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

Abstract

OBJECTIVE: To develop a self-rating Barthel Index questionnaire (SB) for assessing stroke patients living at home, the test-retest reliability of SB versions 1 and 2 and the inter-method reliability of SB version 3 were examined. DESIGN: Case series. SETTING: Clinics of the Department of Rehabilitation Medicine at the University Hospital and two affiliated hospitals. PATIENTS: Thirty-one, 140 and 65 chronic stroke patients living at home, being seen for regular follow-up, and having no severe aphasia for SB versions 1, 2 and 3, respectively. MAIN OUTCOME MEASURE: Kappa coefficients of items in SB versions 1 and 2 for test-retest reliability, intra-class correlation coefficients of the self-care index, mobility index and total score, kappa coefficients of items and Friedman's two-way ANOVAs of ranking in SB version 3 among the self-ratings, family ratings and occupational therapist (OT) ratings; a regression analysis of age, gender, duration, time for filling in the SB, OT ratings, Mini-Mental State score and aphasia. RESULTS: Kappa coefficients in SB version 2 were higher than those in version 1. Intra-class correlation coefficients in SB version 3 among the three ratings were good, and kappa coefficients in each item were also good or excellent. By Friedman's two-way ANOVA, all the items except walking up/down stairs had no significant difference in ranking. Regression analysis revealed that OT ratings and time for filling in the SB affected the absolute difference of scores between the self-ratings and OT ratings. CONCLUSIONS: SB version 3 is sufficiently reliable for practical use.