![]() ![]() Although validated and used globally, the MBI has limitations in application and interpretation. The Modified Barthel Index (MBI) with a five-step scoring system was developed by Shah et al. The values assigned to each item are based on the amount of physical assistance required to perform the task. The original version of the Barthel Index has 10 items, each scored in three steps. Although numerous instruments are available for measuring disability and dependency in stroke survivors, the Barthel Index (BI) and the modified Rankin Scale (mRS) are the most widely used assessment tools in the clinic and in research. Activities in daily living (ADL) are assessed as a measure of functional independency and outcomes of the rehabilitation process. Therefore, reducing the disability caused by stroke and improving the independence of stroke survivors are the primary goals of post-stroke rehabilitation. Stroke is a major global cause of serious, long-term disability and functional dependency. Korean version of the Modified Barthel Index PPV, ![]() The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. The contact information for the data access commitee is as follows: Seungchang Kim, Department of Statistics, Hallym University, Chuncheon, Gangwon Phone: +82-10-3749-2622 E-mail: This work was supported by a grant from the Korea Centers for Disease Control and Prevention (2016E-33003-02 and National Research Foundation of Korea by the Korean government (MSIP) (NRF-2017R1A2A1A05000730 to YHK. Data are available upon request for researchers who meet the criteria for access to confidential data. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: The KOSCO study is ongoing, and the internal regulations of the Korea Center for Disease Control and Prevention (KCDC), prohibit data from being open to the public until the study has been completed. Received: DecemAccepted: NovemPublished: January 29, 2020Ĭopyright: © 2020 Lee et al. PLoS ONE 15(1):Įditor: Ona Wu, Massachusetts General Hospital, UNITED STATES (2020) Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.Ĭitation: Lee SY, Kim DY, Sohn MK, Lee J, Lee S-G, Shin Y-I, et al. The K-MBI cutoff score ranges for representing mRS grades were variable mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940 specificity 0.612), 98 (sensitivity 0.904 specificity 0.838), 94 (sensitivity 0.885 specificity 0.937), 78 (sensitivity 0.946 specificity, 0.973), and 55 (sensitivity 937 specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke.
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