Utility of the functional assessment measure after discharge from inpatient rehabilitation.
OBJECTIVE
To assess the relationship between the Functional Independence Measure (FIM) and the Functional Assessment Measure (FAM), and community integration and return to work in patients with severe traumatic brain injuries (TBI).


METHODS
A cross-sectional, prospective design was used to collect data at 6 and 24 months postdischarge. The Return to Work Scale (RTW) and Community Integration Questionnaire (CIQ) were selected to assess return to work and community functioning. Predictor variables included the motor and cognitive subscales of the FIM and the FAM.


METHODS
Follow-up database of an inpatient and community TBI Rehabilitation Unit.


METHODS
All consenting patients with TBI admitted to the unit, aged 16 or above. There were 88 patients at 6 and 79 patients at 24 month follow-up.


RESULTS
At 6 months follow-up, the FAM and the FIM were roughly equivalent in their ability to predict RTW and CIQ scores. At 24 months, FAM motor was the only significant predictor of CIQ, and FAM cognitive scores displayed an advantage over the FIM in predicting employment status.


CONCLUSIONS
The FAM subscales produced only modest gains in prediction of employment status and community integration at 24 months postdischarge. This may reflect ceiling effects on the functional measures, a limited range on the RTW measure, poor ecologic validity of functional disability measures in assessing handicap, or a combination of these factors.
Gurka
J A
JA
Brain Injury Rehabilitation Service, Westmead Hospital, Westmead, New South Wales, Australia.
Felmingham
K L
KL
Baguley
I J
IJ
Schotte
D E
DE
Crooks
J
J
Marosszeky
J E
JE
D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009048:Motor Skills; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000592:standards*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012917:Social Adjustment