[The Neuro-Mental Index. An addition to the Barthel Index for detection of impairments in basic psychological-mental diemsnions in neurorehabilitation].

The Barthel Index (BI) is the most commonly used scale for assessing impairment of activities of daily living (ADL). For a global view of patients' abilities and the care needed in everyday neurorehabilitation practice, additional information about basic psychological and cognitive functions is essential. We therefore designed a new disability scale comprised of assessments of consciousness, approachability, orientation, memory, behaviour, emotions, communication, problem solving, perception, and behaviour at night. The scale shows exactly the same inner structure as the BI, with ten items and a score of up to 20 in steps from 0-100% (or 0-20 points). By a careful weighing of the items, the final score of the neuromental index (NMI) should create a clearer picture of both the disabilities and the needed resources. A second aim was to cover a broad range of patients including those in coma and coma remission states and those with only slight neuropsychological or behavioural symptoms. The NMI was examined with a group of 179 neurorehabilitation inpatients and proved to be highly valid, reliable, and practicable. It was designed to enable a global assessment of disability as well as the care resources needed, even in patients with different disability levels in ADL and psychological and cognitive functions.