Self-rating Barthel Index Compatible with the Original Barthel Index and the Functional Independence Measure Motor Score

Abstract

To confirm concurrent validity of the final revision of the self-rating Barthel index (SB) and its test-retest reliability, we investigated 171 stroke outpatients without severe aphasia or dementia who were seen by a doctor on predetermined days at eight different hospitals. For 41 patients, the differences in scores among the original Barthel index (BI) and Granger's BI and SB were examined by the Friedman two-way analysis of variance and Wilcoxon matched-pairs signed-ranks test, and the difference in scores between Functional Independence Measure motor score (FIM-MS) and three-level scale FIM-MS was determined by the Wilcoxon's matched-pairs signed-ranks test. Concurrent validity of the SB was confirmed by Spearman's correlation coefficients with the original BI and FIM-MS, and internal consistency of the five measuring instruments was examined. For all 171 patients test-retest reliability of the SB was examined with the Spearman's correlation coefficient for total scores and kappa coefficients for each ADL item. Regression analysis was performed to determine what factors were related with test-retest reliability. Total scores of the SB and Granger's BI and the three-level scale FIM-MS were significantly higher than those of the original BI and FIM-MS, respectively. Correlation coefficients of the SB with the original BI and FIM-MS were 0.994 and 0.904, respectively, and its α-coefficient was 0.842. Test-retest reliability of the total score was 0.835 by the correlation coefficient, and kappa coefficients of 1 and 12 ADL items were fair and good, respectively. Regression analysis revealed that self-rating by a patient with a high SB total score is more accurate. Therefore, the SB has good concurrent validity and is well-related with the original BI and FIM, and its test-retest reliability is sufficiently high for practical use.