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Updated: Jan 25, 2026

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Clinically meaningful changes in functional independence among older patients with subacute stroke: estimating the

Hiroyuki Uchida1,2, Tomoaki Shirakawa2, Kazuki Ishii2

  • 1Graduate School of Health Sciences, Gunma University, Maebashi, Japan.

European Geriatric Medicine
|January 23, 2026
PubMed
Abstract

Insights

The minimal important change (MIC) for the Functional Independence Measure (FIM) in older stroke patients was determined to be 19 for motor, 4 for cognitive, and 23 for total scores. These values help interpret rehabilitation outcomes in geriatric care.

Area of Science:

  • Geriatric Medicine
  • Rehabilitation Medicine
  • Neurology

Background:

  • The Functional Independence Measure (FIM) assesses daily living activities in stroke patients.
  • Establishing the minimal important change (MIC) is crucial for interpreting FIM scores in clinical practice and research.
  • This study focuses on older adults with subacute stroke.

Purpose of the Study:

  • To estimate the minimal important change (MIC) of the FIM in older patients with subacute stroke.
  • To enhance the interpretability of rehabilitation outcomes in geriatric care.
  • To provide benchmarks for evaluating treatment effectiveness.

Main Methods:

  • Analysis of data from 277 eligible patients aged 65+ admitted to a Japanese convalescent rehabilitation ward (CRW).
  • FIM scores were assessed at admission and discharge.
  • The anchor-based adjusted predictive modeling method (MICadj) was used, with the place of discharge as the anchor.

Main Results:

  • The estimated MICadj for motor, cognitive, and total FIM scores were 18.6, 3.9, and 22.8, respectively.
  • Patients showed significant improvements in FIM scores from admission to discharge.
  • The study provides specific MIC values for older adults with subacute stroke.

Conclusions:

  • The MIC for the FIM in older patients with subacute stroke are approximately 19 (motor), 4 (cognitive), and 23 (total).
  • These MIC values can aid clinicians and researchers in interpreting the significance of changes in FIM scores.
  • This research contributes to better understanding and application of FIM in geriatric stroke rehabilitation.
Keywords:
Activities of daily livingFunctional independence measureMinimal important changeRehabilitationStroke

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