The Culturally Adapted Italian Version of the Barthel Index (IcaBI): Assessment of Structural Validity, Inter-Rater Reliability and Responsiveness to Clinically Relevant Improvements in Patients Admitted to Inpatient Rehabilitation Centers
Open accessAbstract
The Barthel Index (BI) is widely used to determine eligibility criteria for inpatient rehabilitation and to monitor patients' recovery, irrespective of the illnesses that affect them. The culturally adapted Italian version of the Barthel Index (IcaBI) was recently validated. This paper reports the structural validity and inter-rater reliability of the IcaBI and its responsiveness to the results of inpatient rehabilitation. The IcaBI was administered to a cohort of 264 patients hospitalized in two rehabilitation centers in Rome, Italy. Factor analysis using principal component analysis revealed a monofactorial structure for neurological patients and, after removal of item 1 "feeding", also for orthopedic patients. Substantial to optimal inter-rater reliability was found (0.74 > intraclass correlation coefficient < 0.96). The IcaBI was found to be accurate (area under the curve= 0.72) with a minimal clinically important change score of 35 points. This work confirms that IcaBI is a useful tool for measuring disability in health and social care settings along the continuum of care. Further studies are needed to assess its criterion validity, interpretability and responsiveness in other specific disease conditions.
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The mean difference in functional independence (37.8 points) was higher than MCID for inpatient rehabilitation for BI (35 points).
“The mean difference in functional independence (37.8 points) was higher than minimal clinically important differences (MCID) for inpatient rehabilitation for BI (35 points) [59].”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [59]
The Responsiveness section reports a 35-point MCIC for the culturally adapted Italian Barthel Index in rehabilitation inpatients, supporting the cited threshold. It reports a mean change of 36.8 points, not 37.8; the Discussion (p. 225) reiterates the 35-point threshold. (LLM, conf=0.88)
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Galeoto, G., Berardi, A., Grassi, M. L., Scialpi, A., Valente, D., Tofani, M., & Paoloni, M. (2021) · Advances in Rehabilitation · doi:10.5114/areh.2021.110001 · Cited by 1 · see citing works
Galeoto, G., Mignolli, E., Tofani, M., Sogos, C., Servadio, A., Valente, D., & Berardi, A. (2022) · Journal of Pediatric Rehabilitation Medicine · doi:10.3233/prm-190674 · Cited by 1 · see citing works
Independencia funcional en la recuperación de pacientes sometidos a cirugía cardiaca.
Castaño, J. H. O., Carvajal, J. P. G., & Londoño, M. G. (2019) · Revista Ciencia y Cuidado · doi:10.22463/17949831.1610
Ishida, Y., Shigematsu, H., Tsukamoto, S., Morimoto, Y., Iwata, E., Okuda, A., Kishi, S., Fujii, H., Honoki, K., Tanaka, Y., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-843585/v1
Letter to Hitomi Tomohara-Ichishima et al
Yamada, K. (2022) · Respiratory Medicine and Research · doi:10.1016/j.resmer.2022.100917
Tomohara-Ichishima, H., Wakabayashi, H., Maeda, K., Nishioka, S., & Momosaki, R. (2022) · Respiratory Medicine and Research · doi:10.1016/j.resmer.2022.100942
Kim, J.-H., & Lee, B.-H. (2025) · The Journal of Korean Academy of Physical Therapy Science · doi:10.26862/jkpts.2025.09.32.3.1
Translation, cross-cultural adaptation and validation of Barthel index into Nepali languagePreprint
Nepal, G. M., Ntsiea, V., Acharya, R. S., Norvang, O. P., & Stensdotter, A.-K. (2026) · Research Square · doi:10.21203/rs.3.rs-10996941/v1
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- Authors
- Castiglia, S.
- Venue
- Functional Neurology
- Publisher
- Edikta s.r.l.
- Published
- 2017
- Volume
- 32
- Issue
- 4
- Pages
- 221
- ISSN
- 0393-5264 (ISSN-L)
- 1971-3274
- PMC
- PMC5762108
- OpenAlex
- W2783862514
- Cited by
- 66
- References
- 36
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 11 · 2019: 7 · 2018: 6
- FWCI
- 16.18
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Functional Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Social Sciences › Education › Health Education and Validation
- Keywords
- Barthel Index, Italian adaptation, functional disability assessment, inpatient rehabilitation, inter-rater reliability, structural validity, responsiveness, minimal clinically important change, neurological patients, orthopedic patients
- MeSH terms
- Adult, Aged, Aged, 80 and over, Culture, Disability Evaluation, Female, Humans, Inpatients, Italy, Male, Middle Aged, Movement Disorders, Surveys and Questionnaires, Rehabilitation Centers, Severity of Illness Index, Translating, Reproducibility of Results, Outcome Assessment, Health Care, Young Adult
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