Stroke rehabilitation: analysis of repeated Barthel index measures

Functional abilities of stroke patients in a rehabilitation hospital are recorded every 2 weeks using the Barthel index. For purposes of this study, data were collected retrospectively and prospectively from consecutive records according to predetermined criteria on forms coded for computer analysis. Total scores of 110 patients were correlated with length of stay, placement at discharge and scores in individual functional abilities. Analysis of the data reveals that an initial score over 40 on the Barthel index defines a population with a greater proportion of discharges to home and that patients with initial scores over 60 have a shorter length of stay. Further analysis indicates a predictable progression in the development of functional skills in this population so that with a Barthel score below 40, no one was independent in the mobility skills and fewer than 50% were independent in the very basic skills, such as feeding, grooming and sphincter control. A score of 60 appears to be a pivotal score where patients move from dependency to assisted independence.