The functional independence measure: its use to identify rehabilitation needs in stroke survivors

To explore the potential of the Functional Independence Measure (FIM) as a prognostic indicator of outcome in stroke survivors, 113 consecutive patients were observed from admission until discharge. Patients received assessment and treatment by a multidisciplinary team in a regional tertiary care stroke-specific rehabilitation program. The FIM, Chedoke-McMaster Stroke Assessment, and discharge location were used as the main outcome measures. The results suggested that; (1) impairment variables alone are insufficient as prognostic indicators of outcome; (2) the absolute admission FIM score, not the change in the FIM score, is the best predictor of outcome disability and place of discharge; and (3) subgroups of stroke survivors with differing rehabilitation needs can be identified. The FIM allows us to classify stroke survivors according to their needs; therefore, attention should be redirected to the development of prognostic indicators for groups of stroke survivors.