1. Choose a scoring scale
Both scales measure the same 10 activities; only the point values differ.
2. Rate each activity
Record what the person actually does, not what they could do under ideal conditions. Pick the option that best matches the current level of help needed.
3. Your result
Band interpretation follows Shah et al. (1989). This score describes observed daily functioning — it is not a diagnosis and says nothing certain about recovery or prognosis.
Copied ✓How scores are interpreted
Dependence bands proposed by Shah et al. (1989), applied to the 0–100 total:
| Score (0–100) | Dependence level |
|---|---|
| 0–20 | Total dependence |
| 21–60 | Severe dependence |
| 61–90 | Moderate dependence |
| 91–99 | Slight dependence |
| 100 | Independent |
Worked example
Suppose a person is rated: feeding 10, bathing 5, grooming 5, dressing 5, bowel control 10, bladder control 10, toilet use 10, transfers 10, mobility 10, stairs 5.
| Activity | Points |
|---|---|
| Feeding | 10 |
| Bathing | 5 |
| Grooming | 5 |
| Dressing | 5 |
| Bowel control | 10 |
| Bladder control | 10 |
| Toilet use | 10 |
| Transfers | 10 |
| Mobility | 10 |
| Stairs | 5 |
| Total | 80 |
Domain sub-scores: self-care 25/30, continence 20/20, mobility 35/50. A total of 80 falls in the 61–90 band → moderate dependence.
Frequently asked questions
What is the Barthel Index?
The Barthel Index is a 10-item measure of functional independence in activities of daily living (ADL), introduced by Mahoney and Barthel in 1965. It rates feeding, bathing, grooming, dressing, bowel control, bladder control, toilet use, transfers (bed to chair), mobility on level surfaces, and stair climbing. Higher scores mean greater independence: 0 reflects dependence in all assessed activities, while 100 reflects independence in all of them.
How is the 0–100 score calculated?
Each activity is scored at a fixed set of levels and the points are added up. Maximum points per activity are: Feeding 10, Bathing 5, Grooming 5, Dressing 10, Bowel control 10, Bladder control 10, Toilet use 10, Transfers 15, Mobility 15, Stairs 10 — summing to 100. For example, transfers and mobility carry up to 15 points each because safe movement is weighted more heavily, while bathing and grooming carry up to 5 points each.
What is the 0–20 version of the Barthel Index?
In 1988, Collin and colleagues proposed a simplified scoring where each item is rated in one-point steps: bathing and grooming score 0–1; feeding, dressing, bowel control, bladder control, toilet use, and stairs score 0–2; transfers and mobility score 0–3 — for a maximum of 20. Multiply a 0–20 score by 5 to get the 0–100 equivalent. For instance, a Collin score of 16 equals 80 on the original scale (16 × 5 = 80).
How do I interpret the total score?
The widely used dependence bands (Shah et al., 1989) are: 0–20 total dependence, 21–60 severe dependence, 61–90 moderate dependence, 91–99 slight dependence, and 100 independent. These bands describe observed daily functioning — they are not a diagnosis and do not determine care decisions on their own.
What does a score of 80 mean?
Take the worked example above: the item scores add to 80, with domain sub-scores of self-care 25/30, continence 20/20, and mobility 35/50. A total of 80 sits inside the 61–90 band, i.e. moderate dependence. The domain breakdown shows mobility as the relatively weakest area, which is where extra support or therapy would typically be discussed with a professional.
Can the score change over time? What counts as a real improvement?
Yes — the index is often repeated during rehabilitation to track change. Collin's guidance suggests that a change of more than 2 points on the 0–20 scale reflects a probable genuine change; that is more than 10 points on the 0–100 scale (2 × 5 = 10). Smaller shifts may just be measurement noise, so look at trends rather than single points.
Who should complete the assessment, and how?
Rate what the person actually does, not what they could do under ideal conditions. The assessment can be done by a clinician or caregiver through direct observation, or by asking the person and people familiar with their daily routine. Direct observation plus input from relatives or nurses is the most reliable combination.
What are the limitations of the Barthel Index?
It is an ordinal scale of basic physical ADLs: it does not measure cognition, communication, vision, or the quality of movement, and it has ceiling effects — many people score 100 while still needing help with more complex tasks. It should not be used alone to predict outcomes such as discharge destination. It is a screening and monitoring aid, not a diagnosis.
Is the Barthel Index free to use?
The copyright is held by the Maryland State Medical Society, and the index may be used freely for non-commercial purposes. This calculator is an educational tool: it runs entirely in your browser and stores nothing.
Method & sources
Item weights and the 0–100 scale follow Mahoney FI & Barthel DW, "Functional Evaluation: The Barthel Index," Maryland State Medical Journal 1965;14:61–65. The 0–20 scale follows Collin C et al., "The Barthel ADL Index: a reliability study," Int Disabil Stud 1988;10(2):61–63 (score ×5 = 0–100 equivalent). Dependence bands follow Shah S et al., J Clin Epidemiol 1989;42:703–709. Score what the person does, not what they could do; the index should not be used alone to predict outcomes.