The Barthel ADL Index: A standard measure of physical disability?

Abstract

There is no agreed single measure of physical disability for use either clinically or in research. It is argued that acceptance of a single standard measure of activities of daily living (ADL) might increase awareness of disability, improve clinical management of disabled patients, and might even increase acceptance of published research. The Barthel ADL Index is proposed as the standard index for clinical and research purposes. Its validity, reliability, sensitivity, and utility are discussed. The Barthel Index is as good as any other single simple index, and should be adopted as the standard against which future indices are compared. The temptation to use variations on the standard Barthel Index should be resisted.

Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study

“…The ability to do daily activities was assessed with the Barthel activities of daily living index. 20 This index consists of ten items (assessing continence of bowels and bladder, grooming, toilet use, feeding, transfer, mobility, dressing, climbing stairs, and bathing) which are ordered in ascending degree of difficulty. High scores indicate good functional independence.…”

Sensitivity to changes in disability after stroke: A comparison of four scales useful in clinical trials

“…al. and Shah both suggest that a 20-point threshold would certainly indicate important change [5,27]. This criterion may be overly rigorous; even so, the BI detected change in a much larger proportion of patients that the MRS. For the purposes of a treatment trial, a smaller difference between the treatment and control groups on the BI might be adequate.…”

“…A newer measure, specifically designed for intervention trials, was proposed for use in the International Stroke Trial Measure (ISTM) that examined the efficacy of aspirin or heparin administration [3]. Stroke investigators have chosen these measures because of perceived high clinical utility, high interrater reliability, and ease of use [4][5][6][7][8][9][10][11]. A fourth disability scale, the Functional Independence Measure (FIM), is widely used in rehabilitation centers and has properties useful for stroke investigators [12].…”

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

“…Patients were transferred to the rehabilitation unit after recovery from acute illness including stroke, fractures, general medical or general surgical illness. Data on routinely collected rehabilitation outcomes for the cohort includes the 20 point Barthel score (a measure of activities of daily living) 8 at admission and discharge. These data were linked to data held by the University of Dundee Health…”