• Developed to provide clinically useful information pertinent to the different levels of the disablement process.
  • Suitable for people with SCI and was designed to correspond closely in wording, format, and scoring to the Functional Independence Measure (FIM).
    • While the FIM provides seven levels of measurement of 13 motor functions (basic activities of daily living (ADL)) and measurements of cognitive and communication functions, the SRFM has four-level response categories to 13 items of basic ADL and 5 items of instrumental ADL. The cognitive and communications domains were excluded due to difficulties with accurate self-report of these items.
  • Covers personal functioning such as moving around indoors and personal hygiene.
  • Scores of the SRFM can indicate the amount of assistance (burden of care) an individual requires. This may be useful when monitoring treatment efficacy after rehabilitation or when the individual has returned to the community.

Clinical Considerations

  • The SRFM is comprehensible to persons with a fourth grade reading level.
  • This scale has been adapted specifically for the SCI population from the FIM.

ICF Domain

Activity ▶ Self-Care

Administration

Self-report or interview; can be administered either in person or by mail.

Number of Items

13 items of basic ADL, 5 items of instrumental ADL, 8 items of disease severity, and 1 item of resource utilization.

Equipment

None

Scoring

  • The 4-point scale is as follows: 4 = no extra time or help, 3 = extra time or special tool, 2 = some help, and 1 = total help or never do.
  • Questions are asked based on an average day and the individual’s usual way of doing the activity.
  • Total scores (13-52) are derived by summing the scores from each question.

Languages

English

Training Required

No advanced training required.

Availability

Can be found here.

# of studies reporting psychometric properties: 3

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Lower scores indicate greater need for assistance.
  • No cut scores or normative values for the SCI population have been established.
  • Published data for the SCI population is available for comparison (see Interpretability section of the Study Details sheet).

Reliability

  • Moderate to High Kappa coefficients:
    ≥0.65 for all but one item:
    Mobility at Home = 0.052 (p = 0.003).
  • High Intraclass correlation (95% CI):
    Answered every SRFM item = 0.90 (0.88).
    Traumatic injury = 0.92 (0.91).
    Disease = 0.87 (0.84).
    Trauma & disease = 0.92 (0.89).
    Memory deficits = 0.86 (0.80).
    Memory intact = 0.91 (0.89).
    History of head injury = 0.85 (0.80).
    No head injury = 0.91 (0.89).

(Hoenig et al. 1998)

Validity

  • Not Ranked Statistically significant correlations between SRFM score with
    • Number of affected limbs
    • Amount of movement
    • Amount of motor dysfunction.
    • Motor impairment*

*Correlation still significant after stratifying on self-reported visual, sensory, or memory impairment

(Hoenig et al. 1999)

  • Not Ranked Odds Ratios for Health Care Utilization of Lowest SRFM Quartile Patients (SRFM 13-22) vs. Highest SRFM Quartile Patients (SRFM 43-52):
    (95% CI).
    Hospitalized: 1.91 (1.71-2.13).
    *Died in hospital: 2.41 (1.62-3.58).
    *Hospital length of stay >7 days: 2.18 (1.85-2.57)
    *Discharged to institution: 2.86 (2.00-4.08).

*Of those hospitalized.

(Hoenig et al. 2001)

Responsiveness

No values were reported for the reliability of the SRFM for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the SRFM for the SCI population.

Reviewer

Dr. Ben Mortenson, Jeff Tan, Ben Mortenson, John Zhu, Gita Manhas.

Date Last Updated

22 July 2020

Hoenig H, Mclntyre L, Sloane R, Branch LG, Truncali A, Homer RD. The Reliability of a Self-Reported Measure of Disease, Impairment, and Function in Persons With Spinal Cord Dysfunction. Arch Phys Med Rehabil. 1998; 79.
https://pubmed.ncbi.nlm.nih.gov/9552102/

Hoenig H, Branch LG, McIntyre L, Hoff J, Horner RD. The validity in persons with spinal cord injury of a self-reported functional measure derived from the Functional Independence Measure. Spine, 1999; 24(6):539-543.
http://www.ncbi.nlm.nih.gov/pubmed/10101817

Hoenig H, Hoff J, McIntyre L, Branch LG. The Self-Reported Functional Measure: Predictive Validity for Health Care Utilization in Multiple Sclerosis and Spinal Cord Injury. Arch Phys Med Rehabil. 2001; 82.
https://pubmed.ncbi.nlm.nih.gov/11346837/

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