VERBALLY ADMINISTERED BARTHEL INDEX AS FUNCTIONAL ASSESSMENT IN BRAIN-TUMOR PATIENTS

Objective: To investigate verbally administered Barthel Index as a mea sure of functional status in patients with high grade gliomas. Backgro und: Barthel Index (BI) is a performance score of activities of daily living which has been validated in patients with neurological disabili ty. While any assessment of quality of life in brain tumour patients s hould include all the aspects of CNS function we concentrated on measu rement of physical performance status and evaluated the role of BI as a measure of palliative effect of treatment in patients with high grad e glioma undergoing radiotherapy. Methods: BI was verbally administere d on 504 occasions in 107 patients with high grade glioma. The BI scor es were correlated with Karnofsky performance score (KPS), and neurolo gical performance score (NPS) as a measure of inter-index reliability The BI's prognostic value was assessed using actuarial survival data. Results: BI was sensitive to change and reflected the degree of functi onal impairment. In patients with high grade glioma BI correlated with KPS, and NPS (R-2 = 0.872 and 0.658 respectively). BI score was also of prognostic value in terms of survival. The median survival of patie nts with functional independence was 9 months with moderate disability 5 months and with severe disability 4 months. Conclusion: Verbally ad ministered Barthel Index is easy to use, reliable and sensitive to cha nge and is of prognostic value. It is a useful tool in the management of patients with gliomas, as an objective evaluation of palliative eff ectiveness of treatment in patients with functional disability.