The fim was also developed to offer a uniform system of measurement for disability based on the international. Predictors of functional independence and stress level of. Barthel index bi, and motor component of functional independence measure mfim and categorical disability measures modified rankin scale mrs are used. It is an 18item measure of dependency for activities of daily living comprising motor and 5 cognitive items each measured on a scale of 17. The functional independence measure fim is widely used and accepted as a functionallevel. The fim was also developed to offer a uniform system of measurement for disability based on the international classification of impairment, disabilities and handicaps for. Functional independence measure synonyms, functional.
Background and purposeresidual disability after stroke presents a major economic and humanistic burden. Demography, stroke severity measured by the national institute of health stroke scale, and stroke outcome measured by the modified rankin scale were also documented. To evaluate the patients with stroke by functional independence measure fim scale, at the times of admission to hospital, discharge, and sixmonth poststroke, and to determine the. The tool is used to assess a patients level of disability as well as change in patient status in response to rehabilitation or medical intervention. Methods for comparing functional independence measure fim improvement degree for stroke patients between rehabilitation hospitals int j. Impact of stroke on quality of life and functional independence. The functional independence measure fim was developed in 1983 in a collaboration between the american congress of rehabilitation medicine and the american academy of physical medicine and rehabilitation headed by carl granger and byron hamilton 7. Its area of use can include skilled nursing facilities and hospitals aimed at acute, subacute and rehabilitation care. Ability of functional independence measure to accurately predict. In order to improve the prediction accuracy, the following methods are used.
Although the fim is widely used and has been shown to be reliable and valid, there is limited information about its responsiveness, particularly in comparison with the bi. The functional independence measure fim is an 18item measurement tool that. The functional independence measure fim is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury or cancer. The functional independence measure fim was developed to be a more comprehensive and sensitive measure of disability than the barthel index bi. We have successfully predicted stroke outcome using regression analysis with the stroke impairment assessment set sias, which we have developed, and the functional independence measure fim. Functional independence measure scores of patients with. The total functional independence measure score, the functional independence measure motor subscore, and the casemix group were equally the strongest predictors for any of the primary outcomes. To examine whether functional independence measure fim scores on admission can predict the future care levels of patients after acute stroke. Functional independence measure provides a uniform system of measurement for disability based on the international classification of impairment, disabilities and handicaps. A comparison of the barthel index and the functional. The functional independence measure fim is a tool used to assess the functional progress of a patient who has had a stroke, traumatic brain injury, or amputation. Ability of functional independence measure to accurately. Average functional independence measure fim score change from inpatient admission to discharge our persons served see an average of 65 percent increase on their fim score.
Patients care levels were assessed according to the. Functional independence measurement fim user manual. Recommendations for use of an outcome measure were rated as follows. Individualized nutritional treatment for acute stroke. Our subjects were 192 stroke patients who had completed rehabilitation whose average number of days from stroke onset was 53. Patients received assessment and treatment by a multidisciplinary team in a regional tertiary care stroke specific rehabilitation program. Measure of functional independence dominates discharge. The functional independence measure fim instrument is a basic indicator of patient disability.
The ability to quantify the functional ability of poststroke patients engaged in a rehabilitation program may assist in prediction of their functional outco me. To translate and crossculturally adapt the functional independence measure fim into the persian language and to test the reliability and validity of the persian fim pfim in patients with stroke. Stroke survivors n 97 were interviewed immediately after discharge to obtain scores on the national institutes of health stroke scale, functional independence measure fim, stroke impact scale, geriatric depression scale15, perceived stress scale, and perceived health status. Functional independence measure an overview sciencedirect. The functional independence measure fim is widely used and accepted as a functional. In this chapter, we attempt to describe how the icf who 2001, 2002 conceptual framework can be used for classifying outcome measures in stroke rehabilitation, and summarize aspects of measurement. Evaluation of complete functional status of patients with stroke by functional independence measure scale on admission, discharge, and six months poststroke. Analysis of variables to determine predictability to stroke patients discharge site by joseph a. Pdf evaluation of complete functional status of patients.
Test of, ascertain function after stroke or cancer. As an example, a common battery for comprehensive stroke outcome assessment could include barthel index and functional independence measure to measure activities of daily living, fuglmeyer for assessment of motor function, berg balance assessment for balance, and western aphasia battery for speech and language function assessment. Functional independence measure scores predict level of long. Abstract stroke is a leading cause of functional impairments. Lauinger thesis submitted to the department of physical therapy of grand valley state university allendale, michigan in partial fulfillment of the requirements for the. However, although they capture the level of independence in the basic activities of daily living, they focus largely on physical function, and clinicians often find them lacking in the.
Clinical assessments were conducted on admission and then again on discharge from the rehabilitation hospital with the stream total stream and upper extremity, lower extremity, and mobility subscales, functional independence measure fim, and stroke impact scale. The most clinically relevant 3variable model used the functional independence measure motor subscore, age, and walking distance at admission r 2 0. Background and purposeidentifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes. A method of calculating functional independence measure at. Measuring change in disability after inpatient rehabilitation. The fim was also developed to offer a uniform system of measurement for disability based on the international classification of impairment, disabilities and. We looked at the available research to determine whether the fim could be used to predict the outcomes of people who had suffered a stroke. An alternative system has been developed by the interrai consortium.
