Barthel

Title of Assessment 

• Barthel Index of ADL

Author(s) 

• Florence I. Mahoney & Dorothea W. Barthel

Year of Publication/Publisher 

• 1965

Identify Type of Assessment 

• performance-based

• questionnaire

Cost (identify source) & How to Access Assessment (include link if possible) 

• Free

Population (who it is appropriate for [age, diagnosis, etc.])  

• stroke, brain injury, Parkinson's disease, and neuromuscular diseases

• older adults and the geriatric population 

Appropriate Settings (potential practice settings appropriate to administer assessment in) 

• inpatient rehabilitation, acute long-term care, skilled nursing facility 

Purpose of Assessment & Function(s)/Area(s) Assessed  

•  this assesses functional independence in personal care and mobility of patients in hospitals. It can predict any changes, how long inpatient stay may be, and indicate the amount of nursing and assistance required

• Assesses feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, chair transfer, ambulation, and stair climbing.

Administration (time to administer, group/individual, if there are subtests, can they be completed individually, are there specific instructions to ensure standardization, etc.) 

• 5 minutes for verbal report

• 25 minutes for observation of tasks

User Qualifications  

• therapist or other observers

Materials Required  

• evaluation form

• writing utensil

• any required materials for ADL tasks

Scoring Procedure (how is assessment scored and what does score indicate)  

• Barthel includes these 10 items. each item is rated in intervals of 5: independent performance (10 or 15), assistance (5 or 10), or inability (0). max score is 100 and scores are based on continence, mobility, and time. 

• • 0-20= total dependence

  • 21-60= severe dependence

  • 61-90= moderate dependence

  • 91-99= slight dependence

  • 100= complete independence 

Psychometrics/Standardization (norms, reliability/validity studies) 

• interrater and test-retest reliability good ranging from 0.52 for dressing to 0.88 for feeding

• 0.73-0.77 validity for index of motor activities in stroke patients

Strengths & Weaknesses of Assessment  

•  strengths

  • free and quick to administer

  • assess levels of independence and assistance required in ADLs

• weaknesses

  • Could require many materials depending on assistive devices needed

  • can be hard to interpret results since everyone observes differently 

References 

• Asher, I. E. (2014). Asher’s occupational therapy assessment tools: An annotated index. American Occupational Therapy Association.

• Barthel index. Shirley Ryan AbilityLab. (n.d.). https://www.sralab.org/rehabilitation-measures/barthel-index