Functional Independence Measure (FIM) was developed to address what? Developed where, when?
- the issues of sensitivity and comprehensiveness that were criticized as being problematic with the Barthel Index (another measure of functional independence).
- dev in SUNY Buffalo -- 1996???
breakdown of questions/sections on the FIM, and how many possible pts/item
7-level scaling system -- a score of 0/not tested is allowed on day 1, but afterwards the lowest score is a 1
the meanings of the 7 scores in the FIM
- 7: complete independence
- 6: modifed indep (needs an AD, extra time, there are safety considerations)
- MOD DEP
- 5: supervision or setup required
- 4: minimal contact assist required - but subject does <75% of work
- 3: mod assist - pt does 50-75%
- COMPLETE DEP
- 2: max assist - pt des 25-50%
- 1: total assist - pt does <25%
on the Nagi model, what does the FIM look at?
- functional limitations
- some impairment (cogn func)
- some disability (social interaction)
criticism of the FIM? lead to?
- not comprehensive enough
- so, in response to this and to more pts surviving head trauma, the FAM (functional assessment measure) was made to supplement the FIM (functional indep measure)
the FAM was made whee? derived for whom?
- Santa Clara Valley Medical Center
- for pts brain injury
what did the FAM add to the FIM
12 cognitive areas, bringing the total to 30 areas to score on the 7-level ordinal scale
on the Nagi model, FAM looks at...?
- functional limitations
- impairments (cognitive)
- disability (employability etc)
Motor Assessment Scale - dev by whom?
Carr and Shephard
a few things to know about the MAS (slide says we'll get into greater detail in a later unit)
- it's an impairment/functional limitation ybrid
- could be used w Barthel to get better pic f pt's general function
- cold be used w Frenchay Arm Test to help clarify functional limitations in UE
NIH stroke Scale is designed to be what? looks at what?
- a compreensive picture of pts w stroke
- looks at IMPAIRMENTS (while Barthel look at function)
- levelof consciousness
- facial paralysis
- motor arm
- motor leg
- limb ataxia
- best lang
- extinction and inattention
Modified Rankin Scale - rated by whom? out of what score? made when?
- rated by outsider - not the pt
- it's a 0-6 scale 0= fine, 6 = dead
Rankin scale, meaning of each rank
- 0=go for icecream
- 1=some symptoms
- 2=slight disability but basically indep
- 3=req some help but can walk w/o assist
- 4=mod to severe disability, can't walk or attend to bodily needs w/o assist
- 5=severe disability, bedridden, incont
Tinnetti Balance Measure - real basic descrip
similar to Berg Balance Scale but w more tests so more time consuming
functional reach test
done sitting or standing - just see how far pt can reach
Frenchay Arm Test -basic descrip and scoring
- 5 function-based tasks to be done w affected arm
- 0=unable 1=completed
3 benefits of Frenchay Arm Test
valid, reliable, quick
utility of FIM, Fugl-Meyer, Barthel Index, and MAS in clinical practice
- FIM - widely accepted in rehab and home care settings
- Fugl-Meyer - used by folks who follow Brunnstrom, also used for research
- Barthel Index - quick measure of gen function, so it's used often
- MAS - used often outside the US
which tests are used as god standards to judge concurrent validity of other motor scales?
Fugl-Meyer and MAS
which test is ofe used aone or in combo w other masures fr showing general functional outcome of an intervention?
QOL measure test
- a stroke-specific qol scale, self-reported or w help from fam
- a bit confusing
- risk of perseveration - pt sticking w one answer again and again regardless of the qs
losing sight in both eyes on the same side - R half or L half loss for both
can't name an object
- can't coordinate movements in sequence
- ex - dressing apraxia