Validity and reliability of the Japanese version of the FIM + FAM in patients with cerebrovascular accident

Abstract

This study showed that the FIM + FAM-j demonstrated acceptable levels of validity and reliability when used for CVA as a measure of disability.

The outcome measures for loss of functionality in the activities of daily living of adults after stroke: a systematic review

“…The assessment of the studies through the QAT provided a more specific overview of the quality of the studies tracked by the review. Only 16 25,28,31,32,34,36,42,43,[47][48][49][50][51][52][53]62 of the 39 studies were published after the publication of the COSMIN checklist and these guidelines were not followed in the majority of the included studies; however, according to the QAT, the studies published after 2010 do seem to have higher quality.…”

“…We have focused, as exemplars, on the two most commonly used stroke scales: the Frenchay Activities Index (FAI) 42,50,54,55 and the FIM 26,51 with two modified versions. 46,49 These scales have been validated, are familiar to many, and have proven utility with each suited to differing assessment scenarios. Thus, in the absence of a "perfect" assessment, we recommend continuing the use, validation, and adaptation of these assessment scales for adults with stroke in different countries to develop a common language throughout the world for discussing ADLs and functionality.…”

“…The most commonly used tools were: The Frenchay Activities Index (FAI), validated in Chinese, 43 Brazilian, 50 English, 54 and Dutch 55 ; the Activity Card Sort (ACS), validated in Chinese 27 and Israeli 38 ; the Daily Living Self-Efficacy Scale (DLSES), validated in Chinese 42 and Australian English 47 ; the Reintegration to Normal Living Index (RNLI), validated in Chinese 53 and Australian English 59 ; the Functional Independence Measure (FIM), validated in French-Canadian 26 and Persian. 51 Additionally, two further studies included the FIM instrument, one 49 in Japanese validating its use in combination with the Functional Assessment Measure (FAM) scale, the other study 46 validating only the motor subscale in the Scandinavian language. The Extended Activities of Daily Living (EADL) is a tool whose measurement properties have been studied by two English authors in two different research studies.…”

“…The two most commonly used stroke scales resulted from this review are the Frenchay Activities Index (FAI) 42,50,54,55 and the FIM 26,51 with two modified versions. 46,49 The FAI is a formal interview for patients who have suffered a stroke or their caregivers to compare functional abilities preceding and following a stroke. It has been used to assess ADLs three and six months before a stroke and consists of 15 items that measure complex activities in the categories of domestic activity, work/leisure, and outdoor activity.…”

“…Items of the FIM +FAM have been grouped into two subscales based on principal component analysis: a motor subscale comprised of 16 items and a cognitive subscale comprised of 14 items. 49 Both the FIM and the FAM use a 7-point scoring system based on whether or not the assistance of another person is required for an individual to perform ADLs effectively. A rating of 1 indicates total dependence and 7 complete independence, with intermediate levels rated as: 6 modified independence, 5 supervision or set up, 4 minimal contact assistance or the subject expends > 75% of the effort, 3 moderate assistance or the subject expends 50 to 74% of the effort, and 2 maximal assistance or the subject expends 25 to 49% of the effort.…”