Verbally administered Barthel Index as functional assessment in brain tumour patients

Objective: To investigate verbally administered Barthel Index asa measure of functional status in patients withhigh grade gliomas. Background: Barthel Index (BI) isa performance score of activities of daily livingwhich has been validated in patients with neurologicaldisability. While any assessment of quality of lifein brain tumour patients should include all theaspects of CNS function we concentrated on measurementof physical performance status and evaluated the roleof BI as a measure of palliative effectof treatment in patients with high grade gliomaundergoing radiotherapy. Methods: BI was verbally administered on504 occasions in 107 patients with high gradeglioma. The BI scores were correlated with Karnofskyperformance score (KPS), and neurological performance score (NPS)as a measure of inter-index reliability. The BI'sprognostic value was assessed using actuarial survival data.Results: BI was sensitive to change and reflectedthe degree of functional impairment. In patients withhigh grade glioma BI correlated with KPS, andNPS (R2=0.872 and 0.658 respectively). BIscore was also of prognostic value in termsof survival. The median survival of patients withfunctional independence was 9 months with moderate disability5 months and with severe disability 4 months.Conclusion: Verbally administered Barthel Index is easy touse, reliable and sensitive to change and isof prognostic value. It is a useful toolin the management of patients with gliomas, asan objective evaluation of palliative effectiveness of treatmentin patients with functional disability.