• generic instrument that can be used with persons with or without disability.
  • developed to measure basic activities of daily living (ADL) independence in both adults and children.

Items are divided into 6 sub-dimensions:
1) Mobility
2) Emergency Communication
3) Dressing
4) Elimination
5) Bathing/Hygiene
6) Eating.

  • The majority of items measure ADLs and others measure body function (bladder/bowel emptying and incontinence, chewing/swallowing food and liquids, verbalizing telephone messages).

Clinical Considerations

  • The K-B Scale divides each activity into its essential components to get a measure of basic ADL. This is advantageous over other known ADL scales as it makes it possible to detect problematic items within activities and thus helps to better identify rehabilitation treatment.
  • The authors suggest using the scale as a method to generate discussion about goals they wish to achieve.
  • The scale was not designed specifically for SCI subjects; therefore, items included in the scale may not be important for SCI populations.

ICF Domain

Activity ▶ Self-Care


  • clinician-administered interview
  • measures degree of patient independence
  • Administration of the scale takes from 1-3 hours.

Number of Items



Items typically used in basic activities of daily living (ex. toilet, bed, etc.)


  • Task weights of 1, 2, or 3 are assigned to each task.
  • In developing the weights, four factors were considered, including: importance to health, difficulty for non-disabled persons, time required to perform the task, and the burden of care-giving.
  • Items are summed (each task is multiplied by its weight)
  • Overall independence scores range from 0 to 313 (0%-100%).



Training Required



Currently unavailable.

# of studies reporting psychometric properties: 2


MCID: not established
SEM: not established
MDC: not established

  • Higher scores indicate greater independence.
  • No normative data has been established for the SCI population at this time.


No values were reported for the reliability of the Klein-Bell Scale for the SCI population.


  • Correlation of the Klein-Bell scale is High with:
    • the Jebsen-Taylor total score (Spearman’s r = -0.635)
    • the Jebsen-Taylor Test- dressing subscale (Spearman’s r = -0.69),
    • the ASIA Upper Extremity Motor Score (UEMS) (Correlation = 0.63)
  • and Moderate with:
    • the Jebsen Taylor Test – Bathing/Hygiene subscale (Spearman’s r = -0.57)
    • the Jebsen Taylor Test – Eating subscale (Spearman’s r = -0.45)
  • and Low with:
    • the COPM Performance (Spearman’s r = 0.07)

(Lynch & Bridle 1989, Dahlgren et al. 2007)


No values were reported for the responsiveness of the Klein-Bell Scale for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the K-B Scale for the SCI population.


Dr. William Miller, Christie Chan, Gita Manhas

Date Last Updated

22 July 2020

Dahlgren A, Karlsson A-K, Lundgren Nilsson A, Friden J, Claesson L. Activity performance and upper extremity function in cervical spinal cord injury patients according to the Klein-Bell ADL Scale. Spinal Cord 2007; 45: 475-484.

Lynch KB, Bridle MJ. Validity of the Jebsen-Taylor Hand Function Test in Predicting Activities of Daily Living. The Occupational Therapy Journal of Research 1989; Volume 9, Number 5: 316-18.