DISABILITY IN PATIENTS FOLLOWING TRAUMATIC BRAIN INJURY - WHICH MEASURE

Head injury results in a wide range of functional sequelae. Thus, meas uring solely physical aspects of functioning may fail to highlight the actual level of disability. This study compares a commonly used measu re of physical disability, the Barthel Index, with three recently devi sed measures - the OPCS Scales of Disability, the Functional Independe nce Measure (FIM) and Functional Assessment Measure (FIM + FAM). Fifty -four head-injured subjects were assessed following discharge-from an in-patient rehabilitation unit utilizing each measure. The majority of subjects had no detectable disability according to the Barthel Index. In contrast, only four subjects (7%) attained maximal scores for inde pendence with the OPCS scale; two (4%) with the FIM and only one subje ct (2%) with the FIM + FAM. This reflected the nature of the disabilit ies in activities such as intellectual functioning, communication, beh aviour and wider aspects of mobility measured by the OPCS, FIM and FIM + FAM but not in the Barthel Index. The relationship between all meas ures was significant (Spearman ranked correlations P < 0.001) but corr elations were greater between OPCS, FIM and FIM + FAM than with the Ba rthel. The results of this study would support considering the use of scales other than the Barthel Index when describing disability followi ng traumatic head injury.