Academic literature on the topic 'Barthel Index (BI)'

Zusammenfassung Standardinstrument Assessment nach Barthel Der Barthel-Index wurde als Kontrollparameter der Therapieabläufe in der geriatrischen Medizin entwickelt. Mittlerweile ist er nicht mehr nur ein Instrument des multiprofessionellen geriatrischen Teams, sondern zunehmend auch für die Kostenträger von Behandlung und Rehabilitation. Hier im Fallbeispiel.

Shah and Cooper, in their ‘Commentary’ (BJOT February 1993), state that ‘rehabilitation workers can feel confident in advocating the use of the BI, as modified by Shah et al in 1989, as the preferred measure of ADL’. The evidence they present in their commentary fails to support this assertion.

It has been more than 50 years ago, when in 1965 Florence Mahoney and Dorothea Barthel published an article entitled "Functional evaluation: the Barthel Index." Since then, Barthel scale, also known as a Basic ADL Index (BI), Barthel Score and Maryland Disability Index, is one of the most well-known scales ADL (Activities of Daily Living) and is still popular. This simple scale is still used by the representatives of a number of medical workers for many pur-poses, including the assessment of the results of treatment, rehabilitation, prognosing, assess-ment of self-reliance, assessment of needs for care and for the purposes of the judgment. De-spite its simplicity, the administration of the original Barthel questionnaire takes about 5-10 minutes; that`s why there is a demand for a shortened form of BI. Based on a review of the literature the advantages and disadvantages of the abbreviated BI versions in assessing activities of daily living has been presented. Key Words ADL, Barthel Index, Barthel scale, clinimetrics, short forms Opara J. Are short forms of Barthel Index equally useful in the assessment of ADL? Med Rehabil 2018; 22(2): 40-44. DOI: 10.5604/01.3001.0012.6932

Aim: To translate and validate of Barthel index in Urdu language for stroke patients Methodology: From June 2020 to January 2021, a descriptive linguistic validation research was done using convenient sampling at Ghurki Trust and Teaching Hospital in Lahore. Twenty neurological rehab professionals and 200 stroke survivors who could understand Urdu were used to validate the content. Two translators, one with a medical background and the other with a technical background in Urdu language, forward translated the BI English version into Urdu. The backward translation of the translated versions BI-Urdu-I and BI-Urdu-II into English was done by two professionals with medical and technical backgrounds who are fluent in Urdu to English translation. After that, the re-translated versions BI-English-III and BI-English-IV were compared to the original BI-English (English version) by expert committee. Data was collected by Final version of Urdu while considering inclusion and exclusion. Patients gave their consent in advance, and anonymity was guaranteed. Results: The mean age of stroke patients was 54.87 and standard deviation was 0.7648. The Chronbach’s alpha of translated version of BI questionnaire is 0.732. The inter item correlation (Pearson Correlation) after testing and re-testing on stroke patients was ranged from (0.425-0.945). The Intra-class Correlation after the translation of BI ranged from 0.314-0.732. Conclusion: Urdu version of Barthel index is a valid and reliable tool for stroke patients. Keywords: Validation, Barthel Index and Stroke

The Community Dependency Index (CDI) was developed due to concerns that the Barthel Index (BI) was limited as a measure of physical function in community settings. However, no studies have compared the two rating scales within multiple sclerosis (MS). The aim of this study was to determine whether, in a community-based sample of people with MS, the CDI is a better measure than the BI. BI and CDI data were collected from 90 people with MS. Four measurement properties were compared: scaling assumptions (item mean scores, corrected item-total correlations), acceptability (score distributions, floor/ceiling effects), reliability (Cronbach’s alpha) and validity (concurrent, discriminant, group differences, relative validity). Both scales satisfied recommended criteria for scaling assumptions (indicating it was legitimate to report a summed score) and internal consistency reliability (alpha-0.85). The scales were highly correlated (r- 0.96), indicating they measured the same construct. Both scales demonstrated good group differences validity, but the BI was marginally superior. Notable ceiling effects (BI-CDI) were demonstrated for both scales, particularly in those less disabled. This study sample had relatively minor levels of disability, with over 70% still being independently mobile. In this sample of people with MS, the measurement properties of the BI and CDI examined were very similar, suggesting the CDI does not appear to have achieved its goal of better measurement.

