Development of the Italian version of the modified Barthel index and preliminary reliability in adults with stroke

This study aimed to develop the Italian version of the modified Barthel Index and assess its reliability within stroke survivors.

Single-centre, prospective observational study for measure validation.

To pre-test the pre-final scale, stroke survivors, caregivers, and health professionals were enrolled. For reliability, only stroke survivors were enrolled. Inclusion of stroke survivors: adults presenting ADL limitation; exclusion: severe visual/hearing impairment, Mini-Mental State Examination <21; severe language disorder, clinical instability.

The Italian modified Barthel Index was developed through forward-and-back translation, and interdisciplinary review. Clarity was evaluated by a sample of all participants. Inter-rater reliability was assessed by 2 independent physiotherapists, and test-retest examined 1-3 days later. Intraclass correlation coefficient (ICC), Spearman's correlation, quadratic weighted Kappa, and agreement percentages were calculated.

Clarity was evaluated with 30 participants (10 per group); minor semantic adjustments were made. Reliability was assessed within 51 stroke survivors, showing Spearman's correlation of 0.990 (test-retest) and 0.985 (inter-rater). ICCs were 0.990 and 0.987, respectively. Weighted Kappa values ranged from 0.76 to 0.98.

The Italian Modified Barthel Index showed high reliability, supporting its use in Italian-speaking stroke populations. The validation of its other psychometric properties needs further research.