Use of the Barthel index and modified Rankin scale in acute stroke trials

Jacques De Keyser, C. Steen, G. Sulter

Research output: Contribution to journalArticlepeer-review

891 Citations (Scopus)


BACKGROUND AND PURPOSE: The Barthel Index (BI) and the Modified Rankin Scale (MRS) are commonly used scales that measure disability or dependence in activities of daily living in stroke victims. The objective of this study was to investigate how these scales were used and interpreted in acute stroke trials. METHODS: We identified from MEDLINE the major efficacy trials with neuroprotective drugs, thrombolytic drugs, and anticoagulants in acute ischemic stroke published between January 1995 and December 1998. We selected those trials that used the BI and/or MRS as outcome parameters. RESULTS: Fifteen trials fulfilling the inclusion criteria were identified. The BI was used in 13 and the MRS in 8. In 4 trials mean and median scores of the BI were used, and in 1 trial median scores of the MRS were compared. Primary end points included the BI in 7, the MRS in 6, and both the BI and MRS in 3. With regard to the BI, a variety of sum scores between 50 and 95 were used as cutoff scores to define favorable outcome. Favorable outcome on the MRS was defined as either 3, or BI
Original languageEnglish
Pages (from-to)1538-1541
Number of pages4
Issue number8
Publication statusPublished - Aug 1999


  • Acute Disease
  • Brain Ischemia/classification/drug therapy/*rehabi
  • *Clinical Trials
  • Phase III
  • Comparative Study
  • Disability Evaluation
  • Fibrinolytic Agents/therapeutic use
  • Human
  • Randomized Controlled Trials
  • Retrospective Studies
  • Severity of Illness Index
  • Support
  • Thrombolytic Therapy


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