La scala FIM nel monitoraggio del recupero funzionale neuromotorio: studio su emiplegici in degenza riabilitativa post-acuta

The FIM (Functional Independence Measure) is an 18-item, seven-level ordinal scale, used to determine the patient's degree of disability and need for assistance or devices in order to accomplish daily activities. It may be separated into motor (13 items) and cognitive (5 items) subscales. The FIM was applied to assess the functional outcome following stroke in 57 hemiparetic patients (30 males and 27 females, aged 69 ± 10 years, time since onset at admission 64 ± 34 days, length of hospital stay 46 ± 17) treated in a Rehabilitation Centre. The mean motor scores (FIM items A-M, range 13-91) changed from 36.8 (admission) to 54.2 (discharge). The admission and discharge total FIM scores manifested a very high correlation. The independence level at admission was progressively higher in the four subscales: locomotion, mobility, sell-care and sphincter control. The relative level of difficulty between admission and discharge ratings was fairly consistent: this is in accordance with USA results and with our clinical experience of stroke patients. Our results suggest: i) the applicability of the FIM to the Italian context; ii) the instrument validity for both clinical and administrative management analysis in Rehabilitation Medicine.