The Utility of the FIM+FAM for Assessing Traumatic Brain Injury Day Program Outcomes
- 1 September 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Head Trauma Rehabilitation
- Vol. 22 (5), 267-277
- https://doi.org/10.1097/01.htr.0000290971.56130.c8
Abstract
To evaluate the effectiveness of the FIM+FAM as a primary outcome measure for traumatic brain injury (TBI) comprehensive day programs. Retrospective data analysis. Single center, TBI comprehensive day program facility. A demographically and regionally diverse sample of 105 persons with moderate or severe TBI admitted to the Shepherd Pathways comprehensive TBI day rehabilitation program. Functional Independence Measure + Functional Assessment Measure (FIM+FAM). Twenty-eight percent or fewer of participants reached ceiling effects on 25 of the 30 FIM+FAM items at day program admission with only 2% of clients rated above ceiling score levels on the FIM+FAM total score. The criteria of Guyatt et al showed that 20 of the 30 FIM+FAM items showed clinically meaningful improvements in 60% or more of clients. On average, clients with TBI improved over 27 points on the FIM+FAM total score. Fifteen of 30 items showed ceiling effects of 33% or less at discharge where only 25% of clients exceeded the FIM+FAM total score ceiling threshold. Discharge FIM+FAM motor scale was a very good predictor of the need for additional single service physical therapy. However, reaching ceiling rating on the FIM+FAM cognitive scale demonstrated poor specificity (0.28) and negative predictive power (0.42) for the need for additional speech/cognitive therapy services. The FIM+FAM demonstrated utility as an outcome measure for TBI comprehensive day program treatment in the current milieu. Future research is required to replicate and extend the current findings.Keywords
This publication has 21 references indexed in Scilit:
- Potential impact of the new medicare prospective payment system on reimbursement for traumatic brain injury inpatient rehabilitation1,2Archives Of Physical Medicine and Rehabilitation, 2003
- Impact of comprehensive day treatment on societal participation for persons with acquired brain injuryArchives Of Physical Medicine and Rehabilitation, 2001
- Traumatic Brain Injury in the United States: A Public Health PerspectiveJournal of Head Trauma Rehabilitation, 1999
- Trends in Hospitalization Associated With Traumatic Brain InjuryPublished by American Medical Association (AMA) ,1999
- Rehabilitation of Persons With Traumatic Brain InjuryJAMA, 1999
- Effect of Cognitive Rehabilitation on Outcomes for Persons with Traumatic Brain Injury: A Systematic ReviewJournal of Head Trauma Rehabilitation, 1999
- Rehabilitation after traumatic brain injuryBritish Medical Bulletin, 1999
- Descriptive Findings from the Traumatic Brain Injury Model Systems National Data BaseJournal of Head Trauma Rehabilitation, 1996
- The effectiveness of traumatic brain injury rehabilitation: A reviewBrain Injury, 1995
- Characteristics and comparisons of functional assessment indicesJournal of Head Trauma Rehabilitation, 1993