The original Barthel Index was developed in the USA by Florence Mahoney and Dorothea Barthel (1965). The Modified Barthel Index was developed in Australia by Surya Shah, Frank Vanclay and Betty Cooper (1989). A third version was developed in England by Collin and colleagues (1988).
The original Barthel Index was developed to measure activities of daily living. The 10 subtest items include (1) feeding, (2) moving from wheelchair to bed and return, (3) personal grooming, (4) getting on/off the toilet, (5) bathing, (6) walking or propelling a wheelchair , (7) stair climbing, (8) dressing and undressing, (9) bowel and (10) bladder continence.. Each subtest item on the original Barthel Index is rated 0, 5 or 10 (or 15 for two of the test items). Maximum total score is 100.
The Modified Barthel Index includes the same 10 subtest items, scored on a 5-point ordinal scale which varies from item to item (eg 0, 1, 3, 4, or 5 for personal hygiene; 0, 3, 8, 12 or 15 for ambulation). This scale was developed to enhance the sensitivity of the original scale. The Modified Barthel Index scores the degree of independence of a client from any assistance (regardless of how minor, and for what purpose the assistance is provided). Maximum total score is 100.
The 20-point Barthel Index includes the same 10 subtest items with variable sub-scores between 0 and 3. For example, bathing can be rated 0 (dependent) or 1 (independent), while transferring can be rated 0 (unable, no sitting balance), 1 (major help one or two people, physical contact), 2 (major help, verbal or physical), or 3 (independent). Maximum total score is 20.
The original Barthel Index uses weighted scoring, with subtest scores ranging from 0 to 15 with increments of 5. A total score of 100 represents the highest level of independence although a perfect score does not necessarily mean that a person is able to perform instrumental activities of daily living. The total score is not as meaningful as the breakdown into individual subtest scores, since these indicate where limitations exist. The Modified Barthel Index and 20-point Barthel Index also use weighted scoring.
Abbreviated Name: BI
Author(s): Surya Shah, Frank Vanclay, Betty Cooper Purpose: To assess all chronic disabilities + acute stages Population: Adult Age Range : 16-99 years
Type of Instrument: Disability / Physical functioning Mode of Administration: Rater:
Scoring: Score Direction:
Number of Items: 10 Original Language: English
Existing Translations : Chinese, German, Greek, Hindi, Italian, Japanese, Polish
12 minutes for self-report status,
10 minutes for a telephone interview to 40 minutes for direct observation of all tasks
Each item is rated in terms of whether the patient can perform the task indenpendently; with some assisstance, or is dependent. Global score
Higher scores show better QoL
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