Barthel Index and Modified Barthel Index

OT Dude Academy’s Free NBCOT® Exam Prep Course Assessments Introduction Barthel Index and Modified Barthel Index

The Barthel Index (BI) is used to assess the functional independence of clients in their activities of daily living (ADLs). The Barthel Index is often used with stroke survivors and is one of the most frequently cited assessments for ADLs.1  The Barthel Index is a 100 point assessment that scores each category as 0 for unable, 5 (depends) or 10 for unable. 5 can either be independent or needs help. If there is a 10 for the category, 10 will be independent and 5 will default to needs help.

A modified version of the Barthel Index is commonly used called the Modified Barthel Index (MBI), which has a 20 point total.

The Categories

  1. Feeding
  2. Bathing
  3. Grooming
  4. Dressing
  5. Bowel control
  6. Bladder control
  7. Toilet Use
  8. Transfers (bed to chair and back)
  9. Mobility on level surfaces
  10. Stairs

MBI Categories

  1. Bowels
  2. Bladder
  3. Grooming
  4. Toilet Use
  5. Feeding
  6. Transfer (bed to chair and back)
  7. Mobility
  8. Dressing
  9. Stairs
  10. Bathing

Quiz Yourself

While you may not necessarily need to memorize both the BI and MBI, you should familiarize yourself with how scoring and interpretation work. Practice with this MBI calculator to see how the scoring and interpretation are determined. For the MBI, interpretation terms include independent, slight dependency, moderate dependency, and severe dependency.

Outcome measure

The Barthel Index and MBI can be used as an outcome measure such as assessing ADL function at evaluation and comparing it to discontinuation.

In discharge planning, occupational therapy practitioners can use the Barthel Index and MBI to make recommendations for whether the client will benefit from a caregiver and the level of supervision, e.g., several times a week vs. 24/7 supervision.

Research

“The MBI is recommended for clinical and research applications because it has better test–retest reliability and relatively lower random measurement error than those of the original BI.”2 

  1. Ohura, T., Hase, K., Nakajima, Y., & Nakayama, T. (2017). Validity and reliability of a performance evaluation tool based on the modified Barthel Index for stroke patients. BMC medical research methodology, 17(1), 1-8.[↩]
  2. Yang, C. M., Wang, Y. C., Lee, C. H., Chen, M. H., & Hsieh, C. L. (2020). A comparison of test–retest reliability and random measurement error of the Barthel Index and modified Barthel Index in patients with chronic stroke. Disability and Rehabilitation, 1-5.[↩]
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