McGilloway Emer, Mitchell James, Dharm-Datta Shreshth, Roberts Andrew, Tilley Haydn, Etherington John
a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
Brain Inj. 2016;30(10):1208-12. doi: 10.1080/02699052.2016.1188215. Epub 2016 Jul 28.
The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury.
A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4.
The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up.
This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.
本研究旨在确定用于患有后天性脑损伤的年轻成年人群的最合适的康复结局指标。
对入住英国军事神经康复科的后天性脑损伤患者进行为期2年的前瞻性研究，以比较功能独立性测量/功能评估测量（FIM+FAM）与梅奥-波特兰适应性量表第4版（MPAI-4）在评估结局方面的适用性。使用FIM+FAM和MPAI-4在入院时、出院时和4个月随访时对患者进行评估。
FIM+FAM总运动评分显示出明显的天花板效应，42%的患者入院时得分为满分，出院时升至80%。MPAI-4未显示出明显的天花板效应。FIM+FAM和MPAI-4的其他子量表总体上具有可比性，随访时达到天花板效应的患者不超过17%。
这是首次在患有后天性脑损伤的年轻成年军人人群中对FIM+FAM和MPAI-4进行的比较研究。所有患者在强化住院康复后，两种结局指标均有所改善。然而，MPAI-4在运动评分中未显示出天花板效应。因此，该指标在该队列中被认为更合适。
