Supervisors info:
Μανδαλίδης Δημήτριος, Επιβλέπων, Επίκουρος Καθηγητής, ΣΕΦΑΑ, ΕΚΠΑ
Γελαδάς Νικόλαος, Καθηγητής, ΣΕΦΑΑ, ΕΚΠΑ
Σκορδίλης Εμμανουήλ, Αναπληρωτής Καθηγητής, ΣΕΦΑΑ, ΕΚΠΑ
Summary:
Neurological disorders refer to diseases of the central and peripheral nervous system with a variety of motor dysfunctions. Functional Independence Measurement (FIM) is a scale that assesses patients regarding their functional independence in daily activities and it is used internationally successfully. Compared to other scales evaluating functionality, it seems to prevail in terms of scoring range and all of the key daily activities it evaluates. In many countries, FIM is a valid and reliable instrument of examining the functional independence of people with a variety of disorders. However, the investigation of the reliability and validity of the FIM scale, to date has not been evaluated by Greek clinicians.
The aim of this study was to evaluate the reliability and validity of the Functional Independence Measurement (FIM) in patients with neurological disorders.
Regarding the research methodology, the study sample consisted of inpatients with stroke (STR, N = 50) and traumatic brain injury (TBI, N = 24), of varying severity, who had been admitted to acute care hospitals and rehabilitation centers in Attica of Greece and healthy individuals (CG, N = 33) with corresponding demographic characteristics (age, gender). All inpatients were evaluated by the lead researcher, within 3 days of their admission, and some of them within 3 days of their discharge from the hospital or rehabilitation center. Thirty inpatients were evaluated by the lead researcher and an independent researcher to determine the reliability between the researchers. The structural validity of the FIM scale was determined by the differences between (i) inpatients and healthy individuals and (ii) inpatients with neurological disorders of varying severity. To determine the synchronic validity, the Greek version of the WHODAS 2.0 functional rating scale and the functional measurements were used: Sit-to-Stand, Time Up and Go and 10 Meter Walking Test. The sensitivity of FIM in determining changes in the clinical condition of patients was determined by reevaluation of them by the lead researcher, before the discharge of the hospital or rehabilitation center.
The results showed a high degree of validity and reliability of the FIM scale. Regarding the objectivity of FIM measurements, the ratings of the two raters gave ICC (2,1) coefficients ranging from .997 to .999. Regarding structural validity, significant differences were found in the sectors and in the overall FIM rating (i) between STR group & Control group and between TBI group & Control group, but also (ii) between the three degrees of severity of the diseases. Regarding the sensitivity of the evaluation scale to the change in the clinical condition of the inpatients, significant differences were found in the above variables between the admission and the discharge of the patients from the hospital or the rehabilitation center. Synchronic validity testing between FIM, WHODAS 2.0 and functional tests showed correlation coefficients ranging from .608 to .985.
The findings of the present study showed that the Functional Independence Measurement (FIM) was valid and reliable in assessing the functional independence of inpatients with neurological disorders in Greece.
Keywords:
Validity, Reliability, FIM, Neurological Disorders
