![]() This was a prospective, double-blind study comparing patient self-reporting of the motor subset of the FIM against multidisciplinary assessment. To the best of our knowledge, the only other study done among stroke patients compared telephone FIM ratings moreover, the assessment was done by a registered nurse rather than a multidisciplinary team.( 3) Therefore, our study tested the validity of self-reported FIM motor scores in stroke patients against scores obtained through multidisciplinary assessment. In another study, two statistically significant factors found to affect the outcome among hospitalised elderly patients were: (a) cognitive impairment and (b) decline in activities of daily living (ADLs) from pre-hospitalisation levels.( 5) Major limitations of these earlier studies included their small sample sizes and the restriction of study criteria to include patients with only non-stroke-related functional impairments. 80.5 p < 0.001), with an intraclass correlation coefficient (ICC) of 0.74.( 2) Studies on stroke patients( 3) and patients with spinal cord injuries( 4) also showed comparable ratings. Another study among elderly patients with hip fractures showed comparable mean FIM ratings between trained personnel and the multidisciplinary team (84.3 vs. A study by Massedo et al on FIM-SR assessment among patients with spinal cord injuries and chronic pain, as well as amputees, showed reliable results in the FIM-SR motor scale and total FIM-SR score, but poor agreement in cognitive score.( 1) The authors also found poor agreement of scores in bathing (63%) and dressing (64%). Studies on the validity of patient self-reported FIM (FIM-SR) have shown both positive and negative agreement. There is thus a need for an alternative and reliable method that can be easily delivered, which could also improve follow-up assessments and aid in future research. However, multidisciplinary measurement of FIM scores is time-consuming and laborious, and hence may not be feasible for all patients. As it allows direct observation of patients and the performance-based assessments are done by multidisciplinary teams – including doctors, therapists and nurses – FIM is considered the gold standard for functional assessments. The Functional Independence Measure (FIM) is a validated, objective assessment of functional status that is commonly used in rehabilitation centres. Keywords: functional status, motor score, self report, strokeĭuring rehabilitation, functional assessment is important to not only accurately assess patients’ functional improvement but also to help with prognostication, individualisation of patient care, quality assurance and national healthcare planning. Although patients tend to overrate their performance, self-reported FIM motor scores could be an alternative in situations where multidisciplinary FIM assessment is difficult. However, a modest agreement between patient self-reporting and multidisciplinary assessment of FIM motor score was demonstrated. Our results may not be valid for patient populations with cognitive or communication deficits. Discrepancies in some scores could be due to patients’ ignorance of their own limitations or feelings of embarrassment about reporting. There was no FIM assessment for 14 (29.8%) patients, highlighting the need for alternative assessment tools. The scores of individual motor items also showed fair-to-good agreement (ICC range 0.431–0.618), except for eating, grooming, bathing and dressing of the lower body (ICC < 0.400). There was substantial agreement on overall FIM motor score between patient self-reporting and multidisciplinary assessment (intraclass correlation coefficient 0.651, 95% confidence interval 0.404–0.811). 33 patients were included in the final analysis. All eligible stroke patients (n = 47) admitted to our rehabilitation centre were included. We conducted a prospective double-blind comparative study of patient self-reporting against multidisciplinary assessment, using the standard FIM algorithm. We tested the validity of the self-reported FIM motor score among stroke patients. Studies show positive and negative agreement on self-reported FIM scores for patients with spinal cord injuries and amputees. It is widely used in rehabilitation centres but may not be practical for all patients due to time and/or personnel constraints. ![]() The Functional Independence Measure (FIM) is a validated, objective assessment of functional status.
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