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Brain Injury Scales >
Barthel Index
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 |
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. |
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. |
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. |
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. |
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. |
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. |
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. |
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. |
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. |
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. |
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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