Relationships between impairment and physical disability as measured by the functional independence measure

Heinemann, Allen W.; Linacre, John M.; Wright, Benjamin D.; Hamilton, Byron B.; Granger, Carl V.

doi:10.1016/0003-9993(93)90153-2

Cited by 485 publications

(235 citation statements)

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“…The instrument consists of two domains, namely motor (13 items) and cognitive aspects (five items), according to a Rasch analysis. 11,12 Extensive studies have conducted on the psychometric properties of the instrument 11,13-17 and they showed that FIM was a valid and reliable instrument for evaluating patients' functional status in rehabilitation programmes. Table 2 illustrates items of the motor and cognitive domains of FIM and the scoring system of each item.…”

Section: Methodsmentioning

confidence: 99%

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard

Chan

2005

Spinal Cord

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Study design: Retrospective descriptive analysis of data of patients with traumatic spinal cord injury (SCI) in a tertiary SCI centre. Objectives: To identify the characteristics of the rehabilitation outcomes of patients with different levels of traumatic SCI and to compare the results with data reported in the American Consortium for Spinal Cord Medicine. Setting: A newly established tertiary SCI centre in Tai Po Hospital, Tai Po, Hong Kong. Methods: A total of 33 patients with traumatic SCI admitted in 2002 were included in the study. They were classified into different ASIA subgroups based on their levels and completeness of injury. The functional status changes measured by the Functional Independence Measure (FIM)t (on admission, placement and upon discharge, and at 1 and 3 months post discharge) and discharge placement were recorded as rehabilitation outcomes. Results: A total, 24 patients were tetraplegic while nine were paraplegic. Seven and two from tetraplegic and paraplegic groups were readmitted with late complications due to urinary tract infection, spasticity and/or occurrence of pressure sores. The mean age was found to be 48.36 (SD ¼ 15.64) years. In all, 16 (48.48%) sustained the injury from falling from height. The trend of FIM motor scores at discharge across different ASIA subgroups appeared to be comparable to those reported in the American Consortium for Spinal Cord Medicine with scores generally lower. Significant functional improvements during the hospital phase were found in the two tetraplegic and paraplegic ASIA D subgroups (t(3) ¼ 3.430, Po0.05; t(2) ¼ 4.083, P ¼ 0.55, respectively). Significant differences were also revealed among subgroups (F(7,32) ¼ 6.625, Po0.0005) with lower level tetraplegic groups appearing to stay much longer in the rehabilitation centre. In all, 64.5% of newly diagnosed patients returned to live in the community. Conclusions: This report gives a preliminary overview on the characteristics of rehabilitation outcomes in one of the SCI centres in Hong Kong in relation to the international standard. Longitudinal study with larger population and community integration outcomes might be included in the future to reveal a better picture in the SCI rehabilitation in Hong Kong.Spinal Cord (2005) 43, 489-498.

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Section: Methodsmentioning

confidence: 99%

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard

Chan

2005

Spinal Cord

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“…13 The functional independence measure (FIM) is the most widely used measure of disability in rehabilitation. 14 There are motor and cognitive domains, 15 but in patients with SCM (including spinal cord infection) the cognitive subscale has a high ceiling effect and is of limited utility. 16 Therefore, only the motor subscale was recorded within 72 h of admission and discharge.…”

Section: Collected Datamentioning

confidence: 99%

Rehabilitation outcomes following infections causing spinal cord myelopathy

New

Astrakhantseva

2014

Spinal Cord

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Study design:Retrospective, open-cohort, consecutive case series. Objective: To describe the demographic characteristics, clinical features and outcomes in patients undergoing initial in-patient rehabilitation after an infectious cause of spinal cord myelopathy. Setting: Spinal Rehabilitation Unit, Melbourne, Victoria, Australia. Admissions between 1 January 1995 and 31 December 2010. Methods: The following data were recorded: aetiology of spinal cord infection, risk factors, rehabilitation length of stay (LOS), level of injury (paraplegia vs tetraplegia), complications related to spinal cord damage and discharge destination. The American Spinal Injury Association (ASIA) Impairment Scale (AIS) and functional independence measure (FIM) were assessed at admission and at discharge. Results: Fifty-one patients were admitted (men ¼ 32, 62.7%) with a median age of 65 years (interquartile range (IQR) 52-72, range 22-89). On admission, 37 (73%) had paraplegic level of injury and most patients (n ¼ 46, 90%) had an incomplete grade of spinal damage. Infections were most commonly bacterial (n ¼ 47, 92%); the other causes were viral (n ¼ 3, 6%) and tuberculosis (n ¼ 1, 2%). The median LOS was 106 days . The most common complications were pain (n ¼ 47, 92%), urinary tract infection (n ¼ 27, 53%), spasticity (n ¼ 25, 49%) and pressure ulcer during acute hospital admission (n ¼ 19, 37%). By the time of discharge from rehabilitation, patients typically showed a significant change in their AIS grade of spinal damage (Po0.001). They also showed significant improvement (Po0.001) in their FIM motor score (at admission: median ¼ 27, IQR 20-34; at discharge: median ¼ 66, IQR 41-75). Conclusion: Most patients returned home with a good level of functioning with respect to mobility, bladder and bowel status, and their disability improved significantly.

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“…The positive correlation between muscular strength and functional ability provides data about each functional level of injury. [6][7][8][9] Nevertheless, there are other factors that have equal or greater influence on the ability of the SCI subjects and that were not considered independently by this analysis. In order to better understand which lesion and individual characteristics could be related to the functional ability, it would be necessary to carry out a logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

The experience of using the scale of Functional Independence Measure in individuals undergoing spinal cord injury rehabilitation in Brazil

2014

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Study Design: Retrospective cohort. Objectives: The aim of this study was to evaluate the correlation between the level and completeness of the injury with Functional Independence Measure (FIM) score and the validity and responsiveness of the FIM in Brazilian individuals with spinal cord injury admitted to rehabilitation. Setting: SARAH Network of Rehabilitation Hospitals, Brasília, Brazil. Methods: A total of 218 patients with spinal cord injury admitted for rehabilitation in 2006 was included in this study. The validity was assessed as the ability of the FIM to discriminate different levels of disability (cervical, thoracic and lumbar) at admission and the responsiveness was obtained by analyzing admission and discharge data for each of the three injury groups. Results: Total FIM score, motor FIM score and each of the 13 items were valid when comparing three groups and comparing groups two by two, except the items 'eating' and 'grooming' among paraplegics, and 'stairs' at cervical and thoracic levels. The scale was not responsive to the five cognitive items, 'stairs' and 'eating', among paraplegics, or 'grooming', 'bathing' and 'dressing upper body' in lumbar level patients. The patient difficulty in performing tasks can vary among populations. Therefore, the continuous evaluation process of psychometric characteristics is important to validate the use of the instrument in different contexts.

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Relationships between impairment and physical disability as measured by the functional independence measure

Cited by 485 publications

References 1 publication

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard

Rehabilitation outcomes following infections causing spinal cord myelopathy

The experience of using the scale of Functional Independence Measure in individuals undergoing spinal cord injury rehabilitation in Brazil

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