Arch Phys Med Rehabil 79(10): 1231-1236. Sharrack, B., Hughes, R. A., et al. The Functional Independence Measure (FIM)(TM) (Guide for the Uniform Data Set for Medical Rehabilitation, 1996) is the most widely accepted functional assessment measure in use in the rehabilitation community. (2015) Validity and reliability of the Japanese version of the FIM + FAM in patients with cerebrovascular accident. Face validity was evaluated by asking clinicians specific questions addressing: Difficulty of understanding (88% had no difficulty), Unnecessary items (97% reported no unnecessary items, Items that should be added (83% felt no extra items needed), 92% of subjects and 88% of clinicians reported a max score on communication, 75% of subjects and 73% of clinicians reported a max score on social cognition, Admission FIM Motor Scores accounted for 52% of variance in discharge motor function among TBI patients, admission FIM Cognitive Scores accounted for 46% of variance in discharge cognitive function – admission motor FIM was the most significant predictor of length of stay, Although the FIM instrument is reliable and key validity characteristics have been established, it has only 5 items directly addressing cognitive, behavioral, and communication issues, which limits its content validity for TBI, Admission motor FIM scores (β = 0.55) and admission cognitive FIM scores (β = 0.38) had the highest impact on discharge total FIM scores, FIM total and FIM motor scores correlated more strongly with OPCS disability scores, LHS scores, SF-36 physical component scores and WAIS – verbal IQ, than with measures of mental health status or psychological distress (SF36 mental component, General Health Questionnaire), FIM Cognitive Scores correlated most strongly with OPCS Disability scores and WAIS-verbal IQ scores and weakly with LHS, SF-36 physical and mental components, and the General Health Questionnaire (ABIEBR), Ceiling effect on FIM motor scale after discharge ranging from 10% at 1 month to 15% at 12 months, Ceiling effect on the FIM cognitive scale after discharge for 70% of subjects at 1 month, reducing to 53% at 12 months, For FIM motor, 15-36% of subjects presented with positive change exceeding the MDC and 15- 25% with negative change exceeding the MDC, For FIM cognitive, 8-9% of subjects presented with positive change exceeding the MDC and 20-24% presented with negative change exceeding the MDC. (Hall et al, 1999; cross-sectional data from SCI Model Systems National Database; average of 8 days post injury [SD = 13 days]; sample size varying pending time post injury, Acute SCI), Mean (SD) Motor FIM Scores at Rehabilitation Admission, Discharge, and 1, 2, and 5 Years Post Injury: All Cases at AIS Grades A, B, C, Divide the score by 13 (i.e. If you are not currently a subscriber, and would like to become one, please call 716.817.7872 or e-mail us at For technical support, please call 716.817.7834 or e-mail The study examined initial characteristics of veterans predictive of grade IV achievement on the FIM. "Adaptation of the Functional Independence Measure for use in Turkey." (Kucukdeveci, 2013) One hundred and eighty-eight community dwelling participants (mean age 63.1 ±12 years), a median of 27 (range 3-240) months post-stroke were evaluated on the FIM and the World Health Organization Disability Assessment Schedule (WHODAS-II). Clin Rehabil 24(12): p. 1121-6. 41;dressing) to excellent (0.77;mobility) with the average absolute item % agreement from 7l.l% (Dressing) to 90.6% (transfers). Yavuz, N., Tezyurek, M., et al. Find it on PubMed. interpersonal activities, [mobility and self-care,; 2}. Arch Phys Med Rehabil 82(3): 367-374. Topics in Geriatric Rehabilitation 1(3): 59-74. Various Diagnoses (meta analytic findings): (Ottenbacher et al, 1996; n = 11 studies published between 1993 and 1995; total sample size = 1,568 participants, Various Diagnoses), (Sharrack et al, 1999; n = 64; mean age = 40 years, MS), (Dodds et al, 1993; n = 11,102 (52% Stroke, 10% Orthopedic; 10% Brain Injury); mean age = 65 years, General Rehab), (Hobart et al, 2001; Neurological Disorders), (Ng, et al., 2007; n= 1502; mean age of total = 61.3 ± 15.0 years; mean acute LOS = 14.5 ± 17.5 days; mean inpatient rehab LOS = 21.5 ±19.0 days, Neurological Disorders), (Hobart et al, 2001; n = 169; neurological rehab patient: MS, stroke, TBI, other), (Coster et al, 2006; n = 516 subjects with neurologic, orthopedic, or complex medical conditions; mean age = 68.3 (14.97) years; discharged from tertiary care or rehab hospital, Rehabilitation Patients), (Coster et al, 2006; Rehabilitation