The Relationship between the Functional Independence Measure and the International Classification of Functioning, Disability, and Health Core Set for stroke

Abstract

The Functional Independence Measure (FIM) is one of many instruments available for assessing the functionality of stroke patients. However, with the approval of the International Classification of Functioning, Disability, and Health (ICF), the Core Set that was developed for stroke patients, a new tool for understanding functionality and disability of these patients is available. Objective: To establish a relationship between the FIM and the ICF Core Set for stroke. Four researchers of different healthcare backgrounds, all working in the field of rehabilitation, considered the descriptions of the activities of the FIM and the definitions of the ICF categories. Method: They selected the categories of the ICF Core Set for stroke, which could be related to the tasks assessed by the FIM. Once the relationship was established, the researchers came to a consensus for the inclusion or exclusion of those categories. Results: From the 130 second-level categories used in the Core Set, 27 (20.8%) were related to the activities of FIM, eight (29.6%) regarded the bodily functions component (b), 17 (63%) concerned activity and participation (d), and two (7.4%) considered environmental factors (e). As for the 10 categories that are part of the Brief Core Set for stroke, only five were related to the activities of FIM. Conclusion: The FIM is focused on the individual, while the ICF is concerned not only with the dysfunctions and disabilities of the patient, but also considers these factors within social activities, as well as environmental influences, either as a facilitator or a barrier to functional independence.