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modified-barthel-index

The Modified Barthel Index is a tool used to assess a patient's ability to perform daily living activities, with scores ranging from total dependence to complete independence. Each activity, such as transfers, ambulation, and personal hygiene, is scored based on the level of assistance required. The total score helps predict the patient's ability to live independently and the need for community services.

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0% found this document useful (0 votes)
258 views4 pages

modified-barthel-index

The Modified Barthel Index is a tool used to assess a patient's ability to perform daily living activities, with scores ranging from total dependence to complete independence. Each activity, such as transfers, ambulation, and personal hygiene, is scored based on the level of assistance required. The total score helps predict the patient's ability to live independently and the need for community services.

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Alandragon88
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Modified Barthel Index (Shah et al.

1989)
Patient name: ____________________________________________ Date: ______________________

Index item Score Description

Unable to participate in a transfer. Two attendants are required to


0
transfer the patient with or without a mechanical device.

3 Able to participate, but maximum assistance of one other person is


required in all aspects of the transfer.

The transfer requires the assistance of one other person. Assistance


8
may be required in any aspect of the transfer.
Chair/bed
transfer The presence of another person is required either as a confidence
12
measure or to provide supervision for safety.

The patient can safely approach the bed walking or in a wheelchair,


lock brakes, lift footrests, or position walking aid, move safely to bed, lie
down, come to a sitting position on the side of the bed, change the
15
position of the wheelchair, transfer back into it safely and/or grasp aid
and stand. The patient must be independent in all phases of this
activity.

0 Dependent in ambulation.

Constant presence of one or more assistants is required during


3
ambulation.

Assistance is required with reaching aids and/or their manipulation.


8
One person is required to offer assistance.

The patient is independent in ambulation but unable to walk 50 meters


Ambulation 12 without help or supervision is needed for confidence or safety in
hazardous situations.

The patient must be able to wear braces if required, lock and unlock
these braces assume standing position, sit down, and place the
15 necessary aids into position for use. The patient must be able to
crutches, canes, or a walkarette, and walk 50 meters without help or
supervision.

Ambulation/ 0 Dependent on wheelchair ambulation.


Wheelchair*
Patient can propel self short distances on flat surface, but assistance is
* (If unable to 1
required for all other steps of wheelchair management.
walk)
Presence of one person is necessary and constant assistance is
Only use this 3
required to manipulate chair to table, bed, etc.
item if the
patient is
The patient can propel self for a reasonable duration over regularly
rated “0” for
4 encountered terrain. Minimal assistance may still be required in “tight
Ambulation,
corners” or to negotiate a kerb 100mm high.
and then
only if the
patient has To propel wheelchair independently, the patient must be able to go
been trained around corners, turn around, maneuver the chair to a table, bed, toilet,
5 etc. The patient must be able to push a chair at least 50 meters and
in wheelchair
management. negotiate a kerb.
Index item Score Description

0 The patient is unable to climb stairs.

Assistance is required in all aspects of chair climbing, including


2
assistance with walking aids.

The patient is able to ascend/descend but is unable to carry walking


Stair climbing 5 aids and needs supervision and assistance.

Generally, no assistance is required. At times supervision is required for


8 safety due to morning stiffness, shortness of breath, etc.

The patient is able to go up and down a flight of stairs safely without


help or supervision. The patient is able to use hand rails, cane or
10
crutches when needed and is able to carry these devices as he/she
ascends or descends.

0 Fully dependent in toileting.

2 Assistance required in all aspects of toileting.

Assistance may be required with management of clothing, transferring,


5
Toilet or washing hands.
transfers
8 Used at night but assistance is required for emptying and cleaning.

The patient is able to get on/off the toilet, fasten clothing and use toilet
10 paper without help. If necessary, the patient may use a bed pan or
commode or urinal at night but must be able to empty it and clean it.

0 The patient is bowel incontinent.

The patient needs help to assume appropriate position, and with bowel
2
movement facilitatory techniques.

The patient can assume appropriate position but cannot use facilitatory
5 techniques or clean self without assistance and has frequent accidents.
Bowel control Assistance is required with incontinence aids such as pad, etc.

The patient may require supervision with the use of suppository or


8
enema and has occasional accidents.

The patient can control bowels and has no accidents, can use
10
suppository, or take an enema when necessary.

The patient is dependent in bladder management, is incontinent, or has


0
indwelling catheter.

The patient is incontinent but is able to assist with the application of an


2
internal or external device.

