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Barthel Index

Barthel Index [1] is a scale to evaluate the ADL of patients. This evaluation takes into account the following facts:

1. The index should be used as a record of what a patient does, not as a record of what a patient could do.
2. The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.
3. The need for supervision renders the patient not independent.
4. A patient's performance should be established using the best available evidence. Asking the patient, friends/relatives and nurses are the usual sources, but direct observation and common sense are also important. Direct testing is not needed.
5. Usually the patient's performance over the preceding 24-48 hours is important, but occasionally longer periods will be relevant.
6. Middle categories imply that the patient supplies over 50 per cent of the effort.
7. Use of aids to be independent is allowed.

Barthel's ADL Index is summarized in the following table:

Unable Needs major help Needs some help Needs minor help Independent
Grooming 0 1 3 4 5
Bathing 0 1 3 4 5
Feeding 0 2 5 8 10
Toilet Use 0 2 5 8 10
Stairs 0 2 5 8 10
Dressing 0 2 5 8 10
Bowels 0 2 5 8 10
Bladder 0 2 5 8 10
Mobility (on level surfaces) 0 3 8 12 15
Transfers (bed to chair and back) 0 3 8 12 15
Total /100


  • [1]. Mahoney FI, Barthel D. “Functional evaluation: the Barthel Index.” Maryland State Medical Journal 1965;14:56-61.
  • [2]. Granger CV, Devis LS, Peters MC, Sherwood CC, Barrett JE. Stroke rehabilitation: analysis of repeated Barthel Index measures. Arch Phys Med Rehabil. 1979;60:14 –17.
  • [3]. Loewen SC, Anderson BA. “Predictors of stroke outcome using objective measurement scales.”Stroke. 1990;21:78-81.
  • [4]. Gresham GE, Phillips TF, Labi ML. “ADL status in stroke: relative merits of three standard indexes.” Arch Phys Med Rehabil. 1980;61:355-358.
  • [5]. Collin C, Wade DT, Davies S, Horne V. “The Barthel ADL Index: a reliability study.”Int Disability Study.1988;10:61-63.
  • [6]. see the term in wikipedia (http://en.wikipedia.org/wiki/Activities_of_daily_living)

Copyright Information The Maryland State Medical Society holds the copyright for the Barthel Index. It may be used freely for non-commercial 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.

Last changed: 29.10.2007 12:30 by David Riaño - HomePage Reload page Download HTML
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