Barthel Index

Activity	Score
Feeding
0 = Unable
5 = Needs help cutting, spreading butter, etc, or requires modified diet
10 = Independent
Bathing
0 = Dependent
5 = Independent (or in shower)
Grooming
0 = Needs to help with personal care
5 = Independent face/hair/teeth/shaving (implements provided)
Dressing
0 = Dependent
5 = Needs help but can do about half unaided
10 = Independent (including buttons, zips, laces, etc)
Bowels
0 = Incontinent (or needs to be given enemas)
5 = Occasional accident
10 = Continent
Bladder
0 = Incontinent, or catheterized and unable to manage alone
5 = Occasional accident
10 = Continent
Toilet use
0 = Dependent
5 = Needs some help, but can do something alone
10 = Independent (on and off, dressing, wiping)
Transfers (bed to chair and back)
0 = Unable, no sitting balance
5 = Major help (one or two people, physical), can sit
10 = Minor help (verbal or physical)
15 = Independent
Mobility (on level surfaces)
0 = Immobile or <50 yards
5 = Wheelchair independent, including corners, >50 yards
10 = Walks with help of one person (verbal or physical) >50 yards
15 = Independent (but may use any aid; for example, stick) >50 yards
Stairs
0 = Unable
5 = Needs help (verbal, physical, carrying aid)
10 = Independent
Total (0-100):

The Barthel ADL Index: Guidelines

The index should be used as a record of what a patient does, not as a record of what a patient could do
The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason
The need for supervision renders the patient not independent
Patient performance should be established using the best available evidence provided by the patient, family, friends and caregivers; direct observation and common sense are also important, but direct testing is not needed
Usually the patient's performance over the preceding 24 to 48 hours is important, but occasionally longer periods will be relevant
Middle categories imply that the patient supplies over 50 percent of the effort
Use of aids to be independent is allowed

ADL: activities of daily living.

References:

Mahoney FI, Barthel D. Functional evaluation: The Barthel Index. Maryland State Medical Journal 1965; 14:56. Used with permission.
Loewen SC, Anderson BA. Predictors of stroke outcome using objective measurement scales. Stroke 1990; 21:78.
Gresham GE, Phillips TF, Labi ML. ADL status in stroke: Relative merits of three standard indexes. Arch Phys Med Rehabil 1980; 61:355.
Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: A reliability study. Int Disability Study 1988; 10:61.

Graphic 77371 Version 3.0