Validity and Reliability of the Thai Version of the Barthel
Index for Elderly Patients with Femoral Neck Fracture
Panai Laohaprasitiporn MD*, Atthakorn Jarusriwanna MD*, Aasis Unnanuntana MD*
Affiliation :
* Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Hip fracture is a common osteoporotic fracture that requires a specific outcome measurement tool to evaluate
functional status. The authors aimed to develop the Thai version of the Barthel Index (TVBI) and to evaluate the validity
and reliability of TVBI for assessment of elderly patients with femoral neck fracture.
Material and Method: The Barthel Index (BI) was translated into Thai using a forward-backward translation protocol.
Fifty-three patients with low-energy femoral neck fracture were then prospectively enrolled and evaluated with TVBI, the
de Morton Mobility Index (DEMMI), the EuroQol-5D (EQ-5D), the two-minute walk test (2MWT), and the timed get-up-
and-go test (TUG) within 2 weeks after surgery. Validity of TVBI was assessed by calculating the index of item-objective
congruence and correlating TVBI scores with scores from other outcome measurements. TVBI reliability was evaluated by
measuring test-retest reliability and internal consistency.
Results : TVBI had high content validity and strong correlation with DEMMI (Spearman’s rho = 0.629; p-value <0.001), and
moderate correlation with EQ-5D utility score, EQ-5D visual analog scale, and 2MWT (Spearman’s rho = 0.452, 0.313, and
0.413, respectively; p-value <0.05). Interobserver and intraobserver reliabilities of TVBI were high, with intraclass correlation
coefficients of 0.714 and 0.968, respectively. The internal consistency of TVBI was acceptable (Cronbach’s alpha = 0.694).
Conclusion : TVBI yields good validity and reliability, is without floor or ceiling effects, and can be used in all patients
during early postoperative treatment after femoral neck fracture.
Keywords : Barthel index, femoral neck fracture, osteoporosis, reliability, validity
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