Abstract
We used the Japanese version of the FIM (functional independence measure). To establish its effectiveness in Japan, we compared the FIM with the Barthel Index (BI). We also examined the contribution of communication scores and social cognition scores to the general ADL items (GEN) such as self care activities, sphincter control or mobility.
Stroke patients (61 at admission and 49 at discharge) were evaluated using both the FIM and the BI. A regression analysis of their total scores was carried out. Next, we examined the distribution of the FIM score in patients with low scores of the BI. Finally, we performed multiple regression analysis to regress each of the GEN factors with the total score of communication and social cognition (COMM), the Brunnstrom stages (BS), the age and the interval between the onset of the stroke and the examination date.
The regression line denoted a correlation coefficient of 0.95, therefore the FIM and the BI seemed equally valid as functional evaluation tools. The FIM score corresponding to 100 points of BI on the regression line didn't attain the full score. This shows that the residual needs for rehabilitation in relatively independent patients are easily detected with the FIM. The number of items in which patients were not totally dependent was greater when using the FIM compared with the BI. The FIM was more sensitive in detecting the initial improvement of disability. From the values of the standard regression coefficient, COMM mainly contributed to GEN at admission, although the contribution of COMM to GEN was less at discharge.