Based on over 534 stroke rehabilitation units par ticipating in the functional independence measure fim uniform data set, it isestimated thatfor patients from the weill medical college ofcornell universityat burke re habilitation hospital, 785 mamaroneck ave. To evaluate the patients with stroke by functional independence measure fim scale, at the times of admission to hospital, discharge, and. Intermodal agreement of followup telephone functional assessment using the functional independence measure in patients with stroke. Multiple linear regression analysis is frequently used in studies investigating the degree of functional independence measure fim improvement in stroke patients. The functional independence measure fim is a global measure of disability and can be scored alone or with the additional 12 items that formulate the functional assessment measure fam.
The functional independence measure fim was used to measure function in firststroke patients on admission to and discharge from a rehabilitation. The use of mobility assistive devices and the functional. Feb 29, 2016 the functional independence measure fim was developed in 1983 in a collaboration between the american congress of rehabilitation medicine and the american academy of physical medicine and rehabilitation headed by carl granger and byron hamilton 7. Evaluation of complete functional status of patients with stroke by. Validity in the study of 197 stroke patients, the pulses profile at admission. Stroke assessment scales overview internet stroke center. Background and purpose residual disability after stroke presents a major economic and humanistic burden. Analysis of variables to determine predictability to stroke patients discharge site abstract the purpose was to define subsets of variables that are found within the functional independence measurement fim scale that demonstrate a high predictability. The functional independence measure fim and the uniform data system for medical rehabilitation udsmr are examined from the perspectives described above, and are found to provide practical measurement for patients undergoing medical rehabilitation for conditions that render them dependent on others for assistance in activities of daily living. Measurement of instrumental activities of daily living in stroke. Functional outcomestrokerehabilitationcerebrovasculardisease. Functional measures of firststroke rehabilitation inpatients. Fim is used to track the changes in the functional ability of a. Center for medicare and medicaid services see figure 6.
To compare the appropriateness and responsiveness of the barthel index and the functional independence measure fim during early inpatient rehabilitation after single incident brain injury. Psychosocial problems, quality of life, and functional. Comparing the functional independence measure and the. International journal of rehabilitation research, 28, 59. Be aware of your loved ones medications and their side effects. Development and validation of the function in sitting test in adults with acute stroke. Sep 19, 2017 john prine and iris dement in spite of ourselves live from sessions at west 54th duration.
The functional independence measure fim is an assessment tool that aims to evaluate the. Fim is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care. Functional independence measure fim 40 minutes widely used for stroke. Initial functional independence measure score and interval. Measures mobility, adl, cognition, functional communication. A comparison of the barthel index and the functional independence measure as outcome measures in stroke rehabilitation. Scant research has examined the functional outcome differences in those with hemorrhagic versus ischemic strokes. Validity of total score of functional independence measure. Nov 29, 2009 the functional independence measure is widely used in rehabilitation settings in canada this is used as the central component of the national rehabilitation reporting system of the canadian institute of health information.
Mar 2017 functional independence measurement fim user manual, version 1. The functional independence measure fim is a global measure of disability, widely used as a common language measure of outcome across the western world. Mental status screening folsteinminimental state examination. The functional independence measure fim is widely used and accepted as a functional level. The functional independence measure fim instrument, which includes an assessment of bladder function, is the industry standard and used by the u. In cases where significant differences are present in fim scores at admission, a. Use of the barthel index and the functional independence. However, the coefficient of determination r2 is about 0. We found some evidence that the fim could be used to accurately predict the functional.
Initial functional independence measure score and interval post stroke help assess outcome, length of hospitalization, and quality of care. Relationship between hospital ranking based on functional. Rayegani sm, raeissadat sa, alikhani e, bayat m, bahrami mh, karimzadeh a, et al. The functional independence measure fim is an 18item measurement tool that explores an individuals physical, psychological and social function. Functional independence measure scores predict level of. Measures of disabilityactivities of daily living adl barthel index. This measure is another test towards returning to independence. To quantify disability in patients, activities of daily living adl. Moreover, higher admission functional independence measure fim score was associated with higher probability of functional improvement during rehabilitation. Assessment for resumed driving in stroke patients via. Ability of functional independence measure to accurately predict functional outcome of strokespecific population. Prognostication of stroke patients using the stroke. The functional independence measure fim was developed to address the issues of sensitivity and comprehensiveness that were criticized as being problematic with the barthel index another measure of functional independence.
Thirty adults with a newly diagnosed, first ischemic stroke. The fim was also developed to offer a uniform system of measurement for disability based on the international classification of impairment. In this multicenter retrospective cohort study, we enrolled postacute stroke patients and assessed stroke subtypes, selfcare abilities using fim scores, and discharge destination. Anxiety and depression measures were recorded using the hospital anxiety depression scale, and functional independence was evaluated using the functional independence measure. Functional independence measure gain in stroke patient is appropriately balanced, hemodynamically and clinically, heshe is set on foot. Functional independence measure rehabmeasures database.
Fim and fam the functional assessment measure fam includes fim items but also adds 12 new items, mainly covering cognition, such as community integration, emotional. Assessing bladder function on admission to shortterm rehabilitation and discharge provides some insight into patient outcomes. Disability measures such as the barthel index bi and the functional independence measure fim have been widely used in the context of a stroke 57. To explore the potential of the functional independence measure fim as a prognostic indicator of outcome in stroke survivors, 1 consecutive patients were observed from admission until discharge.
663 866 729 453 493 691 1455 774 731 1472 824 1483 545 309 1262 1102 1256 1060 141 1258 1054 1004 1401 806 811 1399 1317 580 674 769 9 1139 647 675 48 1089 889