Validity of the functional independence measure for persons with traumatic brain injury.
OBJECTIVE
Replicate and extend studies of the construct validity of the Functional Independence Measure (FIM) for persons with traumatic brain injury (TBI).


DESIGN
A cross-sectional study of admissions to acute rehabilitation evaluated 6 months to 5 years after discharge.


SETTING
An inpatient brain injury rehabilitation unit in a large, academic medical center.


SUBJECTS
Ninety-five patients with primary diagnosis of TBI stratified by time postdischarge.


MAIN OUTCOME MEASURES
Prediction of (1) average daily minutes of assistance and (2) supervision required in comparison to the Sickness Impact Profile (SIP) and SF-36.


RESULTS
The FIM was highly predictive of minutes of assistance (83% accuracy), supervision (82% accuracy), and the need for either type of assistance (78% accuracy). Prediction was only minimally improved by measures of neurobehavioral impairment. The accuracy of the FIM was superior to the SIP and SF-36.


CONCLUSIONS
Results provided substantial support for the validity of the FIM as a measure of functional independence for persons with TBI. The importance of supervision as a type of assistance required after TBI was evident, with the FIM highly predictive of this need, as well.