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RehabMeasures Database

Bowel and Bladder Treatment Index

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The BBTI is a patient self-report that assesses bowel and bladder functioning. It includes items about methods of defecation and urination, complications from SCI surgery, assistance with defecation & urination, and the client’s perceived quality of life (QOL).

Link to Instrument

Instrument Details

Acronym BBTI

Area of Assessment

Activities of Daily Living
Quality of Life

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil




Key Descriptions

  • Number of items in the instrument: 131
  • Minimum and maximum scores N/A, mostly nominal data with some ordinal and interval items that are not scored.
  • Patient reports by checking a series of boxes and filling in blanks denoting patient bowel management methods, complication symptoms and medical procedures, impact on QOL
  • Brief description of item scoring N/A, but consider how many complications were involved
  • Administration instructions patient completes short form with pen or pencil, with clinician assistance if needed
  • Any other important information from manuals or publications should be followed with Behavioral Adherence Assessment of Bowel and Bladder Treatment (BAABBT).
  • Additionally, the BBTI has two versions: one that is completed immediately before discharge (SCI-BBTI-SF), and another that can be completed one year post-discharge (SCI-BBTI-LT 1 year SF). In some cases these forms were compared to consider client change in behavior and perceived quality of life over time.

Number of Items


Equipment Required

  • Pencil/Pen

Time to Administer

10-15 minutes

Required Training

No Training

Age Ranges

18 +


Instrument Reviewers

Initially reviewed by University of Illinois at Chicago Master of Science in Occupational Therapy students Simon Komar, Michael Krakau, and Sam Boyer.

ICF Domain

Body Function


  • The BBTI is in its earliest stages of utility.

  • There is no user manual.

  • After using the BBTI, the assessment authors recommend following up with the Behavioral Adherence Assessment of Bowel and Bladder Treatment (BAABBT).

Spinal Injuries

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Minimal Detectable Change (MDC)

Data not available, but the BBTI has been re-administered to consider change in client response over time.


Tate, D. G., Forchheimer, M. , Hartwig, R., & Kalpakjian, C. (2015, October). The Bowel and Bladder Treatment Index (BBTI): A new tool to assess bowel and bladder management in SCI. Archives of Physical Medicine and Rehabilitation, 96(10), pp. e24-e25.

Tate, D., Forchheimer, M., Rodriguez, G., Chiodo, A., Pelletier, A., Meade, M., & Krassiousov, A. (2016). Risk factors associated with neurogenic bowel complications and dysfunction in spinal cord injury. Archives of Physical Medicine and Rehabilitation, 97. pp. 1679-1686.

Tate, D. (2017). Psychosocial and behavioral factors associated with bowel and bladder management after SCI. US Army Medical Research and Materiel Command, Fort Detrick, MD.