Fim 4w172t

Functional Independence Measure (FIM) Description The FIM, an assessment instrument of functional status, is part of the Uniform Data Set for Medical Rehabilitation (UDS). It can be used clinically as an outcome measure. 1-5 Population

Time to Complete

Cost

All rehabilitation clients

30 minutes

Minimal

Training Workshops to train s and test reliability are available

INSTRUCTIONS Extensive manual for U.D.S. for Medical Rehabilitation available from: 82 Farber Hall, SUNY-South Campus, Buffalo, NY 14214 SCALING Format • Task performance. Subscales • The FIM consists of 23 items in 7 areas of function: • • • • • • •

Self Care (6 items) Sphincter control (2 items) Mobility (3 items) Locomotion (3 items) Communication (2 items) Social adjustment/cooperation (4 items) Cognition/problem solving (3 items)

Scoring The client is scored as: 7. 6. 5. 4. 3. 2. 1.

Independent Dependent

- complete - modified - modified requires supervision - modified requires minimal assistance - modified requires moderate assistance - requires maximal assistance - complete

RELIABILITY Internal Consistency Not reported. Test-rated Reliability Not reported. Inter-rater Reliability One hundred and twenty-seven newly injured spinal cord clients at 13 centres were assessed by 2 raters at ission and discharge. Correlations were high (0.83 to 0.96) VALIDITY Content (domain or face) Eight different disciplines involving 114 clinicians evaluated 110 clients to ensure face validity. Construct Not reported. Concurrent Forty-one spinal cord injured clients were evaluated within 45 days post-injury, on the Modified Barthel and modified FIM (only self care – feeding, grooming, bathing, dresper body, dressing lower body, perineal care, and mobility – chair transfer, toilet transfer, tub transfer, walking, wheelchair propulsion). One nurse clinician tested the clients upon ission to rehabilitation, discharge from rehabilitation and at 12month follow-up. 4 r2 Self-care Mobility Total

Correlation 0.89 - 0.94 0.64 - 0.76 0.83 - 0.89

Predictive The FIM was found to be the most useful tool in predicting burden of care as measured in minutes of assistance provided by another person to clients with multiple sclerosis. In addition, the FIM contributes to predicting the subject’s level of satisfaction with life. Responsiveness Scores on the FIM for 127 spinal cord injured clients changed from ission to discharge (41% – 52%). In a study of clients with multiple sclerosis, the FIM was found to be more sensitive in describing levels of disability and more precise in defining items than the Incapacity Status Scale. 1 Material taken from: Physical Rehabilitation Outcome Measures, by Beverley Cole, Elspeth Finch, Carolyn Gowland and Nancy Nayo © 1994. Published by: The Canadian Physiotherapy Association.