Brazilian version of the Functional Assessment Measure

Jorge, Liliana Lourenço; Marchi, Flávia Helena Garcia; Hara, Ana Clara Portela; Battistella, Linamara Rizzo

doi:10.1097/mrr.0b013e32833ba55f

Cited by 8 publications

(5 citation statements)

References 8 publications

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“… • The UK FIM + FAM software generates a “FAM-splat” providing an “at-a-glance” summary of change in the individual items of the FIM + FAM [21] Burden The time, effort or other demands of administering the instrument Time to administer• Approximately 35 min• Approximately 30 min Alternative modes of administration • Manual includes item level definitions and decision trees as for the FIM• Manual includes item level definitions and decision trees as for the FIM Cultural and language adaptations • UK FIM + FAM [2] • German adaptation and translation [22]. ICCs for single FAM items ranged from 0.08 to 0.87 for inter-rater and from 0.50 to 0.99 for intra-rater reliability.• Brazilian version [23] in Brazilian Portuguese. Intra-rater ICCs for 12 FAM items ranged from 0.60 to 0.94.…”

Section: Clinimetric Evaluation Of the Us Fim + Fam And Uk Fim + Fam mentioning

confidence: 99%

A comprehensive psychometric evaluation of the UK FIM + FAM

Turner-Stokes

Siegert

2013

Disability and Rehabilitation

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Purpose:To evaluate the psychometric properties of the UK FIM + FAM.Methods:(a) A systematic literature review integrating the evidence for psychometric qualities of both the original and UK versions, and (b) exploratory and confirmatory factor analysis of admission/discharge data from an inpatient general neuro-rehabilitation cohort using parametric and non-parametric techniques. A prospective cohort of 459 patients with a male:female ratio of 57:43 and mean age of 44.5 (SD 14.3) years participated in this study.Results:Seven published articles together demonstrated acceptable utility, concurrent validity, inter-rater reliability and responsiveness of the UK FIM + FAM. Factor analysis demonstrated that all items loaded high (>0.58) on the first principal component and distinct motor and cognitive factors emerged after rotation. A four-factor solution also demonstrated four distinct, interpretable dimensions (Physical, Psychosocial, Communication and Extended Activities of Everyday Living (EADL)). Mokken analysis of the second data set confirmed these dimensions. Cronbach’s αs were 0.97 and 0.96 for the motor and cognitive domains and 0.90–0.97 for the subscales. Analysis of responsiveness demonstrated “large” effect sizes (0.86–1.29).Conclusions:The UK FIM + FAM, including the newer EADL module, is a valid, reliable scale of functional independence. It has high internal consistency in two domains and four subscales and is responsive to changes occurring in a general inpatient neuro-rehabilitation population.Implications for RehabilitationThe UK FIM + FAM is a valid, reliable scale of functional independence, which is responsive to changes occurring in a general inpatient neuro-rehabilitation population.Physical, Psychosocial, Communication It can be used to derive a reliable, single score of overall independence and also yields specific information in two main domains and four separate subscales of independence: Physical, Psychosocial, Communication and Extended Activities of Daily Living (EADL).The newer EADL item module provides added value, measuring functional independence for community-based activities.

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Section: Clinimetric Evaluation Of the Us Fim + Fam And Uk Fim + Fam mentioning

confidence: 99%

A comprehensive psychometric evaluation of the UK FIM + FAM

Turner-Stokes

Siegert

2013

Disability and Rehabilitation

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“…The UK FIM+FAM now forms the principal outcome measure for the UK national database for specialist rehabilitation in patients with complex disabilities [ 11 ] (the UK Rehabilitation Outcomes Collaborative (UKROC)). It has been used in other countries in Europe (notably Spain), South America, Australasia, Iran and Japan; and has also been found to perform reliably in several other languages [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset

