INTERINSTITUTIONAL AGREEMENT OF INDIVIDUAL FUNCTIONAL INDEPENDENCE MEASURE (FIM) ITEMS MEASURED AT 2 SITES ON ONE SAMPLE OF SCI PATIENTS

Individual items of the Functional Independence Measure (FIM) were ana lyzed for interinstitutional agreement using a sample of 57 spinal cor d injured (SCI) patients at discharge from an acute care rehabilitatio n setting (ACRS) and at admission to an ongoing rehabilitation setting (ORS). The two FIM ratings were performed within 6 days of each other . The reliability coefficient for total FIM scores was good: 0.83. Ind ividual items were classified into four groups: (1) above average reli ability coefficient, above average proportion agreement, which include d the feeding items and items from the mobility category; (2) above av erage reliability coefficient, below average agreement, which included the majority of items in the selfcare category; (3) below average rel iability coefficient, above average agreement, which included items in the sphincter control and communication categories; and (4) below ave rage reliability coefficient, below average agreement, which included items in the social cognition category. Patients received significantl y higher ratings on most selfcare items in the ACRS, and significantly higher ratings on social cognition items in the ORS. Implications of these results are discussed in terms of using individual FIM items for research purposes. Reliability coefficients were acceptably high for subgroups of complete and incomplete paraplegics and for complete quad riplegics, ranging from 0.74 to 0.87, but low for incomplete quadriple gics, r = 0.49. However, these sample sizes were small, ranging from 9 to 17 patients. Data collection will continue in order to increase sa mple size and permit further analysis of these subgroups.