The functional independence measure used in a Dutch rehabilitating stroke population:a pilot study to assess progress

In contrast to the United States, the Functional Independence Measure (FIM) is seldom used in Dutch rehabilitation settings. The purpose of this study was to determine if the FIM could be used in a Dutch stroke population to assess progress during rehabilitation. Patients with a recent stroke who received inpatient treatment were included in this longitudinal pilot study, which used the standard error of measurement (SEM) to quantify progress. Mean (SD) age of the subjects (n =48) was 61.3 (10.5) and 25 (56%%) were male. Mean (SD) length of stay (LOS) was 141.3 (75.0) days. For 42 subjects, admission and discharge scores of the FIM were registered. The mean admission (93.0, SD=23.3), as well as the discharge (112.4, SD=11.0) scores were rather high. The mean FIM difference (SD) between admission and discharge was 19.3 (16.9). However, only 55% exceeded a difference score of 13 points, indicating progress. Results of this pilot study confirm the ceiling effect of the FIM in this population. Based on the findings of our pilot study we conclude that the FIM is not suitable to assess progress in a Dutch rehabilitating stroke population

Functional status and prosthesis use in amputees, measured with the Prosthetic Profile of the Amputee (PPA) and the short version of the Sickness Impact Profile (SIP68)

Amputation of (a part of) the lower extremity will cause loss or disturbance of locomotion. With prosthetic devices and rehabilitation many amputees are able to restore their locomotive function as well as their social function. Maintenance or restoration of function after discharge is even more important. In rehabilitating amputees, prosthetic devices can improve mobility. Little is known about whether these devices will still be used at home after discharge and if the improvement in functioning is stable. To verify whether the treatment strategy of amputees is sufficient or needs to be modified, it is important to check if the goals of rehabilitation are achieved. Outcome in amputees used to be related to mortality and cure, especially mobility, for example, by the Amputee Activity Score, a measure for activity, not related to age, sex or handicap (Day, 1981). Recently, ‘quality of life’ and ‘reintegration in normal life’ have been emphasized in measuring outcomes of rehabilitation programmes. Research on 42 amputees (Nissen and Newman, 1992) indicated that more attention should be paid to community, mobility, recreation and additional illnesses after amputation to improve reintegration to normal living. The purpose of this study is to evaluate (1) the status at discharge and (2) the maintenance of physical functioning (including mobility) and psycho-social functioning after a follow-up period of 2 months after discharge from a rehabilitation setting. Since mobility is related to prosthesis use, prosthesis use is also evaluated