Barthel Index and modified Rankin Scale: Psychometric properties during medication phases in idiopathic Parkinson disease - 22/12/19

Doi : 10.1016/j.rehab.2019.08.006

Ghorban Taghizadeh ^a, Pablo Martinez-Martin ^b, Mahsa Meimandi ^a, Sayed Amir Hasan Habibi ^c, Shamsi Jamali ^a, Arian Dehmiyani ^a, Siavash Rostami ^a, Alieh Mahmuodi ^d, Maryam Mehdizadeh ^e,^f,^g,⁎ , Seyed-Mohammad Fereshtehnejad ^h,^i,^j
^a Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
^b National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
^c Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
^d Department of Aging, University of Social Welfare Rehabilitation Sciences, Tehran, Iran
^e Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
^f Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
^g Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
^h Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
ⁱ Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
^j Division of Neurology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

^⁎Corresponding author at: Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, 1449614535, Iran.Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical SciencesShahid Hemmat HighwayTehran1449614535Iran

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Highlights

•	The Barthel Index and modified Ranking Scale are valid and reliable outcome measures that can be used to assess level of disability in Parkinson disease (PD).
•	Along with PD specific assessments, the Barthel Index and modified Rankin Scale are accurate tools for patients in clinical settings.
•	The Barthel Index and modified Ranking Scale can be used in future research to measure level of disability in the ON and OFF medication phase, particularly.

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Abstract

Background

Independence in activities of daily living (ADL) is one of the most important aspects in planning treatment for people with Parkinson disease (PD). The Barthel Index (BI) and modified Rankin Scale (mRS) are commonly used in neurological diseases.

Objective

This study was conducted to confirm the validity and reliability of the BI and mRS in PD during ON and OFF medication phases.

Methods

We included 260 individuals with a diagnosis of idiopathic PD. The disability in ADL was measured by the BI, mRS, Parkinson's Disease Questionnaire-39 (PDQ-39), Unified Parkinson Disease Rating Scale-Activities of Daily Living (UPDRS-ADL), and Schwab and England ADL scale (SE). Test–retest, inter-rater reliability, and internal consistency were assessed by the intra-class correlation (ICC) and Cronbach α coefficients. Dimensionality was evaluated by factor analysis. Convergent validity was assessed by the SE, Berg Balance Scale (BBS), PDQ-39 and UPDRS-ADL.

Results

For the 260 participants (187 [71.9%] males; mean [SD] age 60.3 [12.3] years), both the BI and mRS achieved an acceptable level of test–retest and inter-rater reliability (ICC=0.77 to 0.91) in ON and OFF medication phases. The Cronbach α for BI was 0.85 and 0.88, respectively. We found 1 and 2 factors for BI in ON and OFF phases, respectively. Investigation of convergent validity showed moderate to high correlation for the BI with the UPDRS-ADL, SE, PDQ-39 (ADL), BBS and mRS scores in ON and OFF phases (ρ=0.51–0.74) and mRS with SE, UPDRS-ADL, PDQ-39 (ADL) and BBS scores (ρ=0.48–0.82).

Conclusion

The BI and mRS showed acceptable validity and reliability to measure the degree of disability in patients with PD in daily activities in both ON and OFF medication phases.

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Keywords : Idiopathic Parkinson disease, Disability measures, Reliability, ON and OFF medication, Validity