoneyBarthel>{{cite journal | author=Mahoney F. Barthel D | title=Functional evaluation: the Barthel Index | journal=Md Med J | year=1965 | volume=14 | pages=61–65 | pmid=14258950}}</ref> and yielded a score of 0-20. Although this original version is still widely used, it was modified by Granger ''et al.'' in 1979, when it came to include 0-10 points for every variable,<ref>{{cite journal | author=Granger CV, Dewis LS, Peters NC, Sherwood CC, Barrett JE | title=Stroke rehabilitation: analysis of repeated Barthel index measures | journal=Arch Phys Med Rehabil | year=1979 | month=January | volume=60 | issue=1 | pages=14–7 | pmid=420565}}</ref> and further refinements were introduced in 1989.<ref>{{cite journal |author=Shah S, Vanclay F, Cooper B |title=Improving the sensitivity of the Barthel Index for stroke rehabilitation |journal=J Clin Epidemiol |volume=42 |issue=8 |pages=703–9 |year=1989 |pmid=2760661 |doi=10.1016/0895-4356(89)90065-6}}</ref> The Barthel index signifies one of the first contributions to the functional status literature and it represents [[Physical Therapist]]s' lengthy period of inclusion of functional mobility and ADL measurement within their scope of practice.<ref name="O'Sullivan"/> The scale is regarded as reliable, although its use in [[clinical trial]]s in stroke medicine is inconsistent.<ref>{{cite journal |author=Sulter G, Steen C, De Keyser J |title=Use of the Barthel index and modified Rankin scale in acute stroke trials |journal=Stroke |volume=30 |issue=8 |pages=1538–41 |year=1999 |month=August |pmid=10436097 |doi= |url=http://stroke.ahajournals.org/cgi/content/full/30/8/1538}}</ref> It has however, been used extensively to monitor functional changes in individuals receiving in-patient rehabilitation, mainly in predicting the functional outcomes related to [[stroke]]. The Barthel index has demonstrated high interrator reliability (0.95) and test re-test reliability (0.89) as well as high correlations (0.74-0.8) with other measures of physical disability.<ref name="O'Sullivan"/>
The scale was introduced in 1965,<ref name=MahoneyBarthel>{{cite journal | author=Mahoney F. Barthel D. | title=Functional evaluation: the Barthel Index | journal=Md Med J | year=1965 | volume=14 | pages=61–65 | pmid=14258950}}</ref> and yielded a score of 0–100 (Mahoney, F.I. & Barthel, D.W., 1965. Functional Evaluation: The Barthel Index. Maryland state medical journal, 14, pp.&nbsp;61–65.). Collin et al. (1988) argued that the original scoring system gave an exaggerated impression of accuracy and subsequently proposed a modification where each domain was scored in one-point increments with a full score of 20 indicating functional independence (Collin, C. et al., 1988. The Barthel ADL Index: a reliability study. International disability studies, 10(2), pp.&nbsp;61–63.). The sensitized version sharply discriminates between good and better and poor and poorer performances. Its effectiveness is not just with in-patient rehabilitation but home care, nursing care, skilled nursing, and community. The Barthel index signifies one of the first contributions to the functional status literature and it represents [[occupational therapist]]s' lengthy period of inclusion of functional mobility and ADL measurement within their scope of practice.<ref name="O'Sullivan"/> The scale is regarded as reliable, although its use in [[clinical trial]]s in [[stroke]] medicine is inconsistent.<ref>{{cite journal |vauthors=Sulter G, Steen C, De Keyser J |title=Use of the Barthel index and modified Rankin scale in acute stroke trials |journal=Stroke |volume=30 |issue=8 |pages=1538–41 |date=August 1999 |pmid=10436097 |doi= 10.1161/01.str.30.8.1538|doi-access=free }}</ref> It has however, been used extensively to monitor functional changes in individuals receiving in-patient rehabilitation, mainly in predicting the functional outcomes related to stroke. The Barthel index has been shown to have portability and has been used in 16 major diagnostic conditions as well as different clinical settings (e.g., nursing homes) with satisfactory reliability and validity.<ref>{{Cite journal|last1=Lam|first1=Simon C.|last2=Lee|first2=Diana T. F.|last3=Yu|first3=Doris S. F.|date=2014-03-01|title=Establishing CUTOFF Values for the Simplified Barthel Index in Elderly Adults in Residential Care Homes|journal=Journal of the American Geriatrics Society|language=en|volume=62|issue=3|pages=575–577|doi=10.1111/jgs.12716|pmid=24628634|s2cid=5175652 |issn=1532-5415}}</ref> The Barthel index has demonstrated high [[inter-rater reliability]] (0.95) and [[test–retest reliability]] (0.89) as well as high correlations (0.74–0.8) with other measures of physical disability.<ref name="O'Sullivan"/>


Copyright Information: The Maryland State Medical Society holds the copyright for the Barthel Index. It may be used freely for noncommercial
⚫
The ten variables addressed in the Barthel scale are<ref name=MahoneyBarthel/>:
purposes with the following citation: Mahoney FI, Barthel D. "Functional evaluation: the Barthel Index." Maryland State Med Journal 1965;14:56-61. Used with permission. Permission is required to modify the Barthel Index or to use it for commercial purposes.
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* presence or absence of [[fecal incontinence]]

