Development of the Italian version of the modified Barthel index and preliminary reliability in adults with stroke

Objective: This study aimed to develop the Italian version of the modified Barthel Index and assess its reliability within stroke survivors. Design: Single-centre, prospective observational study for measure validation. Subjects/Patients: To pre-test the pre-final scale, stroke survivors, caregivers, and health professionals were enrolled. For reliability, only stroke survivors were enrolled. Inclusion of stroke survivors: adults presenting ADL limitation; exclusion: severe visual/hearing impairment, Mini-Mental State Examination <21; severe language disorder, clinical instability. Methods: The Italian modified Barthel Index was developed through forward-and-back translation, and interdisciplinary review. Clarity was evaluated by a sample of all participants. Inter-rater reliability was assessed by 2 independent physiotherapists, and test–retest examined 1–3 days later. Intraclass correlation coefficient (ICC), Spearman’s correlation, quadratic weighted Kappa, and agreement percentages were calculated. Results: Clarity was evaluated with 30 participants (10 per group); minor semantic adjustments were made. Reliability was assessed within 51 stroke survivors, showing Spearman’s correlation of 0.990 (test–retest) and 0.985 (inter-rater). ICCs were 0.990 and 0.987, respectively. Weighted Kappa values ranged from 0.76 to 0.98. Conclusion: The Italian Modified Barthel Index showed high reliability, supporting its use in Italian-speaking stroke populations. The validation of its other psychometric properties needs further research.