Test-retest and inter-method reliability of the self-rating Barthel Index

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Gerontology

Background:

• Accurate assessment of functional status is crucial for stroke patient rehabilitation.
• Existing tools may require adaptation for self-administration by home-dwelling stroke patients.
• The Barthel Index (BI) is a widely used functional assessment tool.

Purpose of the Study:

• To develop a self-rating version of the Barthel Index (SB) for home-dwelling stroke patients.
• To evaluate the test-retest reliability of SB versions 1 and 2.
• To assess the inter-method reliability of SB version 3 against occupational therapist (OT) and family ratings.

Main Methods:

• A case series design was employed across university hospital rehabilitation clinics.
• Chronic stroke patients without severe aphasia were recruited for SB versions 1 (n=31), 2 (n=140), and 3 (n=65).
• Reliability was assessed using kappa coefficients for item agreement and intra-class correlation coefficients for overall scores.

Main Results:

• SB version 2 showed higher test-retest reliability (kappa coefficients) than version 1.
• SB version 3 demonstrated good inter-method reliability (intra-class correlation coefficients) among self, family, and OT ratings.
• Most items in SB version 3 showed good to excellent agreement, with no significant ranking differences except for stair negotiation.

Conclusions:

• The self-rating Barthel Index (SB) version 3 is a reliable tool for assessing functional status in home-dwelling stroke patients.
• SB version 3 is suitable for practical clinical application in stroke rehabilitation.
• Further analysis indicated that OT ratings and time to complete the questionnaire influenced score discrepancies.