Maximum Score for Barthel Index
The maximum total score for the Barthel Index is 100 points, indicating complete independence in all activities of daily living. 1
Scoring Structure
The Barthel Index consists of 10 items that assess basic activities of daily living (ADL) and mobility, with scores ranging from 0 (complete dependence) to 100 (complete independence). 1 The higher the score, the more independent the patient is in performing daily activities. 1
Individual Component Maximum Scores
The 10 components have varying maximum point values: 1
- Feeding: 10 points (independent)
- Bathing: 5 points (independent or in shower)
- Grooming: 5 points (independent with face/hair/teeth/shaving)
- Dressing: 10 points (independent including buttons, zips, laces)
- Bowel control: 10 points (continent)
- Bladder control: 10 points (continent)
- Toilet use: 10 points (independent on and off, dressing, wiping)
- Transfers (bed to chair): 15 points (independent)
- Mobility (on level surfaces): 15 points (independent, may use aids like stick, >50 yards)
- Stairs: 10 points (independent)
Clinical Interpretation
A score of 100 indicates the patient can perform all basic ADL independently, though the use of assistive devices (such as a cane or walker) is permitted. 1 This is an important distinction—independence does not require performing activities without any aids, only without human assistance. 1
Common Cutoff Points in Clinical Practice
While 100 is the maximum, various thresholds have clinical significance: 1
- ≥85-95: Generally considered "favorable outcome" or minimal assistance to independence 1
- ≥60: Transition from dependence to assisted independence 1
- <60: Often defines unfavorable outcome or significant dependence 1
Important Clinical Caveats
The Barthel Index has significant ceiling effects—approximately 60% of stroke patients achieve the maximum score of 100, which can limit its ability to detect meaningful differences in higher-functioning patients. 1 This limitation means that patients scoring 100 may still have residual impairments in instrumental ADL, cognition, or quality of life that the scale does not capture. 1, 2
The scale should document what the patient actually does, not what they could potentially do, and any need for supervision renders the patient not independent. 1