Validation of the Brazilian version of Functional Independence Measure
DOI:
https://doi.org/10.5935/0104-7795.20040003Keywords:
Validity, Sensibility, Disability Assessment, Functional Independence MeasureAbstract
Introduction: the Brazilian version of the Functional Independence Measure (FIM) was developed in the 2000. Studies of validity is still required in order corroborate its use in rehabilitation assessment of Brazilian individuals, since local peculiarities may determine differences in the data provided by such instrument. Objectives: the aim of this study is test construct validity of the FIM by checking its convergent validity in groups of patients with impairments expected to develop specific levels of disability. Methods: Medical charts of 150 SCI and 103 hemiplegic patients from 2 rehabilitation centers in São Paulo provided data about demographic characteristics, clinical and functional features. The level of disability was evaluated by the Functional Independence Measure. Traumatic SCI patients were classified according to the level of injury as cervical, thoracic and lumbar or below. Hemiplegic patients were classified according to the side of motor impairment as right, left or bilateral. Sensibility to change was tested in 93 hemiplegic and 59 SCI patients by comparing admission and discharge values of motor, cognitive and total FIM. Results: among SCI we could demonstrate a clear association between the level of the injury and the motor FIM (cervical = 34.4 ± 25.2, thoracic = 51.6 ± 19.5, lumbar = 67.5 ± 18.6; p < 0.001). Cognitive FIM showed a ceiling effect in SCI (85% patients had cFIM at the highest value), on the other hand, among hemiplegic patients this could not be noticed and an association between cognitive FIM and the side of impairment, being the left-side-disabled patients the least cognitively dependent. Statistically significant variations during treatment could be noticed in mFIM in SCI and stroke patients (44.5 ± 24.1x 61.0 ± 23.8; p < 0.001 and 54.1 ± 23.0 x 64.7 .± 21.3; p <0.001). The same could be observed with cFIM in left-sided and right-sided stroke patients, but not for patients with bilateral motor impairment. Conclusion: convergent validity of the Brazilian version of FIM could be shown by the comparison of the results of motor domain among SCI patients with different levels of impairment. Cognitive FIM was proved of little use in chronic SCI patients under rehabilitation, although its association with the better results in left-sided stroke patients also collaborates with its validity. The Brazilian version of FIM proved to be sensitive to changes and of clinically useful as a measure of outcome of rehabilitation for subacute and chronic outpatients in Brazil.
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References
Granger CV, Hamilton BB, Keith RA, Zielezny M, Sherwin FS. Advances in functional assessment for rehabilitation. In: Topics in geriatric rehabilitation. Rockville: Aspen; 1986.
Linacre JM, Heinemann AW, Wright BF, Granger CV, Hamilton BB. The structure and stability of the Functional Independence Measure. Arch Phys Med Rehabil. 1994;75:127-32
Riberto M, Miyazaki MH, Jorge Filho D, Sakamoto H, Battistella LR. Reprodutibilidade da versão brasileira da medida de independência funcional. Acta Fisiátr. 2001;8(1):45-52. Doi: https://doi.org/10.5935/0104-7795.20010002
Stineman MG, Shea JA, Jette A, Tassoni CJ, Ottenbacher KJ, Fiedler R, Granger CV. Arch Phys Med Rehabil. 1996;77:1101-8
Dodds TA, Martin DP, Stolov WC, Deyo RA. A validation of the functional independence measure and its performance among rehabilitation inpatients. Arch Phys Med Rehabil. 1993;74:531-6
Marshall SC, Heisel B, Grinnell D. Validity of PULSES profile compared with the functional independence measure for measuring disability in a stroke rehabilitation setting. Arch Phys Med Rehabil. 1999;80:760-5.
Hsueh IP, Lin JH, Jeng JS, Hsieh CL. Comparison of the psychometric characteristics of the functional independence measure, 5 item Bathel index, and 10 item Barthel index in patients with stroke. J Neurol Neurosurg Psychiatry. 2002;73:188-190.
Ota T, Akaboshi K, Nagata M, Sonoda S, Domen K, Seki M, Chino N. Functional assessment of patients wit spinal cord injury: measured by the motor score and the functional independence measure. Spinal Cord. 1996;34:531-5
Menter RR, Whiteneck SW, Chalifue MA, Gerhart K, Solnick SJ, Brooks CA, Hughes L. Impairment, disability, handicap and medical expenses of persons aging with spinal cord injury. Paraplegia.1991;29:613-9
Pollack N, Rheault W, Stoecker JL. Reliability and validity of the FIM for persons aged 80 years and above from a multilevel continuing care retirement community. Arch Phys Med Rehabil. 1996;77:1056-61.
Küçüdeveci AA, Yavuzer G, Elhan AH, Sonel B, Tennant A. Adaptation of the functional independence measure for use in Turkey. Clin Rehabil. 2001;15:311-9.
Tsuji T, Lui M, Sonoda S, Domen K, Chino N. The stroke impairment assessment set: its internal consistency and predictive validity. Arch Phys Med Rehabil. 2000;81:863-8.
Garrinson SJ, Rolak LA. Rehabilitation of the stroke patient. In: DeLisa JA, Gans BM, editors. Rehabilitation medicine: principles and practice. 2 ed. Philadelphia: JB Lippincott; 1993.
Davidoff GN, Roth EJ, Haughtin JS, Ardner MS. Cognitive dysfunction in spinal cord injury patients: sensitivity of the functional independence measure subscales vs neurophychological assessment. Arch Phys Med Rehabil. 1990;71:326-9.
DeLisa JA, Gans BM. Rehabilitation medicine: principles and practice. 2 ed. Philadelphia: Lippincott; 1993.
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