Among all deaths, 40-50% are due to vascular events and out of these 10% aredue to stroke. More than 66% of the global stroke occurrence is in developing countries, wherethe average age of patients with stroke is 15 years less than in developed countries. Objectives:To determine the correlation between higher total cholesterol level and high Barthel Indexscore(estimate of functional daily independent activity level) in patients with acute ischemicstroke. Design: Cross sectional study. Period: May 2013 to Apr 2014. Setting: Medical Units ofDHQ and Allied Hospital, Faisalabad. Methodology: Sample size of 200 patients was collectedand patients were included through Consecutive (non-probability) sampling technique. Allpatients underwent CT scan Brain from the radiology department of the hospital to determinethe respective changes (hypo dense area) of the ischemic stroke. Fasting serum cholesterolwas measured in all patients after an overnight fast of 12 hours. Then patients were assessed byusing Barthel Index score (BI). The data was analyzed by using SPSS version 16.0. SpearmanRank correlation coefficient was calculated to BI score in patients with ischemic stroke. Results:The mean age of the patients was noted as 61.76±11.55 years. In this study 55.50% weremales and 44.50% patients were females. The mean total cholesterol value of patients wasnoted as 251.58±71.15 mg/dl. Out of 200 patients, 111(55.5%) patients had high cholesterol(>200mg/dl) whereas 89(44.5%) patient had low cholesterol of(<200mg/dl).In statical analysisthe results showed that the mean value of total Barthel index score was 57.50±19.52. The studyresults described that 51.50% patients had high Barthel index score (>53) whereas 48.50%patients had low Barthel index score (<53). Spearman correlation coefficient was calculatedbetween high TC and high BI score as r= 0.641. This value was statistically significant i.e.p-value=0.000*. Conclusions: With the help of this study, we found a significant positiverelationship between high TC and high BI score in patients presented with ischemic stroke.Now we can better prognosticate the functional outcome of ischemic stroke in our patients.

For the estimation of short-term prognosis in terminal cancer patients, it is important to establish a prognostic index that does not involve blood tests. We compared the prognostic ability of the Barthel Index (BI) with the Glasgow Prognostic Score (GPS). Ninety-seven inpatients with terminal cancer at Onomichi Municipal Hospital who died between 2018 and 2019 were retrospectively analyzed. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUROC) were compared between the BI and GPS. For predicting the 15 day prognosis, the BI showed higher specificity, accuracy, and AUROC than the GPS. For predicting the 30 day prognosis, the BI showed higher sensitivity, accuracy, and AUROC than the GPS. The BI can predict the 15 or 30 day prognosis in terminal cancer patients. As the BI does not require blood tests, it may be an option for prognostic prediction in terminal cancer patients.

AbstractThe aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. Methodology. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini–Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. Results. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = −0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale – the risk of falling was higher in patients with severe cognitive impairment. Conclusions. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient’s discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.

A questionnaire was designed for a recent survey into the outcome of stroke patients in Soweto, named the Soweto Stroke Questionnaire (SSQ). It was based on the Barthel ADL Index (BI) but modified to suit the local context. This paper introduces the SSQ, and reports on its inter-rater reliability and its concurrent validity. Fifty-four subjects, in the age range 30 to 75 years, were interviewed and nineteen re-interviewed using the SSQ. Four different scores were calculated: a total score, a Barthel Index score, an Impairment score, and a Quality of Life score. The Pearson’s Correlation Coefficient was found to be high between the total score and the BI score. (r=0.948) which supports the concurrent validity of the developed questionnaire. In assessing the reliability of the SQQ, the Wilcoxin Test showed that there was no significant difference between the initial and repeat interviews for the total score, the Barthel Index score, and the Impairment score (p<0,05). The Quality of Life Score came closer to a difference, but not statistically significantly so. These tests were collaborated by Bland and Altman graphs which showed that in 95% of the time, the questions were repeatable. Mc Nemar’s Test of Symmetry showed that 34 out of 38 questions asked were found to have over 70% correlation. Four questions showed a lower correlation, the lowest being 63.16%. The SSQ was found to have interrater reliability, and to be concurrently valid to the Barthel Index. It is quick and easy to use, requiring no sophisticated equipment or training. It still requires to be investigated for sensitivity and predictiveness, and to be validated in a more general South African stroke population.

