The test-retest reliability and minimal detectable change of the short-form Barthel Index (5 items) and its associations with chronic stroke-specific impairments.
Chang-Sik Park
PMID 29950775WHAT IT FOUND
In 24 chronic stroke patients, the 5-item Barthel Index was stable across tests a week apart and tracked postural control and motor function.
A 7.84-point change is the smallest score change unlikely to be random measurement error.
Key findings
01In 24 chronic stroke patients, SF-BI total scores were consistent across two tests one week apart (ICC=0.91, 0.86-0.95).
02The minimal detectable change for the 5-item SF-BI total score was 7.84 points.
03SF-BI total scores correlated with the original Barthel Index (r=0.95), PASS postural control scores (r=0.81), and FMA motor scores (r=0.76).
STILL TO COME
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What it does not show
The study included only 24 chronic stroke patients, so the reliability and minimal detectable change may not apply to acute stroke, more severe impairments, or other settings. The short form focuses on mobility and self-care and may have a floor effect in patients with severe ADL limitations. Bathing and toilet use agreement was lower, possibly because these items relied on self-report rather than direct observation. The study did not test whether SF-BI changes because of treatment; it only checked measurement consistency and associations.
The easy way to misread this
Do not read the 7.84-point change as evidence that a therapy worked. It only says that a change this large is unlikely to be random measurement error, and the study did not test treatment.