Bladder The patient is generally dry by day, but not at night and needs some
5
control assistance with the devices.

The patient is generally dry by day and night but may have an
8 occasional accident or need minimal assistance with internal or external
devices.

The patient is able to control bladder day and night, and/or is


10
independent with internal or external devices.
Index item Score Description

0 Total dependence in bathing self.

Assistance is required in all aspects of bathing, but patient is able to


1
make some contribution.

Assistance is required with either transfer to shower/bath or with


3 washing or drying; including inability to complete a task because of
Bathing condition or disease, etc.

Supervision is required for safety in adjusting the water temperature, or


4
in the transfer.

The patient may use a bathtub, a shower, or take a complete sponge


5 bath. The patient must be able to do all the steps of whichever method
is employed without another person being present.

The patient is dependent in all aspects of dressing and is unable to


0 participate in the activity.

The patient is able to participate to some degree, but is dependent in all


2
aspects of dressing.
Dressing
5 Assistance is needed in putting on, and/or removing any clothing.

Only minimal assistance is required with fastening clothing such as


8
buttons, zips, bra, shoes, etc.

10 The patient is able to put on, remove, corset, braces, as prescribed.

The patient is unable to attend to personal hygiene and is dependent in


0
all aspects.

Assistance is required in all steps of personal hygiene, but patient able


1
to make some contribution.

3 Some assistance is required in one or more steps of personal hygiene.


Personal
hygiene Patient is able to conduct his/her own personal hygiene but requires
4
(Grooming) minimal assistance before and/or after the operation.

The patient can wash his/her hands and face, comb hair, clean teeth
and shave. A male patient may use any kind of razor but must insert the
5 blade, or plug in the razor without help, as well as retrieve it from the
drawer or cabinet. A female patient must apply her own make-up, if
used, but need not braid or style her hair.

Dependent in all aspects and needs to be fed, nasogastric needs to be


0 administered.

Can manipulate an eating device, usually a spoon, but someone must


2
provide active assistance during the meal.

Feeding Able to feed self with supervision. Assistance is required with


5 associated tasks such as putting milk/sugar into tea, salt, pepper,
spreading butter, turning a plate or other “set up” activities.

Independence in feeding with prepared tray, except may need meat cut,
8 milk carton opened or jar lid etc. The presence of another person is not
required.
Index item Score Description

Feeding The patient can feed self from a tray or table when someone puts the
(Continued) 10 food within reach. The patient must put on an assistive device if
needed, cut food, and if desired use salt and pepper, spread butter, etc.

Total score:

Scoring, interpretation, and prediction

Score Interpretation

00 - 20 Total dependence

21 - 60 Severe dependence

61 - 90 Moderate dependence

91 - 99 Slight dependence

- 100 Independence

Score Prediction

Unlikely to go home
Less than 40 Dependent in mobility
Dependent in self-care

60 Pivotal score where patients move from dependency to assisted


independence.

60 - 80 If living alone will probably need a number of community services to


cope.

More than 85 Likely to be discharged to community living Independent in transfers


and able to walk or use a wheelchair independently

References

Granger, V., Dewis, L., Peters, W., Sherwood, C., & Barrett, J. (1979). Stroke rehabilitation analysis of
repeated Barthel Index measures. Archives of Physical and Medical Rehabilitation, 60, 14 - 17.

Hasselkus, B. (1982). Barthel self-care index and geriatric home care patients. Physical and
Occupational Therapy in Geriatrics, 1, 11 - 22.

Leonard, R., & McGovern, L. (2010). The Barthel Index in an acute geriatric setting. Australian
Occupational Therapy Journal, 39(3), 41–43. https://doi.org/10.1111/j.1440-1630.1992.tb01758.x
Shah, S., Cooper, B., & Maas, F. (1992). The Barthel Index and ADL evaluation in stroke rehabilitation
in Australia, Japan, the UK, and the USA. Australian Occupational Therapy Journal, 39(1), 5–13.
https://doi.org/10.1111/j.1440-1630.1992.tb01729.x

Shah, S., & Cooper, B. (1991). Documentation for measuring stroke rehabilitation outcomes. Australian
Medical Record Journal, 21(3), 88–95. https://doi.org/10.1177/183335839102100304
Shah, S., Vanclay, F., & Cooper, B. (1989). Improving the sensitivity of the Barthel Index for stroke
rehabilitation. Journal of Clinical Epidemiology, 42(8), 703–709. https://doi.org/10.1016/0895-
4356(89)90065-6

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