Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 4 , Pages 641-647 , April 2008

Rasch Analysis of the Barthel Index in the Assessment of Hospitalized Older Patients After Admission for an Acute Medical Condition

  • Natalie A. de Morton, PhD

      Affiliations

    • Department of Physiotherapy, Monash University, Victoria, Australia
    • Corresponding Author InformationReprint requests to Natalie A. de Morton, PhD, Dept of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, PO Box 527, Frankston, Victoria, Australia 3199
    • ,
  • Jennifer L. Keating, PhD

      Affiliations

    • Department of Physiotherapy, Monash University, Victoria, Australia
    • ,
  • Megan Davidson, PhD

      Affiliations

    • School of Physiotherapy, La Trobe University, Victoria, Australia.

References 

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  2. Wade D. Measurement in neurological rehabilitation. Oxford: Oxford Univ Pr; 1992;
  3. Royal College of Physicians. Standardised assessment scales for elderly people (Report of joint workshops of the Research Unit of the Royal College of Physicians and the British Geriatric Society). London: RCP; 1992;
  4. Shah S. In praise of the biometric and psychometric qualities of the Barthel Index. Physiotherapy. 1994;80:769–771
  5. Hsieh CL, Hsueh IP. A cross-validation of the comprehensive assessment of activities of daily living after stroke. Scand J Rehabil Med. 1999;31:83–88
  6. Tennant A, Geddes J, Chamberlain M. The Barthel Index: an ordinal score or interval level measurement?. Clin Rehabil. 1996;10:301–308
  7. Barer D, Murphy J. Scaling the Barthel: a 10-point hierarchial version of the activities of daily living index for use with stroke patients. Clin Rehabil. 1993;7:271–277
  8. Kucukdeveci A, Yavuzer G, Tennant A, Suldur N, Sonel B, Arasil T. Adaption of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000;32:87–92
  9. Waugh R. An analysis of dimensionality using factor analysis (true score theory) and Rasch measurement: what is the difference? (Which method is better?). J Appl Meas. 2005;6:80–99
  10. Wright B, Stone M. Best test design. Chicago: Mesa Pr; 1979;
  11. van Hartingsveld F, Lucas C, Kwakkel G, Lindeboom R. Improved interpretation of stroke trial results using empirical Barthel item weights. Stroke. 2006;37:162–166
  12. de Morton NA, Jones CT, Keating JL, et al. The effect of exercise on outcomes for hospitalised older acute medical patients: an individual patient data meta-analysis. Age Ageing. 2007;36:219–222
  13. de Morton NA, Keating JL, Berlowitz DJ, Jackson B, Lim WK. Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial. Aust J Physiother. 2007;53:105–111
  14. Jones C, Lowe A, Tweddle N, McGregor L, Russell D, Brandt C. A randomised controlled trial of an exercise intervention to reduce functional decline and health service utilization in the hospitalized elderly. Aust J Ageing. 2006;25:126–133
  15. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42:703–709
  16. Smith E. Effect of item redundancy on Rasch item and person estimates. J Appl Meas. 2005;6:147–163
  17. Smith E. Detecting and evaluating the impact of multidimensionality using item fit statistics and principal components analysis of residuals. J Appl Meas. 2002;3:205–231
  18. Tennant A, Pallant J. Unidimensionality matters! (A tale of two Smiths?). Rasch Meas Trans. 2006;20:1048–1051
  19. Binomial calculator. http://home.clara.net/sisa/binomial.htmAccessed April 2, 2007
  20. Linacre J. Sample size and item calibration stability. Rasch Mes Trans. 1994;7:328
  21. de Morton N, Keating J, Jeffs K. Exercise for acutely hospitalised older medical patients. Cochrane Database Syst Rev. 2007;(1):CD005955
  22. de Morton NA, Keating JL, Jeffs K. The effect of exercise on outcomes for older acute medical inpatients compared with control or alternative treatments: a systematic review of randomized controlled trials. Clin Rehabil. 2007;21:3–16
  23. World Health Organization. International classification of functioning, disability and health. Geneva: WHO; 2001;
  24. Hobart J, Thompson A. The five item Barthel Index. J Neurol Neurosurg Psychiatry. 2001;71:225–230
  25. Ellul J, Watkins C, Barer D. Estimating total Barthel scores from just three items: the European Stroke database ‘minimum dataset’ for assessing functional status at discharge from hospital. Age Ageing. 1998;27:115–122

 Supported by the National Health and Medical Research Council of Australia (Dora Lush Postgraduate Scholarship no. 280632).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00027-0

doi: 10.1016/j.apmr.2007.10.021

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 4 , Pages 641-647 , April 2008

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