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Observational Study
. 2025 Sep 30:57:jrm44279.
doi: 10.2340/jrm.v57.44279.

Development of the Italian version of the modified Barthel index and preliminary reliability in adults with stroke

Stefano Doronzio  1 , Diego Longo  2 , Michele Piazzini  3 , Angela M Politi  4 , Tommaso Ciapetti  4 , Monica Barnabé  4 , Chiara Castagnoli  4 , Donata Bardi  4 , Julieta Giacani  4 , Maria L Del Vicario  4 , Giulio Cherubini  3 , Marco Baccini  4 , Francesca Cecchi  1
Affiliations
Observational Study

Development of the Italian version of the modified Barthel index and preliminary reliability in adults with stroke

Stefano Doronzio et al. J Rehabil Med. .

Abstract

Objective: This study aimed to develop the Italian version of the modified Barthel Index and assess its reliability within stroke survivors.

Design: Single-centre, prospective observational study for measure validation.

Subjects/patients: To pre-test the pre-final scale, stroke survivors, caregivers, and health professionals were enrolled. For reliability, only stroke survivors were enrolled. Inclusion of stroke survivors: adults presenting ADL limitation; exclusion: severe visual/hearing impairment, Mini-Mental State Examination <21; severe language disorder, clinical instability.

Methods: The Italian modified Barthel Index was developed through forward-and-back translation, and interdisciplinary review. Clarity was evaluated by a sample of all participants. Inter-rater reliability was assessed by 2 independent physiotherapists, and test-retest examined 1-3 days later. Intraclass correlation coefficient (ICC), Spearman's correlation, quadratic weighted Kappa, and agreement percentages were calculated.

Results: Clarity was evaluated with 30 participants (10 per group); minor semantic adjustments were made. Reliability was assessed within 51 stroke survivors, showing Spearman's correlation of 0.990 (test-retest) and 0.985 (inter-rater). ICCs were 0.990 and 0.987, respectively. Weighted Kappa values ranged from 0.76 to 0.98.

Conclusion: The Italian Modified Barthel Index showed high reliability, supporting its use in Italian-speaking stroke populations. The validation of its other psychometric properties needs further research.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Bland–Altman graph for both test–retest and inter-rater evaluations.
See this image and copyright information in PMC

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