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Functional Independence Measure: Dr. Harshada (PT) Desbjcop, Pune

The Functional Independence Measure (FIM) is an 18-item ordinal scale used to assess a patient's level of disability and changes in status during rehabilitation, focusing on self-care, mobility, and cognitive functions. It categorizes assistance levels from complete independence to total dependence, with scores ranging from 18 to 126, where higher scores indicate greater independence. The FIM is reliable and valid, with strong inter-rater reliability and concurrent validity with other assessments like the Barthel Index.

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4 views11 pages

Functional Independence Measure: Dr. Harshada (PT) Desbjcop, Pune

The Functional Independence Measure (FIM) is an 18-item ordinal scale used to assess a patient's level of disability and changes in status during rehabilitation, focusing on self-care, mobility, and cognitive functions. It categorizes assistance levels from complete independence to total dependence, with scores ranging from 18 to 126, where higher scores indicate greater independence. The FIM is reliable and valid, with strong inter-rater reliability and concurrent validity with other assessments like the Barthel Index.

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Pursuit Exam
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FUNCTIONAL INDEPENDENCE Dr.

Harshada (PT)

MEASURE DESBJCOP, Pune


OBJECTIVE
•(FIM) was developed as a measure of dependency for a variety of populations and
is not specific to any diagnosis.

•The FIM instrument Includes measures of independence for self-care, including


sphincter control, transfers, locomotion, communication, and social cognition[1].

•The tool is used to assess a patient's level of disability as well as a change in


patient status in response to rehabilitation or medical intervention.[2][3]
OBJECTIVE
•Is an 18-item, seven-level, ordinal scale intended to be sensitive to changes
over the course of a comprehensive inpatient medical rehabilitation program.

•Uses the level of assistance an individual needs to grade functional status


from total independence to total assistance).
INTENDED POPULATION
Designed to assess areas of dysfunction in activities that commonly occur in
subjects with any progressive, reversible or stable neurologic,
musculoskeletal, or other disorder i.e. patients with functional mobility
impairments[4].

The FIM is used by healthcare practitioners to assess and grade the


functional status of a person based on the level of assistance he or she
requires

FIM™ is comprised of 18 items, grouped into 2 subscales - motor and


cognition
MOTOR
SUBSCALE
1. Eating
2. Grooming
3. Bathing
4. Dressing, upper body
5. Dressing, lower body
6. Toileting
7. Bladder management
8. Bowel management
9. Transfers - bed/chair/wheelchair
10. Transfers – toilet
11. Transfers - bath/shower
12. Walk/ Wheelchair
13. Stairs
COGNITION SUBSCALE
1. Comprehension
2. Expression
3. Social interaction
4. Problem solving
5. Memory
FIM levels: each item is scored on a 7-point ordinal
scale, ranging from a score of 1 to a score of 7.
No Helper

Helper - Complete Dependence


7. Complete Independence (Timely,
Safety)
6. Modified Independence (Device) 2. Maximal Assistance (Subject = 25% or
more)
1. Total Assistance or not Testable
Helper - Modified Dependence (Subject less than 25%)

5. Supervision (Subject = 100%)


4. Minimal Assistance (Subject = 75% or
more)
3. Moderate Assistance (Subject = 50%
or more)
TOTAL SCORE FOR THE FIM
• Motor subscale (the sum of the individual motor subscale items) will be a value
between 13 and 91.

• Cognition subscale (the sum of the individual cognition subscale items) will be a
value between 5 and 35.

•The total score for the FIM instrument (the sum of the motor and cognition
subscale scores) will be a value between 18 and 126.[5]

•The higher the score, the more independent the patient is in performing the task
associated with that item.[5]
METHOD OF USE
o Assess at the start of a rehabilitation episode of care and

o at the end of a rehabilitation episode of care.

o Admission assessment is collected within 72 hours of the start of a


rehabilitation episode.

o Discharge assessment is collected within 72 hours prior to the end of a


rehabilitation episode.
RELIABILITY AND VALIDITY
[Link]-Rater Reliability of FIM has been established at an
acceptable psychometric performance (Intraclass co-relation
coefficients ranging from 0.86 to 0.88)

[Link] concurrent validity with Barthel Index (ICC > 0.83)


have shown strong construct validity between items on
Barthel Index and items on the FIM the measure functional
limitations[6]

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