PERFORMANCE PROFILES OF THE FUNCTIONAL INDEPENDENCE MEASURE

The functional independence measure (FIM) is use to determine the degr ee of disability that patients experience and the progress that they m ake through programs of medical rehabilitation. Rasch analysis is a st atistical technique for constructing interval measures from ordinal da ta that was applied to derive FIM measures. The major factors that are taken into account to produce FIM measures are the relative difficult y in performance of FIM items and the ability of the persons tested. O ur analyses showed the relative difficulties that patients experienced in performing items in the FIM. There were two dominant patterns of d ifficulty, one for motor FIM items and the other for cognitive FIM ite ms. The patterns were consistent across impairment groups, although no t identical. Of the motor items, eating and grooming were easiest wher eas stair climbing, tub/shower transfers and locomotion were most diff icult. Of the cognitive items, expression and comprehension were easie st and problem solving was the most difficult. The patterns of difficu lty in performing FIM items are illustrated by analysis of the followi ng impairment groups: for motor items, orthopedic conditions, stroke w ith left hemiparesis and spinal cord dysfunction; for cognitive items, orthopedic conditions, brain dysfunction, stroke with right hemipares is and spinal cord dysfunction. By understanding patterns of difficult y in performing FIM items according to types of impairment and levels of function, clinicians may more precisely design treatment programs, use services and predict outcomes of medical rehabilitation.