Barthel Index Calculator

Barthel Index scoring table

This is the Collin and Wade version of the Barthel Index, scored out of 20. Higher totals mean greater independence.

The Modified Barthel Index scores the same ten activities across five levels of assistance and totals 100 rather than 20. Scores from the two versions are not interchangeable, so always state which version you have used.

Barthel Index interpretation

The Barthel Index is most useful as a repeated measure: the change between admission and discharge says more than any single total.

• 20Independent

  Functionally independent in basic activities of daily living.

• 15–19Mildly dependent

  May need minimal assistance with some activities.

• 10–14Moderately dependent

  Requires help with several activities.

• 5–9Severely dependent

  Requires significant assistance with most activities.

• 0–4Totally dependent

  Requires full assistance with all activities.

How to score the Barthel Index

1. 1Score what the patient actually did over the preceding 24 to 48 hours, not what they are theoretically capable of.
2. 2Use the best available evidence: direct observation, nursing records, and reports from the patient, family or carers.
3. 3Score each of the ten activities using the levels above; unavailable information means the item cannot be scored, so find it rather than guessing.
4. 4Count the need for supervision as not independent, and count the use of aids as independent if no person is required.
5. 5Total the ten items out of 20 and record the date so that change over an episode of care can be measured.

Common pitfalls

• Scoring potential rather than performance. The Barthel Index measures what is done, not what could be done in ideal circumstances.
• Mixing the 0–20 and 0–100 versions in the same record. Always label which version the score came from.
• Expecting it to detect small changes at the extremes. The index has well-described ceiling and floor effects, so it is insensitive near 20 and near 0.
• Treating it as a cognitive or social assessment. It covers basic physical ADLs only, and says nothing about instrumental activities such as cooking, finances or medication management.
• Scoring supervision as independence — if a person is needed for safety, the activity is not independent.

Frequently asked questions

When should the Barthel Index be used?

The Barthel Index is used to assess functional status in patients with stroke, neurological conditions, frailty, and rehabilitation needs. It is commonly used on admission and discharge to measure change, and as part of comprehensive geriatric assessment. It assesses what the patient actually does, not what they could do.

How do you interpret the Barthel Index score?

A score of 20 indicates independence in basic ADLs. 15-19 is mildly dependent - needs minimal assistance. 10-14 is moderately dependent - requires help with several activities. 5-9 is severely dependent - significant assistance with most activities. 0-4 is totally dependent - full assistance required.

What is the difference between the Barthel Index and the Modified Barthel Index?

The version used here is the Collin and Wade Barthel Index, scored out of 20 across ten activities. The Modified Barthel Index rates the same ten activities across five levels of assistance and totals 100. The two totals are not interchangeable.

What are the ten Barthel Index items?

Bowels, bladder, grooming, toilet use, feeding, transfer from bed to chair, mobility, dressing, stairs and bathing.

What is a good Barthel Index score?

A total of 20 means independence in basic activities of daily living. In rehabilitation the more informative figure is usually the change between two assessments rather than the absolute total, because the index has ceiling and floor effects.

Sources and further reading

• The Barthel ADL Index: a reliability study (Collin, Wade, Davies and Horne) — International Disability Studies
• Stroke rehabilitation in adults (NG236) — NICE

This page is reference information for registered healthcare professionals. It is not medical advice and does not replace clinical judgement, local policy, or the current version of the source guidance. Always verify scores and thresholds against your own organisation's pathway before acting on them.