The Early Rehabilitation Barthel Index (ERBI)

An extended version of the Barthel index, the so-called "Early Rehabilitation Barthel Index", or ERBI, is widely used in German early neurological rehabilitation centres and even was used in defining early rehabilitation procedures in the German DRG system. It contains highly relevant items like mechanical ventilation, tracheostomy, or dysphagia. This study presents an English version of the ERBI and examines its validity and reliability. Two samples of early neurological rehabilitation patients have been analyzed. In one sample (n=1,669), measures of morbidity and length of stay (LOS) have been compared between certain ERBI categories. In a second sample (n=273), inter-rater reliability (nurses vs. physicians) has been examined. Patients with low ERBI had a significantly longer LOS than those with high ERBI values (p<0.001). Further, parameters of morbidity (patient clinical complexity level, number of co-diagnoses) were significantly higher in a low ERBI subgroup. Inter-rater reliability was r=0.849 (p<0.001). The findings suggest that the ERBI is a reliable and valid scale to assess early neurological rehabilitation patients.