Rezaei Sajjad, Dehnadi Moghadam Anoush, Khodadadi Naeima, Rahmatpour Pardis
Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran.
Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran; Department of Anesthesiology and Intensive Care Unit, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran.
Arch Trauma Res. 2015 Dec 12;4(4):e25363. doi: 10.5812/atr.25363. eCollection 2015 Dec.
The functional independence measure (FIM) is one of the most important assessment instruments for motor and cognitive dependence in rehabilitation medicine; however, there is little data about its confirmatory factor analysis (CFA) and ceiling/floor effects from other countries and also in Iranian patients.
The aim of this study was to evaluate a two-factor model (motor and cognitive independence as latent variables) and ceiling/floor effects for FIM in Iranian patients with traumatic brain injuries (TBI).
In this cross-sectional study, 185 subacute TBI patients were selected from emergency and neurosurgery departments of Poursina Hospital (the largest trauma hospital in northern Iran, Rasht) using the consecutive sampling method and were assessed for functional independence.
The results of this study showed that the floor effect was not observed; however, ceiling effects were observed for the FIM total score and its subscales. The confirmatory factor analysis showed that the chi-square/df ratio was 2.8 for the two-factor structure and the fit indices for this structural model including root mean square error of approximation (RMSEA) = 0.099, normed fit index (NFI) = 0.96, tucker lewis index (TLI) = 0.97, comparative fit index (CFI) = 0.97 were close to standard indices.
Although ceiling effects should be considered for rehabilitation targets, the two-factor model of FIM (motor and cognitive independence) has an eligible fitness for Iranian patients with TBI.
功能独立性测量（FIM）是康复医学中评估运动和认知依赖性最重要的评估工具之一；然而，来自其他国家以及伊朗患者中关于其验证性因素分析（CFA）和天花板/地板效应的数据很少。
本研究的目的是评估伊朗创伤性脑损伤（TBI）患者中FIM的双因素模型（运动和认知独立性作为潜在变量）以及天花板/地板效应。
在这项横断面研究中，采用连续抽样方法从普尔西纳医院（伊朗北部拉什特最大的创伤医院）的急诊科和神经外科选取了185例亚急性TBI患者，并对其功能独立性进行评估。
本研究结果表明未观察到地板效应；然而，观察到FIM总分及其子量表存在天花板效应。验证性因素分析表明，双因素结构的卡方/自由度比为2.8，该结构模型的拟合指数包括近似均方根误差（RMSEA）=0.099、规范拟合指数（NFI）=0.96、塔克-刘易斯指数（TLI）=0.97、比较拟合指数（CFI）=0.97，接近标准指数。
尽管在确定康复目标时应考虑天花板效应，但FIM的双因素模型（运动和认知独立性）对伊朗TBI患者具有合适的拟合度。
