Functional Independence Measure Self-Report (FIM-SR)

Download Clinical Summary PDF

Tool Description

  • assesses burden of care and functional impairment.
  • this version of the FIM is completed by the patient.
  • contains 6 subscales:
    1) Self-care
    2) Sphincter control
    3) Mobility
    4) Locomotion
    5) Communication
    6) Social cognition.

ICF Domain:

Activity – Subcategory: Self-Care.

Number of Items:

18

Brief Instructions for Administration & Scoring

Administration:

  • Self-report
  • was developed for administration by telephone interview.

Equipment:None.

Scoring:

  • The 18 items are rated on a 1 – 7 scale where 1 = total assistance is needed and 7 = complete independence.
  • The scoring considers the use of adaptive equipment and/or the extent of personal assistance or supervision required to complete the task. If assistive equipment (ex. raised toilet seat) is used, the individual cannot achieve a score of 7 on the item.
  • The scores can be reported as FIM Motor scores, FIM Cognitive scores or FIM Total summed scores.
  • Total FIM scores range from 18 (totally dependent) to 126 (totally independent); motor scores range from 13 (total dependence) to 91 (total independence); and cognitive scores range from 5 (total dependence) to 35 (total independence).

Interpretability

MCID: not established
SEM & MDC:
SEM and MDC for total FIM-SR and subscales (calculated from data in Masedo et al. 2005):

Variable

SEM

MDC

Self-care

4.03

11.2

Sphincter

1.45

4.02

Mobility

2.51

6.96

Locomotion

1.59

4.41

Communication

0.49

1.35

Social cognition

0.74

2.04

Motor

7.67

21.2

Cognitive

0.93

2.56

Total

8.05

22.30

  • Total FIM-SR scores range from 18 (total dependence) to 126 (total independence).
  • The higher the FIM score, the fewer care hours required upon discharge.
  • No normative data has been established for the SCI population.
  • Published data for the SCI population is available for comparison (see Interpretability section of the Study Details sheet)

Languages:

English.

Training Required:

Health care professionals scoring the FIM–SR are required to complete training and testing protocol (contact information is available at: http://www.udsmr.org/WebModules/International/int_About.aspx)

Availability:

Must be purchased (contact the USDMR for details: http://www.udsmr.org/WebModules/FIM/Fim_About.aspx)

Clinical Considerations

  • The instrument reports the patient perspective on their level of independence and in general, is well known as the internationally accepted, global tool to measure functional independence.
  • The FIM-SR has less clinician and client burden than the original FIM which requires observation of performance.
  • Most items on the FIM-SR generalize to all populations, however modified versions of the FIM exist to accommodate the needs of individuals with SCI.The motor scale adequately discriminated subjects with different injury levels

Measurement Property Summary

# of studies reporting psychometric properties: 1

Reliability:

  • Internal consistency of the total FIM-SR is High for both pre-treatment (Cronbach’s α=0.95) and post-treatment (Cronbach’s α=0.94)
  • Internal consistency for the FIM-SR items range from Low to High for pre-treatment (Cronbach’s α=0.14-0.98) and post-treatment (Cronbach’s α=0.20-0.98).
  • Test-retest reliability is High for total FIM-SR (r=0.89)
  • Test-retest reliability ranges from Moderate to High for individual FIM-SR items (r=0.54-0.91).

[Masedo 2005]

Validity:

  • Correlation of the FIM-SR is Moderate with the CHART physical subscale (r=0.49), and Low with the CHART Total score (r=0.26) and the CHART mobility subscale (r=0.30).

[Masedo 2005]

Responsiveness:

No values were reported for the responsiveness of the FIM-SR for the SCI population.

Floor/ceiling effect:

  • Ceiling effects were detected in both the FIM-SR cognitive subscale (88% subjects reported max score) and the FIM-SR communication and social cognition subscale (76% subjects reported max score).

[Masedo 2005]

Reviewer

Dr. William Miller, Christie Chan

Date Last Updated:

Feb 1, 2013

Download the measure

Download Worksheet:
Must be purchased (contact the USDMR for details: http://www.udsmr.org/WebModules/FIM/Fim_About.aspx)

Video

n/a

Scoring

n/a

Equipment Needed

FIM-SR:

Graves D. The construct validity and explanatory power of the AISA Motor Score and the FIM: implications for theoretical models of spinal cord injury Top Spinal Cord Inj Rehabil 2005;10:65-74.
http://thomasland.metapress.com/content/xa251uv2e6j6ngln/

Hall KM, Cohen ME, Wright J, Call M, Werner P. Characteristics of the Functional Independence Measure in traumatic spinal cord injury. Arch Phys Med Rehabil 1999;80:1471-1476.
http://www.ncbi.nlm.nih.gov/pubmed/10569443

Hamilton BB, Deutsch A, Russell C, Fiedler RC, Granger CV. Relation of disability costs to function: spinal cord injury. Arch Phys Med Rehabil 1999;80:385-391.
http://www.ncbi.nlm.nih.gov/pubmed/10206599

Heinemann AW, Kirk P, Hastie BA Semik,P, Hamilton BB, Linacre JM, Wright BD, Granger C. Relationships between disability measures and nursing effort during medical rehabilitation for patients with traumatic brain and spinal cord injury. Arch Phys Med Rehabil 1997;78:143-149.
http://www.ncbi.nlm.nih.gov/pubmed/9041894

Masedo AI, Hanley M, Jensen MP, Ehde D, Cardenas DD. Reliability and validity of a self-report FIM (FIM-SR) in persons with amputation or spinal cord injury and chronic pain. Am J Phys Med Rehabil 2005;84:167-176.
http://www.ncbi.nlm.nih.gov/pubmed/15725790