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

Arch Phys Med Rehabil. 1998 Oct;79(10):1231-6. doi: 10.1016/s0003-9993(98)90267-2.


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.

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Brain Injuries / physiopathology*
  • Brain Injuries / rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Patient Care Team
  • Psychometrics
  • Reproducibility of Results
  • Self Care*
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*
  • Time Factors
  • Treatment Outcome