Interrater reliability of the Functional Assessment Measure in a brain injury rehabilitation program.

OBJECTIVE

To examine the interrater reliability and completion time of the Functional Assessment Measure, which is the Functional Independence Measure (FIM) plus additional items (FIM+FAM).

DESIGN

Interrater reliability study.

SETTING

Inpatient rehabilitation units of a postacute care brain injury rehabilitation program.

PATIENTS

A convenience sample of 53 extremely severely impaired adult survivors of traumatic brain injuries (40 men, 13 women, mean age 38yrs).

MAIN OUTCOME MEASURES

Treatment team members' ratings of the 30 FIM +FAM items, and time taken to complete the FIM+FAM.

RESULTS

Intraclass Correlation Coefficients (ICCs) were within the good to excellent range (ICC > .60) for 29 of 30 items and for all subscales except psychosocial adjustment. Higher mean ICC values were obtained for motor domain items than for cognitive/psychosocial domain items. Treatment teams became progressively faster over a 12-week period in completing the FIM+FAM. The generally good to excellent range interrater reliability found in this study helps support the use of the FIM+FAM in rehabilitation settings. Further support was obtained for the finding that motor items are more reliable than cognitive and psychosocial items. Administration of the FIM+FAM can be done in a timely manner in a rehabilitation setting.