IS THE BARTHEL SCALE APPROPRIATE IN NONINDUSTRIALIZED COUNTRIES - A VIEW OF RURAL PAKISTAN

Purpose: To determine if the Barthel Index, a conventional scale for a ssessing disability, is appropriate for stroke patients in rural Pakis tan, rather than an observational study by visiting stroke patients in their homes. Method: Stroke patients attending hospital out patient c linics in Islamabad, together with others identified in local villages , were assessed to test the validity of the Barthel Activities of Dail y Living Scale. Result: For each item on the disability scale, differe nces in local customs, lifestyle and architecture meant that the Barth el Scale was not appropriate in rural Pakistan. Conclusions: There is unlikely to be a disability scale which can be applicable universally. Care must be taken when standard scales are used for international co mparisons of stroke disability.