FIM(TM) Properties

Evaluation of the metric properties of the FIM(TM) have been reported extensively (Granger et al., 1993; Heinemann et al., 1993; Linacre et al., 1994; Dodds et al., 1994; Heinemann et al., 1997). Precision (the ability of the instrument to detect meaningful change in level of function during rehabilitation) has been observed to be high (Granger et al., 1990). The FIM(TM) has clinically appropriate validity and interrater agreement (Hamilton et al., 1991).

In a Rasch Analysis of the FIM(TM), two separate domains of items were defined: the motor domain consisting of 13 items and the cognitive domain consisting of 5 items (Linacre et al., 1994; Heinemann et al., 1993). Previous analyses of FIM(TM) data from the SCI Model Systems suggest that the cognitive domain may be inappropriate for individuals with SCI (Ditunno et al., 1995).

Ceiling effects of the FIM(TM) at rehabilitation discharge, and particularly at one year post injury were observed in the moderate and severely injured TBI population (Hall et al., 1996). Forty-nine percent and eighty-four percent of the sample had attained independence (average score of 7 or 6) by discharge and one year post injury respectively. In other words, the FIM(TM) is not sensitive to more subtle changes expected after acute inpatient rehabilitation discharge.