Barthel scale
Encyclopedia
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.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 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.
The scale was introduced in 1965, 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, and further refinements were introduced in 1989. The Barthel index signifies one of the first contributions to the functional status literature and it represents Physical Therapists' lengthy period of inclusion of functional mobility and ADL measurement within their scope of practice. The scale is regarded as reliable, although its use in clinical trial
s in stroke medicine is inconsistent. 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.
The ten variables addressed in the Barthel scale are:
Activities of daily living
Activities of Daily Living is a term used in healthcare to refer to daily self-care activities within an individual's place of residence, in outdoor environments, or both...
(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 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
Assessment
Educational assessment is the process of documenting, usually in measurable terms, knowledge, skills, attitudes and beliefs. Assessment can focus on the individual learner, the learning community , the institution, or the educational system as a whole...
, 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.
The scale was introduced in 1965, 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, and further refinements were introduced in 1989. The Barthel index signifies one of the first contributions to the functional status literature and it represents Physical Therapists' lengthy period of inclusion of functional mobility and ADL measurement within their scope of practice. The scale is regarded as reliable, although its use in clinical trial
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...
s in stroke medicine is inconsistent. 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
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
. 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.
The ten variables addressed in the Barthel scale are:
- presence or absence of fecal incontinenceFecal incontinenceFecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation...
- presence or absence of urinary incontinenceUrinary incontinenceUrinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...
- 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
- and help needed with bathing
External links
- Patient.co.uk, online calculator
- Stroke Center (deviates from other versions)