TITLE:
Monitoring recovery by physical therapists using the FIM scale during rehabilitation programs: An inter-rater and intra-rater reproducibility study
AUTHORS:
Tommasina Russo, Giorgio Felzani, Mario Giunta, Cristina Di Mascio, Carmine Marini
KEYWORDS:
Reproducibility; Rehabilitation; Functional Independence Measure
JOURNAL NAME:
Health,
Vol.5 No.6B,
June
27,
2013
ABSTRACT: Our aim was
to evaluate the reproducibility of the Functional
Independence Measure (FIM) scale when assessed by physical therapists in
the routine setting of a Rehabilitation Hospital. We included a consecutive
series of patients with spinal cord or cerebral lesions. Each of the 50
selected patients was evaluated by two of the 5 experienced physical therapists
participating in the study. The degree of inter-rater and intrarater
agreement was measured by a weighted k statistic, k for perfect agreement, and k for the agreement with tolerance. The
weighted k index for inter-rater
agreement on the FIM score was in the almost perfect range (k 0.87; 95% CI = 0.79 - 0.95), but a 20-point
tolerance was necessary to reach a k value
of 0.81 (95% CI = 0.66 - 0.95). Agreement was substantial or almost perfect for
most subscales, but the k index with
1-point tolerance reached the almost perfect rating for comprehension only. For intra-rater agreement, weighted k index was in the almost perfect range
for the FIM score and for all subscales; kappa index reached the almost
perfect range with a 4-point tolerance for FIM score and with 1-point of
tolerance for all subscales except interpersonal relations. FIM is useful to
monitor patient improvement during rehabilitation treatment, mostly when
assessed by the same physical therapist.