A RASCH-BASED COMPARISON OF THE FUNCTIONAL INDEPENDENCE MEASURE AND SPINAL CORD INDEPENDENCE MEASURE FOR OUTCOME AND QUALITY IN THE REHABILITATION OF PERSONS WITH SPINAL CORD INJURY

Journal of Rehabilitation Medicine, 2022 · DOI: 10.2340/jrm.v54.82 · Published: January 25, 2022

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This study compares the Functional Independence Measure (FIM™), a general tool, and the Spinal Cord Independence Measure (SCIM), a tool specific to Spinal Cord Injury rehabilitation, to measure functional independence in Spinal Cord Injury. The content of the two tools was compared using the International Classification of Functioning Disability and Health (ICF), and their measurement properties were tested using Rasch analysis to create a common measurement scale. The study found that FIM™ motor items can be compared to SCIM items from both content and metric perspectives, suggesting an advantage in using SCIM for assessing functional independence in Spinal Cord Injury rehabilitation.

Study Duration

May 2017 to March 2018

Participants

663 patients with SCI

Evidence Level

Not specified

Key Findings

1
The ICF linking and Rasch analysis restricted the analysis to the motor scales of FIM™ and SCIM.
2
The Rasch analysis of the motor scales showed good metric properties.
3
The operational range of SCIM is larger than for the FIM™ motor scale.

Research Summary

This study equates and compares FIM™ motor and SCIM III scores to determine which assessment is best for SCI rehabilitation. The results showed that SCIM III has a more comprehensive operational range, supporting its use for SCI rehabilitation, especially for patients with lower functional abilities. Evaluations based uniquely on SCIM can be expected to result in a comparable benchmarking in comparison with other rehabilitation populations, in which the FIM™ has been used as outcome measure.

Practical Implications

Clinical Practice

SCIM III provides more detailed information for patients with lower functional abilities, aiding in targeted interventions.

Quality Reporting

Using SCIM in SCI rehabilitation may result in a more precise description of rehabilitation outcomes for quality reports.

Research

Future research could focus on transformations at the subscale level to improve monitoring in clinical practice.

Study Limitations

1
Lack of data on sex, age, time since injury, lesion type, and lesion level limited refined analysis and determination of scale invariance across subgroups.
2
More advanced research is needed to improve the precision of the score transformation.
3
The Rasch analyses are based on a random sample of 663 participants with SCI, which may affect the generalizability of results.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury