Barthel Index

The Barthel scale or Barthel ADL index is an ordinal scale used to measure performance in activities of daily living (ADL). Each performance item is rated on this scale with a given number of points assigned to each level or ranking. It uses ten variables describing ADL and mobility. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence following discharge from hospital. The amount of time and physical assistance required to perform each item are used in determining the assigned value of each item. External factors within the environment affect the score of each item. If adaptations outside the standard home environment are met during assessment, the participant’s score will be lower if these conditions are not available. If adaptations to the environment are made, they should be described in detail and attached to the Barthel index.

The ten variables addressed in the Barthel scale are

  • presence or absence of fecal incontinence
  • presence or absence of urinary incontinence
  • help needed with grooming
  • help needed with toilet use
  • help needed with feeding
  • help needed with transfers (e.g. from chair to bed)
  • help needed with walking
  • help needed with dressing
  • help needed with climbing stairs
  • and help needed with bathing

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


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