Relationship between Barthel Index scores during the acute phase of rehabilitation and subsequent ADL in stroke patients

Abstract

The Barthel Index (BI) cannot be used to measure initial stroke severity or by extension, to stratify patients by severity in acute stroke trials because most patients are bedbound in the first few hours after stroke, either by their deficit or by medical directive. Our objectives were to clarify the threshold of acute BI for use in the prediction of subsequent independence in activities of daily living (ADL) and to assist in the definition of acute stroke rehabilitation goals. Subjects comprised 78 patients out of 191 inpatients admitted with acute stroke at our hospital during 2006-2007. The BI ADL score was divided into 2 ranges (BI> or =60 and < or =40), in a process similar to previous studies. During the acute period (from onset to approximately 3 weeks), all patients with a BI> or =40 could improve their ADL in 6 months. Patients with a BI< or =40 exhibited two ADL recovery outcomes (improved and no change) at 6 months. We also found that the skill level of basic activities related to standing was significant indicator of BI improvement (P<0.001). BI scores determined at approximately 3 weeks were reliable predictors of ADL disabilities at 6 months.

Guidelines for Adult Stroke Rehabilitation and Recovery

“…Both the Barthel Index and the FIM are strong predictors of discharge functional status, discharge destination after inpatient rehabilitation, and length of rehabilitation stay. [278][279][280][281] The FIM is the most commonly used functional measure in the United States because it is tied to the prospective payment system of the Centers for Medicare & Medicaid Services.…”

Analiza učinaka Bobath tretmana i klasičnoga fizioterapijskog tretmana u aktivnostima svakodnevnog života kod bolesnika nakon moždanog udara Barthelovim indeksom

“…14 Mnogi autori smatraju da ako je rezultat Barthel indeksa niži od 40, bolesnici imaju manju vjerojatnost da budu samostalni, 15 a Grangera i suradnici smatraju da kod 70 % bolesnika bolest završava smrću ako imaju rezultat Barthela manji od 40. 16 Barthelov je indeks uz Functional measure scale (FIM indeks) najčešće mjerilo samostalnosti pacijenata.…”

Functional recovery of post stroke patients with hemiparesis after stroke of different aetiology

“…Najveći značaj ima rana medicinska rehabilitacija i specijalizovana nega koje bi trebalo da se sprovode u stacionarnim zdravstvenim ustanovama, uz uključiva-nje tima lekara različitih specijalnosti [8].…”

“…Određivanje Bartelovog indeksa (BI) na početku rane rehabilitacije pokazalo se izuzetno korisnim, jer je inicijalna vrednost BI dobar pokazatelj funkcionalnog oporavka pacijenta koji se može očekivati kroz šest meseci od obolevanja [8].…”

“…Nakao i saradnici smatraju da vrednost BI tri nedelje posle doživljenog moždanog udara može pouzdanije da ukaže na stepen funkcionalnog oporavka koji se može očekivati šest meseci posle moždanog udara [8].…”