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Barthel Index

(Full credit is not given for an activity if the patient needs even minimal help/supervision.)
A score of 0 is given when patient cannot meet criteria as defined.

1. Feeding

10 Independent; feeds self from tray or table; can put on assistive device if needed; accomplishes feeding in reasonable time.
5 Assistance necessary with cutting food, etc
0 Cannot meet criteria

2. Moving (from wheelchair to bed and return)

15 Independent in all phases of this activity.
10 Minimal help needed or patient needs to be reminded or supervised for safety of 1 or more parts of this activity.
5 Patient can come to sitting position without help of second person but needs to be lifted out of bed and assisted with transfers.
0 Cannot meet criteria

3. Personal Toilet

5 Can wash hands, face; combs hair, cleans teeth. Can shave (males) or apply makeup (females) without assistance; females need not braid or style hair.
0 Cannot meet criteria

4. Getting On and Off Toilet

10 Able to get on and off toilet, fastens/unfastens clothes, can use toilet paper without assistance. May use wall bar or other support if needed; if bedpan necessary patient can place it on chair, empty, and clean it.
5 Needs help because of imbalance or other problems with clothes or toilet paper.
0 Cannot meet criteria.

5. Bathing Self

5 May use bath tub, shower or sponge bath. Patient must be able to perform all functions without another person being present.
0 Cannot meet criteria.

6. Walking on Level Surface

15 Patient can walk at least 50 yards without assistance or supervision; may use braces, prostheses, crutches, canes, or walkerette but not a rolling walker. Must be able to lock/unlock braces, assume standing or seated position, get mechanical aids into position for use and dispose of them when seated (putting on and off braces should be scored under dressing).
10 Assistance needed to perform above activities, but can walk 50 yards with little help.
0 Cannot Meet Criteria.

7. Propelling a Wheelchair
Do not score this item if patient gets score for walking.

5 Patient cannot ambulate but can propel wheelchair independently; can go around corners, turn around, maneuver chair to table, bed, toilet, etc. Must be able to push chair 50 yards.
0 Cannot meet criteria.

8. Ascending and Descending Stairs

10 Able to go up and down flight of stairs safely without supervision using canes, handrails, or crutches when needed and can carry these items as ascending/descending.
5 Needs help with or supervision of any of the above items.
0 Cannot meet criteria.

9. Dressing/Undressing

10 Able to put on, fasten and remove all clothing; ties shoelaces unless necessary adaptions used. Activity includes fastening braces and corsets when prescribed; suspenders, loafer shoes and dresses opening in the front may be used when necessary.
5 Needs help putting on, fastening, or removing clothing; must accomplish at least half of task alone within reasonable time; women need not be scored on use of brassiere or girdle unless prescribed.
0 Cannot meet criteria.

10. Continence of Bowels

10 Able to control bowels and have no accidents. Can use a suppository or take an enema when necessary (as for spinal cord injury patients who have had bowel training).
5 Needs help in using a suppository or taking an enema or has occasional accidents.
0 Cannot meet criteria.

11. Controlling Bladder

10 Able to control bladder day and night. Spinal injury patients must be able to put on external devices and leg bags independently, clean and empty bag, and must stay dry day and night.
5 Occasional accidents occur, cannot wait for bed pan, does not get to toilet in time or needs help with external device.
0 Cannot meet criteria.

TOTAL (0–100):

Source: Mahoney FI, Barthel D. “Functional evaluation: the Barthel Index.”  Maryland State Med Journal 1965;14:56-61


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