Development of a Barthel index based on dyspnea for patients with respiratory diseases

BACKGROUND: As Barthel index quantify motor impairment but not breathlessness, it could under-estimate disability in chronic respiratory disease (CRD). To our knowledge, no study evaluated with a unique instrument and simultaneously both motor and respiratory disability in CRD during activities daily living (ADLs). AIM: The objective of this study was to validate Barthel Index (BI) based on dyspnea (BI-d) perception during ADLs for patients with chronic respiratory disease. METHODS: Comprensibility, reliability, internal consistency, validity, responsiveness and ability to differentiate between disease groups were assessed on 219 subjects. RESULTS: Good comprensibility, high reliability [(interrater ICC was 0.93 (95% CI 0.892-0.964 and test-retest ICC was 0.99 (95% CI 0.983-0.994)], good internal consistency (Cronbach9s alpha 0.89), high concurrent validity with 6MWD (Pearson r= -0.538 p S =0.70, p CONCLUSIONS: The Barthel Index based on dyspnea perception showed good psychometric properties. A unique instrument simultaneously administered may provide a global assessment of disability during ADLs incorporating both motor and respiratory aspects.