Development of the Italian version of the modified Barthel index and preliminary reliability in adults with stroke.
Stefano Doronzio, Diego Longo, Michele Piazzini and 10 others
PMID 41025881WHAT IT FOUND
An Italian version of the modified Barthel Index showed high agreement among 51 adults with stroke when scored by different raters and repeated within days.
Total scores were stable, but some individual items were less consistent.
Key findings
01The total mBI-IT score did not differ significantly between assessments, with reported agreement values of 0.990 for test-retest and 0.985 for inter-rater.
02The total-score limits of agreement were -8.6 to +8.4 points for test-retest and -10 to +9.7 points for inter-rater.
03During pre-testing, only ambulation and toilet scoring instructions were unclear to more than 20% of participants, and individual item agreement ranged from 0.72 to 0.98.
STILL TO COME
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What it does not show
This was a preliminary reliability study, not a full validation, so it does not show that the scale measures stroke recovery or works in other populations. Only 51 stroke survivors were analysed, all in subacute rehabilitation, so results may not apply to acute or chronic stroke or to other disabling conditions. The raters were mainly physiotherapists, and the authors state that results may not generalise to health professionals other than occupational therapists or physiotherapists. Test and retest were deliberately close in time to reduce functional change, but this could have allowed raters to remember earlier scores and overestimate reliability. Some individual items had lower agreement, and the initial pre-test found unclear scoring instructions for ambulation and toilet.
Declared interests
The authors declared no conflicts of interest. The research was funded by a grant from the Italian Ministry of Health, Current Research 2023-24 funds, and the authors report no sponsor involvement that could have influenced the outcome.
The easy way to misread this
Do not read the high total-score agreement as evidence that a small change in a patient's mBI-IT score is real. The reported limits of agreement were -8.6 to +8.4 points for test-retest and -10 to +9.7 points for inter-rater, and this was a preliminary reliability study in 51 subacute stroke survivors.
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