title: Verbally administered Barthel Index as functional assessment in brain tumour patients.
abstract: OBJECTIVE
  To investigate verbally administered Barthel Index as a measure of functional status in patients with high grade gliomas.
  
  
  BACKGROUND
  Barthel Index (BI) is a performance score of activities of daily living which has been validated in patients with neurological disability. While any assessment of quality of life in brain tumour patients should include all the aspects of CNS function we concentrated on measurement of physical performance status and evaluated the role of BI as a measure of palliative effect of treatment in patients with high grade glioma undergoing radiotherapy.
  
  
  METHODS
  BI was verbally administered on 504 occasions in 107 patients with high grade glioma. The BI scores were correlated with Karnofsky performance score (KPS), and neurological performance score (NPS) as a measure of inter-index reliability. The BI's prognostic value was assessed using actuarial survival data.
  
  
  RESULTS
  BI was sensitive to change and reflected the degree of functional impairment. In patients with high grade glioma BI correlated with KPS, and NPS (R2 = 0.872 and 0.658 respectively). BI score was also of prognostic value in terms of survival. The median survival of patients with functional independence was 9 months with moderate disability 5 months and with severe disability 4 months.
  
  
  CONCLUSIONS
  Verbally administered Barthel Index is easy to use, reliable and sensitive to change and is of prognostic value. It is a useful tool in the management of patients with gliomas, as an objective evaluation of palliative effectiveness of treatment in patients with functional disability.
authors.affiliation: Neuro-Oncology Unit, Royal Marsden NHS Trust, Surrey, UK.
authors.forename: L
authors.initials: L
authors.lastname: Brazil
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: Laing
authors.forename: F
authors.initials: F
authors.lastname: Hines
authors.forename: D
authors.initials: D
authors.lastname: Guerrero
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: M
authors.initials: M
authors.lastname: Brada
mesh_terms: D000203:Activities of Daily Living; D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005910:Glioma / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D015996:Survival Rate; D013997:Time Factors