Office of Technology Transfer – University of Michigan

Functional Independence Measure Software, Based on Barthel Index, Assesses Activities of Daily Living (ADLs) with Animated Images

Technology #4537

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Activities of daily life: assessment of patient's ability to climb stairsfunctional independence softwarevisual depiction of patient's ability to get out of bed with or without assistance
Andrew J. Haig
Managed By
Drew Bennett
Associate Director - Software Licensing 734-615-4004
Development of a Language-Independent Functional Evaluation
Archives of Physical Medicine and Rehabilitation Volume 90, Issue 12, Pages 2074-2080, December 2009, 2009
Rehabilitation Needs of Persons Discharged from an African Trauma Center
Pan African Medical Journal 10:32, 7/11/2011, 2011

This functional independence measurement tool is computer-animated medical diagnostic software, based on the commonly used Barthel Index, that evaluates a patient’s functional independence and quality of life prior to or during treatment for a traumatic injury, chronic disability, or disease.

This functional independence assessment tool, called Language Independent Functional Evaluation (L.I.F.E.), presents fluid, 3D animations of activities of daily living, or ADLs, on a computer screen. ADLs are common activities of daily living like bathing, feeding, toileting, and dressing, and more.

A touch screen allows patients to choose the level of functional independence or assistance they require (partial, total, or independent) to perform these functions.

This animated approach is more explicit and understandable than the Barthel Index and other common functional independence measures that use checklists or static, two-dimensional pictures.

Activities of Daily Living and Functional Independence Software Applicable Worldwide in Hospitals and Clinics Regardless of Language Barrier and Illiteracy

This approach to measuring functional independence works well for patient populations with high levels of illiteracy or other language barriers. 

According to the World Health Organization (WHO), there are 650 million people living with disabilities worldwide. Eighty percent of them live in countries with high rates of illiteracy and very low physical rehabilitation therapy resources. Differences in language and literacy impede an understanding of the impact of disability around the world.

A study at Ghana’s second largest hospital served as a pilot study to demonstrate the software’s practical use in any acute hospital setting, validating L.I.F.E.’s use in developing-country populations, as well as in American hospitals.

In tests on trauma patients in Ghana, Mongolia, Colombia, and the United States, this software was proven to have good face validity, content validity, and construct validity.

L.I.F.E. software has implications for international health care and in health care policy research, as well as applications in acute-care settings, hospitals and clinics, physical therapy offices and more.


  • Hospitals and clinics worldwide

  • Acute hospitals

  • Physical therapy/Physiatrist offices

  • Regions with high-rates of illiteracy

  • Geriatric medicine

  • Patients unable to communicate verbally


  • Image, rather than language-based

  • Animated, rather than static images

  • Viable in diverse cultures

  • More detailed depictions of functional status

  • Tested in low-resource, high-illiteracy countries

  • Expands health organization’s ability to compare prevalence of disability and the impact of rehabilitation across regions

  • Could help with resource allocation in areas with high levels of disability and low levels of physical rehabilitation

  • Evaluation is completely language and literacy independent 

  • Can be adapted to various social and cultural environments 

  • Provides more reliable information than either questionnaires or static graphic picture