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Dallmeijer, A.J., Dekker, J., Roorda, L.D., Knol, D.L., van Baalen, B., de Groot, V., Schepers, V. and Lankhorst, G.J. (2005) Differential item functioning of the functional independence measure in higher performing neurological patients. Journal of Rehabilitation Medicine, 37, 346-352. doi:10.1080/16501970510038284

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• 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.