Barthel Index (BI)


Barthel Index (BI) Evaluation Summary

  What does the tool measure? Activities of Daily Living
  What types of clients can the tool be used for? Patients with stroke, patients with other neuromuscular or
musculoskeletal disorders, oncology patients
  Is this a screening or assessment tool? Assessment
Time to administer Self report: 2-5 minutes; Direct observation: 20 minutes,
but may vary according to patient’s abilities and tolerance
  Versions Modified 10-item version (MBI); 5-item short form; The expanded 15-item version; The extended BI (EBI); The 3-item BI; Self-rating BI (SB); Early Rehabilitation Barthel Index (ERI)
Other Languages Dutch, German, Turkish, Persian, French, Chinese
Measurement Properties


– Five studies of the MBI reported excellent internal consistency
– One study of the MBI reported excellent test-retest reliability
– One study of the MBI and 4 studies of BI reported excellent inter-rater reliability; and 1 study of the BI reported adequate inter-rater reliability


One study demonstrated excellent concurrent validity between the MBI and motor-Functional Independence Measure (FIM) at admission and discharge

The MBI predicted instrumental ADL permformance at 6-months post-stroke; likelihood a patient will regain continence following stroke; risk for falls in patients with stroke; functional recovery following stroke; and acute care hospital length following stroke.

Excellent correlations in patients with stroke on the physical mobility dimension of the Nottingham Health Profile Subscale; the Physical Functioning subscale of the SF-36Berg Balance Scale; the Fugl-Meyer Assessment ScaleFrenchay Activities Indice.

  Does the tool detect change in patients? Significant ceiling effects noted for the BI, meaning that it doesn’t detect change well in highly functional individuals. 
The Functional Independence Measure was developed as a measure that would be better able to detect change in disability than the BI, however little to no difference has been found.  
Out of 8 studies examined, 3 reported that the BI had a large ability to detect change, 3 reported adequate ; 2 reported small.
  Acceptability The MBI/BI has been evaluated for both self-report and use with proxy respondents in addition to direct observation.
Feasibility The MBI/BI is simple to administer. Requires training if
administered by direct observation. It has been developed in many forms that can be administered in many situations and can be used for longitudinal assessment.
How to obtain the tool? For a copy of the original BI click here