Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey

The aim of this study was to adapt the modified Barthel Index for Turkey an d to determine its reliability and validity. After the translation procedur e, 50 stroke patients and 50 spinal cord injury patients, undergoing inpati ent rehabilitation were assessed by the newly adapted index at admission an d discharge, Reliability was tested using internal consistency, inter-rater reliability and the intraclass correlation coefficient, Construct validity was assessed by association with impairments (Brunnstrom motor stages in s troke, American Spinal Injury Association motor/sensory scores and impairme nt scale in spinal cord injury) and by Rasch analysis. Internal consistency was good at 0.93 for stroke, and 0.88 for spinal cord injury. The level of agreement between two raters was sufficient with Kappa levels of above 0.5 for spinal cord injury and above 0.6 for stroke. Intra-class correlation c oefficients were 0.99 and 0.77 for stroke and spinal cord injury, respectiv ely, The newly adapted index showed expected associations with the impairme nt scales, confirming its construct validity. However, Rasch analysis showe d that bladder and bowel items compromise unidimensionality, In conclusion, adaptation of the modified Barthel Index has been successful and it can be used in Turkey as long as its limitations are recognized.