Saltychev Mikhail, Lähdesmäki Janne, Jokinen Petteri, Laimi Katri
Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland.
Rehabil Res Pract. 2017;2017:6938718. doi: 10.1155/2017/6938718. Epub 2017 Dec 21.
To evaluate the factor structure of Functional Independence Measure (FIM®) scale amongst people with spinal cord injury (SCI).
This was a retrospective, register-based cohort study on 155 rehabilitants with SCI. FIM was assessed at the beginning and at the end of multidisciplinary inpatient rehabilitation. The internal consistency of the FIM was assessed with Cronbach's alpha and exploratory factor analysis was employed to approximate the construct structure of FIM.
The internal consistency demonstrated high Cronbach's alpha of 0.95 to 0.96. For both pre- and postintervention assessments, the exploratory factor analysis resulted in 3-factor structures. Except for two items ("walking or using a wheelchair" and "expression"), the structures of the identified three factors remained the same from the beginning to the end of rehabilitation. The loadings of all items were sufficient, exceeding 0.3. Both pre- and postintervention chi-square tests showed significant values < 0.0001. The "motor" domain was divided into two factors with this 2-factor structure enduring through the intervention period.
Amongst rehabilitants with SCI, FIM failed to demonstrate unidimensionality. Instead, it showed a 3-factor structure that fluctuated only little depending on the timing of measurement. Additionally, when measured separately, also motor score was 2-dimensional, not 1-dimensional. Using a total or subscale FIM, scores seem to be unjustified in the studied population.
评估脊髓损伤（SCI）患者中功能独立性测量（FIM®）量表的因子结构。
这是一项基于登记的回顾性队列研究，纳入了155例SCI康复患者。在多学科住院康复开始时和结束时对FIM进行评估。用克朗巴哈系数评估FIM的内部一致性，并采用探索性因子分析来近似FIM的结构。
内部一致性显示克朗巴哈系数较高，为0.95至0.96。对于干预前和干预后的评估，探索性因子分析均得出三因子结构。除两项（“行走或使用轮椅”和“表达”）外，从康复开始到结束，所确定的三个因子的结构保持不变。所有项目的载荷均足够，超过0.3。干预前和干预后的卡方检验均显示显著值<0.0001。“运动”领域分为两个因子，这种两因子结构在干预期持续存在。
在SCI康复患者中，FIM未表现出单维性。相反，它显示出一种三因子结构，仅根据测量时间略有波动。此外，单独测量时，运动评分也是二维的，而非一维。在研究人群中，使用FIM总分或分量表得分似乎不合理。
