Use Of Functional Independence Measure Research Articles

Healthcare Professionals' Experiences with Functional Independence Measure (FIM) as a Structured Framework for Interprofessional Team Meetings in Danish Stroke Rehabilitation: A Qualitative Cross-Sectoral Collaborative Study.

An ethnographic and phenomenological mapping of the experiences of healthcare professionals with the functional independence measure (FIM) in stroke rehabilitation. This is a cross-sectoral qualitative study with triangulation of data from two focus group interviews, 15 individual interviews, and 11 participant observations of FIM assessments performed by six different healthcare professions in interprofessional teams. FIM assessments were performed at hospital and in a community rehabilitation centre as interprofessional meetings with a local facilitator certified in FIM. Three overarching themes, learning space, improved interprofessional collaboration, and transferability, emerged from the data. The use of FIM within the provided structures established an environment that allowed the various healthcare professionals (HCP) to learn with, about, and from each other. This is perceived as promoting interprofessional collaboration and enhancing patient-specific knowledge within the interprofessional team. The established patient-specific knowledge is specific to the individual team and is difficult to transfer intraorganisationally and across sectors. FIM was a catalyst for improved interprofessional knowledge transfer and interprofessional collaboration within the individual teams, but intraorganisational and cross-sectoral dissemination of patient-specific knowledge was limited.

[Suitability of the SINGER as a tool for assessment in outpatient neurological rehabilitation].

The scales Barthel-Index (BI) and Functional Independence Measure (FIM) are the most frequently used instruments for measurement of outcome in neurological rehabilitation. Both instruments show appropriate psychometric characteristics but there are some limitations for their use in outpatient neurorehabilitation. The "Score of Independence for Neurologic and Geriatric Rehabilitation (SINGER)" was developed to compensate the weaknesses of the established instruments and to facilitate a direct connection to the ICF. The results of the original validation study of the SINGER in an inpatient setting recommended a test of the SINGER also in an outpatient setting. The SINGER has been applied in a multicentric validation study. Patients of 17 outpatient rehabilitation centres were included consecutively. In this study patients with stroke or TBI were asked to fill in a questionnaire at 4 points of measurement. Additionally, medical staff were asked to rate the patients' status at admission and discharge. SINGER-data could be collected of 429 patients. In sum, results recommend to use the SINGER in outpatient neurorehabilitation, though with some restrictions. In comparison to BI and FIM, the SINGER results show in any case considerably less ceiling effects. The further exclusive use of FIM and, above all, BI cannot be recommended. But for very weak affected patients SINGER is poor sensitive for change and because SINGER is not covering all relevant aspects of rehabilitation a combined clinical use of SINGER and other assessment instruments seems to be a constructive solution.

Functional independence measure at rehabilitation admission as a predictor of return to driving after traumatic brain injury

Objective: To examine the utility of three common measures as predictors of return to driving after traumatic brain injury (TBI): Glasgow Coma Score (GCS) within the first 24 hours of injury and both Functional Independence Measure (FIM) and Disability Rating Scale (DRS) at rehabilitation admission.Methods: Seventy-two participants with TBI completed a questionnaire that assessed return to driving post-TBI, as measured by reinstatement of the driver’s license. Participants who did not return to driving for non-medical reasons or who had not driven pre-injury and did not obtain a driver’s license post-injury were excluded from analysis. This produced a final sample of 59 participants. Scores on GCS, FIM and DRS, leveraged from an existing database, were compared between participants who had and those who had not returned to driving post-injury. Multiple logistic regression analysis was performed to determine the relationship of each predictor variable to return to driving.Results: Only the FIM score at rehabilitation admission was significantly associated with return to driving (p < 0.01). FIM score had a sensitivity of 72% and specificity of 73% with respect to return to driving.Conclusions: This study supports the use of FIM at rehabilitation admission as a predictor of return to driving. Future studies should be directed at identifying other measures to be used in combination with FIM to accurately predict return to driving post-TBI.

Use of functional independence measure in rehabilitation of inpatients with respiratory failure

Most outcomes do not deeply express the degree of disability in patients with respiratory failure (RF) following inpatient pulmonary rehabilitation (IPR). The aim of our study was to evaluate the efficacy of an IPR in patients with confirmed COPD and RF using functional independence measure (FIM) that determines the degree of disability experienced by patients and the progress they make during rehabilitation. This scale includes several items: self care, mobility, locomotion, communication and social recognition. Twenty-two patients (age 70+/-2 years, PO(2) 58.18+/-7.63mmHg, PCO(2) 46.82+/-9.11mmHg) were prospectively observed and studied. IPR included respiratory and peripheral muscle training, mucus evacuation techniques, and energy conservation techniques. FIM, Medical Research Council dyspnoea scale (MRC), St. George's Respiratory Questionnaire (SGRQ), and 6-min walking distance (6-MWD) were assessed on admission (pre) and discharge (post) from IPR. After IPR there was a statistically significant improvement (p<0.01) in all the FIM items (total score in self care, mobility, locomotion, social recognition) except for communication. Changes of MRC (pre 4.32+/-0.84; post 3.00+/-1.15, p<0.001), SGRQ (%) (pre 69.86+/-4.62; post 46.50+/-11.94, p<0.001), and 6-MWD (pre 164.54+/-98.63; post 214.32+/-97.64, p<0.001) paralleled those improvements. An inverse correlation between MRC and FIM (r=-0.5042, p=0.016) was observed. Our preliminary study has shown that the benefits of IPR in COPD with RF do not only translate in dyspnoea, exercise capacity and quality of life but also within neuromotor disabilities as assessed by FIM. Our results warrant future studies in pulmonary rehabilitation using FIM as an outcome measure.

Outcome measure for paediatric rehabilitation: use of the Functional Independence Measure for children (WeeFIM). A pilot study in Chinese children with neurodevelopmental disabilities.

To study the use of Functional Independence Measure for children (WeeFIM) in monitoring neurorehabilitation programmes for children with neurodevelopmental disabilities. The neurorehabilitation team of the Children's Habilitation Institute of the Duchess of Kent Children's Hospital were trained to administer the WeeFIM. The WeeFIM was administered to children with various neuro-developmental impairment groups undergoing neurorehabilitation programmes in the hospital inpatient and also outpatient setting. The WeeFIM was scored on hospital admission and prior to discharge for those admitted for the rehabilitation programme. The WeeFIM profile was then monitored half yearly. The pilot study used WeeFIM in assessing 104 children with different medical disease categories. The disease or impairment categories included very low birth weight babies (n = 44), cerebral palsy (n = 19), Down's syndrome (n = 9), pervasive developmental disorder (n = 11), Duchenne Muscular Dystrophy (n = 18), and others (n = 3). WeeFim could be used to measure disability, monitor progress, enhance communication, measure the effectiveness of treatment, and document the benefits of rehabilitation intervention. It also served as a networking of neurorehabilitation programmes for different impairment categories in a continuum of settings: hospital, community, school and at home. WeeFIM was found to be a quick and reliable functional assessment instrument in this rehabilitation facility. WeeFIM could be used to assist neurorehabilitation clinicians in the selection of short term realistic goals and long term rehabilitation strategies for children with various neurodevelopmental disabilities, and the subsequent progress of the children could be monitored objectively.