Cross-cultural validation of the Persian version of the Functional Independence Measure for patients with stroke

Abstract

Purpose: To translate and cross-culturally 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. Method: In this cross-sectional study carried out in an outpatient stroke rehabilitation center, 40 patients with stroke (mean age 60 years) were participated. A standard forward–backward translation method and expert panel validation was followed to develop the PFIM. Two experienced occupational therapists (OTs) assessed the patients independently in all items of the PFIM in a single session for inter-rater reliability. One of the OTs reassessed the patients after 1 week for intra-rater reliability. Results: There were no floor or ceiling effects for the PFIM. Excellent inter-rater and intra-rater reliability was noted for the PFIM total score, motor and cognitive subscales (ICCagreement 0.88–0.98). According to the Bland–Altman agreement analysis, there was no systematic bias between raters and within raters. The internal consistency of the PFIM was with Cronbach's alpha from 0.70 to 0.96. The principal component analysis with varimax rotation indicated a three-factor structure: (1) self-care and mobility; (2) sphincter control and (3) cognitive that jointly accounted for 74.8% of the total variance. Construct validity was supported by a significant Pearson correlation between the PFIM and the Persian Barthel Index (r = 0.95; p < 0.001). Conclusions: The PFIM is a highly reliable and valid instrument for measuring functional status of Persian patients with stroke.Implications for RehabilitationThe Functional Independence Measure (FIM) is an outcome measure for disability based on the International Classification of Functioning, Disability and Health (ICF).The FIM was cross-culturally adapted and validated into Persian language.The Persian version of the FIM (PFIM) is reliable and valid for assessing functional status of patients with stroke.The PFIM can be used in Persian speaking countries to assess the limitations in activities of daily living of patients with stroke.