et al. 2016

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The UK Functional Assessment Measure (UKFIM+FAM) is the principal outcome measure for the UK Rehabilitation Outcomes Collaborative (UKROC) national database for specialist rehabilitation. Previously validated in a mixed neurorehabilitation cohort, this study is the first to explore its psychometric properties in a stroke population, and compare left and right hemispheric strokes (LHS vs RHS). We analysed in-patient episode data from 62 specialist rehabilitation units collated through the UKROC database 2010–2013. Complete data were analysed for 1,539 stroke patients (LHS: 588, RHS: 566 with clear localisation). For factor analysis, admission and discharge data were pooled and randomised into two equivalent samples; the first for exploratory factor analysis (EFA) using principal components analysis, and the second for confirmatory factor analysis (CFA). Responsiveness for each subject (change from admission to discharge) was examined using paired t-tests and differences between LHS and RHS for the entire group were examined using non-paired t-tests. EFA showed a strong general factor accounting for >48% of the total variance. A three-factor solution comprising motor, communication and psychosocial subscales, accounting for >69% total variance, provided acceptable fit statistics on CFA (Root Mean Square Error of Approximation was 0.08 and Comparative Fit Index/ Tucker Lewis Index 0.922/0.907). All three subscales showed significant improvement between admission and discharge (p<0.001) with moderate effect sizes (>0.5). Total scores between LHS and RHS were not significantly different. However, LHS showed significantly higher motor scores (Mean 5.7, 95%CI 2.7, 8.6 p<0.001), while LHS had significantly lower cognitive scores, primarily in the communication domain (-6.8 95%CI -7.7, -5.8 p<0.001). To conclude, the UK FIM+FAM has a three-factor structure in stroke, similar to the general neurorehabilitation population. It is responsive to change during in-patient rehabilitation, and distinguishes between LHS and RHS. This tool extends stroke outcome measurement beyond physical disability to include cognitive, communication and psychosocial function.

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“…Third, the functional evaluation was based on FIM™ (a sensitive, non-specific instrument), associated with two non-sensitive specific tools (Rankin for ST and GOS for TBI). Other scales could have been chosen, such as the FAM™ (Functional Assessment Measure) [ 31 ], for providing more robust functional data and exploring the cognitive aspects of abilities. FIM™ could be used as a measure of change at follow-up as well [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

New rehabilitation models for neurologic inpatients in Brazil

Jorge¹,

Brito²,

Marchi³

et al. 2014

Disability and Rehabilitation

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Purpose: To describe the effects of a rehabilitation program in a neurological inpatient unit in terms of independence for activities of daily living and return to work. Method: Retrospective study with 148 adults with stroke, traumatic brain injury (TBI), spinal cord injury, and Guillain–Barré syndrome admitted as rehabilitation inpatients within a 1-year period for hospitalization at the Instituto de Reabilitação Lucy Montoro, Brazil. According to their diagnostic groups, subjects undergone semi-standardized models of intensive multidisciplinary rehabilitation for 4–6 weeks. Primary outcome measures: Functional Independence Measure (FIM™), Modified Rankin scale (Rankin), and Glasgow Outcome Scale (GOS Subjects were evaluated at admission, discharge, and 6 months after discharge. Results: Improvement in motor FIM™, Rankin and GOS was observed in all groups. Cognitive FIM™ increase was less evident in TBI patients. After 6 months, 37.6% of patients were unemployed, 34% underwent outpatient rehabilitation, and 65.2% maintained gains. Conclusions: This is the first report on the effects from an inpatients rehabilitation model in Brazil. After a short intensive rehabilitation, there were motor and cognitive gains in all groups. Heterogeneity in functional gains suggests more individualized programs may be indicated. Controlled studies are required with larger samples to compare inpatient and outpatient programs.Implications for RehabilitationThe proposed brief model of rehabilitation for stroke, traumatic brain injury, spinal cord injury, and Guillain–Barre syndrome inpatients shows promising results in terms of functional improvement.Apparent improvements in cognitive and motor levels can be observed after 30 d of the intensive hospital-based program five times a week focusing on caregiver and patients training.After 6 months of discharge, more than one third of patients remained out of work, but appeared to have kept the benefits attained during hospitalization, and performed physical activities in the community as outpatients.

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Brazilian version of the Functional Assessment Measure

Cited by 8 publications

References 8 publications

A comprehensive psychometric evaluation of the UK FIM + FAM

A comprehensive psychometric evaluation of the UK FIM + FAM

The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset

New rehabilitation models for neurologic inpatients in Brazil

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