Patients), Bates, B.E., Xie, D., et al. The validity of the FIM associated with the actual LOS was lower (-0.6846) compared to the SIS-16 (-0.7953) and the STREAM Total (-0.7972). Scores are generally rated at admission and discharge. A task force representing the US rehabilitation community set about developing the Uniform Data System for Medical Rehabilitation (UDSMR) - a minimum data set that includes a rating scale to measure function, the Functional Independence Measure (FIM instrument). "Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with stroke." Although the FIM instrument was originally developed to address issues of sensitivity and comprehensiveness for Barthel Index (BI), subsequent studies demonstrated that psychometric properties of the FIM instrument and BI are similar (Hsueh et al, 2002; Stroke EDGE task force), “The FIM instrument does not contain key activity or participation elements of patient recovery important for measuring outcome and burden of illness (e.g., return to work, relationships, social and recreational pastimes, etc. The FIM mark is owned by UBFA, Inc. vi the process of taking a well-known clinical tool and making it the basis of a national prospective payment system. The FIM Motor Scale satisfied Rasch model expectations including the uni-dimensionality assumption without requiring deletion of any of the 13 items. Barthel Index can be measured directly or estimated from the Northwick Park Dependency Scale (NPDS) or the FIM. 1-844-355-ABLE, Visiting & COVID-19 Precautions     |     TeleHealth Visits. Poor to excellent predictive validity was found between the domains of the Stroke Impact Scale and the FIM (0.26-0.70, p < 0.05). (2008). Participants with an initial Total FIM score ≤ 109 at admission, improved significantly more (P = 0.006) on the Stroke Impact Scale and on measures of activities of daily living and instrumental activities of daily living at completion of the intervention. (2008). Racial/ethnic group, age, length of stay and medical comorbidities were significant predictors of total FIM ratings over the four time points. Participants received constraint-induced movement therapy, bilateral arm training, or conventional rehabilitation for two hour sessions, five times per week for three weeks. The UDSMR Guide, Version 5.1 (1997) formed the basis for much of the clinical content in the current document, and Dr. Granger’s clinical insight and wisdom contributed Please e-mail us! Spinal Cord 36(12): 832-837. This analysis reinforces that the FIM Motor Scale contains clinically important items. Data were drawn from the Uniform Data System for Medical Rehabilitation (UDSMR), 24, 25 which contains a national sample of all conditions requiring IRF care. "Rehabilitation outcome of Turkish stroke patients: in a team approach setting." "Outcome measures for gait and ambulation in the spinal cord injury population." (2011) Tennant, Past and present issues in Rasch analysis: the functional independence measure (FIM) revisited. Provides a uniform system of measurement for disability based on the International Classification of Impairment, Disabilities and Handicaps; measures the level of a patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. "Evaluating the effectiveness of stroke rehabilitation: choosing a discriminative measure." A systematic review of the validity of cognitive screening instruments within one month after stroke. Find it on PubMed, Heinemann, A. W., Linacre, J. M., et al. (2006). A significant relationship was found between the FIM-Motor and the Clock Drawing Test (Exp (B) = 0.984, p = 0.030). Singapore Med J . If this is an emergency, please dial 911, A Young Scientist's Journey after a Stroke, Care by the Numbers: Skilled Nursing versus Inpatient Rehabilitation, Community-Ready Upper Extremity Interactive Rehabilitation, Global Advisory Services — Hospital Training & Consulting, Medical Student Education & Residency Program, 3 Day Vestibular Rehabilitation: Theory, Evidence and Practical Application Course, Updates in Supporting Patients Communication with New Technologies, Overcoming Challenges: Evaluation & Treatment of Sensory Based Feeding Disorders in Children,, Making Waves Following a Spinal Cord Injury, Full Circle After a Non-Traumatic Brain Injury, An Unanticipated Head Injury and Incredibly Bright Future. With Parkinson disease? receiving consultative or comprehensive rehabilitation care post-stroke, uniform data system for medical rehabilitation fim,! A new tool for rehabilitation. one rehabilitation setting to another. has. 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