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* presence or absence of [[urinary incontinence]]
==Variables==
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* help needed with grooming
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The ten variables addressed in the Barthel scale are:<ref name=MahoneyBarthel/>
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* help needed with toilet use
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* Presence or absence of [[fecal incontinence]]
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* help needed with feeding
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* Presence or absence of [[urinary incontinence]]
* help needed with transfers (e.g. from chair to bed)
* help needed with walking
* Help needed with grooming
* help needed with dressing
* Help needed with toilet use
* help needed with climbing stairs
* Help needed with feeding
* and help needed with bathing
* Help needed with transfers (e.g. from chair to bed)
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* Help needed with walking
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* Help needed with dressing
* Help needed with climbing stairs
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* Help needed with bathing


==See also==
==See also==
Line 19: Line 46:


==References==
==References==
{{reflist}}
{{Reflist}}


==External links==
==External links==
* [http://www.strokecenter.org/wp-content/uploads/2011/08/barthel.pdf Stroke Center reprint] {{Webarchive|url=https://web.archive.org/web/20150226072457/http://www.strokecenter.org/wp-content/uploads/2011/08/barthel.pdf |date=2015-02-26 }}
* [http://www.patient.co.uk/showdoc/40001654/ Patient.co.uk], online calculator
*[http://neurotoolkit.com/barthel/ Free online Barthel Index calculator]
* [http://www.strokecenter.org/trials/scales/barthel.pdf Stroke Center] (deviates from other versions)


[[Category:Rehabilitation medicine]]
[[Category:Rehabilitation medicine]]
[[Category:Medical scales]]

[[Category:Occupational therapy]]
[[de:Barthel-Index]]
[[ja:バーセル指数]]

Latest revision as of 17:43, 1 August 2024

Barthel scale
SynonymsBarthel ADL index
Purposemeasure performance in activities of daily living

The Barthel scale is an ordinal scale used to measure performance in activities of daily living (ADL). Each performance item is rated on this scale with a given number of points assigned to each level or ranking.[1] It uses ten variables describing ADL and mobility. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence following discharge from a hospital. The amount of time and physical assistance required to perform each item are used in determining the assigned value of each item. External factors within the environment affect the score of each item. If adaptations outside the standard home environment are met during assessment, the participant's score will be lower if these conditions are not available. If adaptations to the environment are made, they should be described in detail and attached to the Barthel index.[2]

The scale was introduced in 1965,[3] and yielded a score of 0–100 (Mahoney, F.I. & Barthel, D.W., 1965. Functional Evaluation: The Barthel Index. Maryland state medical journal, 14, pp. 61–65.). Collin et al. (1988) argued that the original scoring system gave an exaggerated impression of accuracy and subsequently proposed a modification where each domain was scored in one-point increments with a full score of 20 indicating functional independence (Collin, C. et al., 1988. The Barthel ADL Index: a reliability study. International disability studies, 10(2), pp. 61–63.). The sensitized version sharply discriminates between good and better and poor and poorer performances. Its effectiveness is not just with in-patient rehabilitation but home care, nursing care, skilled nursing, and community. The Barthel index signifies one of the first contributions to the functional status literature and it represents occupational therapists' lengthy period of inclusion of functional mobility and ADL measurement within their scope of practice.[1] The scale is regarded as reliable, although its use in clinical trials in stroke medicine is inconsistent.[4] It has however, been used extensively to monitor functional changes in individuals receiving in-patient rehabilitation, mainly in predicting the functional outcomes related to stroke. The Barthel index has been shown to have portability and has been used in 16 major diagnostic conditions as well as different clinical settings (e.g., nursing homes) with satisfactory reliability and validity.[5] The Barthel index has demonstrated high inter-rater reliability (0.95) and test–retest reliability (0.89) as well as high correlations (0.74–0.8) with other measures of physical disability.[1]

Copyright Information: The Maryland State Medical Society holds the copyright for the Barthel Index. It may be used freely for noncommercial purposes with the following citation: Mahoney FI, Barthel D. "Functional evaluation: the Barthel Index." Maryland State Med Journal 1965;14:56-61. Used with permission. Permission is required to modify the Barthel Index or to use it for commercial purposes.

Variables

[edit]

The ten variables addressed in the Barthel scale are:[3]

  • Presence or absence of fecal incontinence
  • Presence or absence of urinary incontinence
  • Help needed with grooming
  • Help needed with toilet use
  • Help needed with feeding
  • Help needed with transfers (e.g. from chair to bed)
  • Help needed with walking
  • Help needed with dressing
  • Help needed with climbing stairs
  • Help needed with bathing

See also

[edit]

References

[edit]
  1. ^ a b c O'Sullivan, Susan B; Schmitz, Thomas J (2007). Physical Rehabilitation, Fifth Edition. Philadelphia, PA: F.A. Davis Company. p. 385.
  2. ^ Carroll, Douglas. "Functional Evaluation: The Barthel Index" (PDF). Archived from the original (PDF) on 28 September 2011. Retrieved 12 May 2011.
  3. ^ a b Mahoney F. Barthel D. (1965). "Functional evaluation: the Barthel Index". Md Med J. 14: 61–65. PMID 14258950.
  4. ^ Sulter G, Steen C, De Keyser J (August 1999). "Use of the Barthel index and modified Rankin scale in acute stroke trials". Stroke. 30 (8): 1538–41. doi:10.1161/01.str.30.8.1538. PMID 10436097.
  5. ^ Lam, Simon C.; Lee, Diana T. F.; Yu, Doris S. F. (2014-03-01). "Establishing CUTOFF Values for the Simplified Barthel Index in Elderly Adults in Residential Care Homes". Journal of the American Geriatrics Society. 62 (3): 575–577. doi:10.1111/jgs.12716. ISSN 1532-5415. PMID 24628634. S2CID 5175652.
[edit]
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