Frailty and malnutrition are two major medical issues influencing the health of older people. This doctoral thesis investigated the predictive ability and discriminatory power of clinically applicable frailty instruments and their malnutrition counterparts - nutritional screening tools (NSTs). The study was prospective and observational by design, and included patients aged ≤ 70 years consecutively admitted to the Geriatric Evaluation and Management Unit (GEMU) at The Queen Elizabeth Hospital, South Australia. Thesis aims were to: (i) identify the prevalence rates of malnutrition and frailty in hospitalised older people and (ii) determine the predictive ability and accuracy of these measurements. The mean (standard deviation) age of patients was 85.2 (6.4) years; 123 (72 %) were female, n = 172. Malnutrition and frailty prevalence rates were high: malnutrition was found in 53 (31 %) of patients using the Mini Nutritional Assessment (MNA) for classification; and frailty was found in 107 patients (62 %) by the Cardiovascular Health Study (CHS) frailty index. When looking at nutritional screening tools as predictors of hospital discharge outcomes: the MNA and the MNA-short form (MNA-SF) were associated with length of stay (LOS); the Geriatric Nutritional Risk Index (GNRI) and calf circumference (CC) were associated with functional decline; and mid arm circumference (MAC) was associated with a higher level of care on discharge. At six months post-hospitalisation, malnutrition by the MNA (OR = 3.29) and GNRI (OR = 2.84) was predictive of poor outcome (defined as mortality or admission to high level care). However the discriminative ability of this prediction was inadequate (area under Receiver Operating Characteristic curve (auROC) values were < 0.7). iii Regarding frailty, almost all frailty and functional decline indices were predictive of poor outcome (mortality or high level care admission) at both hospital discharge and at six month post-hospitalisation. However when discriminative ability was considered, only the Frailty Index of Cumulative Deficits (FI-CD) and the adapted Katz score of Activities of Daily Living showed adequate values (auROC values of 0.735 and 0.704 respectively). The FI-CD was the only instrument to show adequate discriminatory power in predicting poor six month outcome (auROC = 0.702, P < 0.001). Malnutrition shares many characteristics with frailty; however the overlap between these two conditions lacks a quantitative foundation. Therefore, this doctoral project also looked at the efficacy of nutritional screening tools as frailty indices in hospitalised older people. An additional focus of this thesis was the association between appetite, body composition and inflammation in healthy people of all ages. This thesis illustrated the high prevalence rate of both malnutrition and frailty in hospitalised older people. Results highlight the importance of research into the predictive ability of both NSTs and frailty instruments in hospitalised older people. Such knowledge will be of assistance in the areas of gerontology research, clinical practice and public health policy, particularly in the wake of the global expansion of the number of older people. Thesis results may also assist in standardising definitions for both frailty and malnutrition, definitions which are greatly needed in clinical practice and research.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2013

Review question / Objective: This study will provide evidence-based references for the efficacy of 5 different non-pharmaceutical therapies in the treatment of post-stroke cognitive impairment(PSCI). 1. Types of studies. Only randomized controlled trials (RCTs) of Transcranial Magnetic Stimulation(TMS), Transcranial Direct Current Stimulation(tDCS), Acupuncture, Virtual Reality Exposure Therapy(VR) and Computer-assisted cognitive rehabilitation(CA) for PSCI will be recruited. Additionally, Studies should be available in full papers as well as peer reviewed and the original data should be clear and adequate. 2. Types of participants. All adults with a recent or previous history of ischaemic or hemorrhagic stroke and diagnosed according to clearly defined or internationally recognized diagnostic criteria, regardless of nationality, race, sex, age, or educational background. 3.Types of interventions and controls. The control group takes non-acupuncture treatment, including conventional rehabilitation or in combination with symptomatic support therapy. The experimental group should be treated with acupuncture on basis of the control group. 4.The interventions of the experimental groups were Transcranial Magnetic Stimulation(TMS), Transcranial Direct Current Stimulation(tDCS), Acupuncture, Virtual Reality Exposure Therapy(VR) or Computer-assisted cognitive rehabilitation(CA), and the interventions of the control group takes routine rehabilitation and cognition training or other therapies mentioned above that were different from the intervention group. 5.Types of outcomes. The primary outcomes are measured with The Mini-Mental State Examination (MMSE) and/or The Montreal Cognitive Assessment Scale (MoCA), which have been widely used to evaluate the cognitive abilities. The secondary outcome indicator was the Barthel Index (BI) to assess independence in activities of daily living (ADLs).