Article

Two widely used outcome measures to assess functioning in
neurological rehabilitation are the Functional Independence Measure (FIM) and the
Barthel Index. The current study aims to establish the equivalence of the total
score of the FIM motor scale and the Barthel Index through the application of the
International Classification of Functioning, Disability and Health, and Rasch
measurement theory. METHODS: Secondary analysis of a large sample of patients
with stroke, spinal cord injury, and multiple sclerosis, undergoing
rehabilitation was conducted. All patients were assessed at the same time on both
the FIM and the Barthel Index. The International Classification of Functioning,
Disability and Health Linking Rules were used to establish conceptual coherency
between the 2 scales, and the Rasch measurement model to establish an exchange of
the total scores. RESULTS: Using the FIM motor scale, items from both scales
linked to the International Classification of Functioning, Disability and Health
d4 Mobility or d5 Self-care chapters. Their co-calibration satisfied the
assumptions of the Rasch model for each of 3 diagnostic groups.
A ceiling effect
was observed for the Barthel Index when contrasted against the FIM motor scale.
CONCLUSION: Having a Rasch interval metric to transform scores between the FIM
motor scale and Barthel Index is valuable for monitoring functioning,
meta-analysis, quality audits and hospital benchmarking.

Langue : ANGLAIS