Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure
TLDR
The FIM cognitive scale has limited usefulness as an outcome measure in progressive multiple sclerosis, suggesting that both the FIM total and FIM motor scales have no advantage over the BI in evaluating change.Abstract:
BACKGROUND The importance of evaluating disability outcome measures is well recognised. The Functional Independence Measure (FIM) was developed to be a more comprehensive and “sensitive” measure of disability than the Barthel Index (BI). Although the FIM is widely used and has been shown to be reliable and valid, there is limited information about its responsiveness, particularly in comparison with the BI. This study compares the appropriateness and responsiveness of these two disability measures in patients with multiple sclerosis and stroke. METHODS Patients with multiple sclerosis (n=201) and poststroke (n=82) patients undergoing inpatient neurorehabilitation were studied. Admission and discharge scores were generated for the BI and the three scales of the FIM (total, motor, and cognitive). Appropriateness of the measures to the study samples was determined by examining score distributions, floor and ceiling effects. Responsiveness was determined using an effect size calculation. RESULTS The BI, FIM total, and FIM motor scales show good variability and have small floor and ceiling effects in the study samples. The FIM cognitive scale showed a notable ceiling effect in patients with multiple sclerosis. Comparable effect sizes were found for the BI, and two FIM scales (total and motor) in both patients with multiple sclerosis and stroke patients. CONCLUSION All measures were appropriate to the study sample. The FIM cognitive scale, however, has limited usefulness as an outcome measure in progressive multiple sclerosis. The BI, FIM total, and FIM motor scales show similar responsiveness, suggesting that both the FIM total and FIM motor scales have no advantage over the BI in evaluating change.read more
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Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient A Scientific Statement From the American Heart Association
Elaine L. Miller,Laura L. Murray,Lorie Richards,Richard D. Zorowitz,Tamilyn Bakas,Patricia C. Clark,Sandra A. Billinger +6 more
TL;DR: In the United States, the incidence rate of new or recurrent stroke is approximately 795 000 per year, and stroke prevalence for individuals over the age of 20 years is estimated at 6.5 million as discussed by the authors.
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Improving the evaluation of therapeutic interventions in multiple sclerosis: the role of new psychometric methods.
Jeremy Hobart,Stefan J. Cano +1 more
TL;DR: Findings from each of the five studies show that Rasch analysis is empirically superior to traditional psychometric methods for evaluating rating scales, developing ratings scales, analysing rating scale data, understanding and measuring stability and change, and understanding the health constructs the authors seek to quantify.
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Analysis and comparison of the psychometric properties of three balance measures for stroke patients
TL;DR: The Postural Assessment Scale for Stroke Patients showed slightly better psychometric characteristics than the other 2 measures, and showed very acceptable levels of reliability, validity, and responsiveness for both clinicians and researchers.
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The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study.
Malka Itzkovich,Ilana Gelernter,Fin Biering-Sørensen,C Weeks,M T Laramee,B C Craven,M. Tonack,Sander L. Hitzig,E Glaser,G Zeilig,S Aito,Giorgio Scivoletto,M Mecci,R J Chadwick,W S El Masry,Aheed Osman,C A Glass,P. Silva,Bakul M Soni,B P Gardner,G Savic,E M Bergström,V Bluvshtein,J Ronen,Amiram Catz +24 more
TL;DR: The results indicate that SCIM III is an efficient measure for functional assessment of SCL patients and can be safely used for clinical and research trials, including international multi-center studies.
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Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment.
Philippe Rossier,Derick T Wade +1 more
TL;DR: All 4 measures tested showed similar validity and reliability, and the 4-level RMI version failed to show an increased ability to detect differences, and all measures showed more disability in patients using aids and those with sensory impairment.
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