Self-Scoring Templates for Motor and Cognitive Subscales of the FIM Instrument for Persons With Spinal Cord Injury

Abstract

ObjectiveTo provide self-scoring templates for the FIM instrument's motor and cognitive scales that enable clinicians to monitor progress during rehabilitation using equal-interval Rasch-calibrated measures instead of ordinal raw scores. DesignSecondary analysis of a prospective, observational cohort study. SettingSix geographically dispersed hospital-based rehabilitation centers in the United States. ParticipantsSubset of consecutively enrolled individuals with new traumatic spinal cord injuries discharged from participating rehabilitation centers (N=1146). InterventionNot applicable. Main Outcome MeasuresSubscores of the FIM instrument, including a 13-item motor scale, a 5-item cognitive scale, an 11-item (without sphincter control items) motor scale, a 3-item transfer scale, a 6-item self-care scale, a 3-item self-care upper extremity scale, and a 3-item self-care lower extremity scale. ResultsKeyForms for the FIM instrument scales allow clinicians and investigators to estimate patients' functional status and monitor progress. In cases with no missing data, the look-up tables provide more accurate estimates of patients' functional status. ConclusionClinicians can use KeyForms and look-up tables for FIM instrument subscales to monitor patients' progress and communicate improvement in equal-interval units.