title: The Mayo Portland Adaptability Inventory-4 outcome measure is superior to UK FIM+FAM in a British military population.
abstract: The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury.
  
  
  
  A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4.
  
  
  
  The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up.
  
  
  
  This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: Emer
authors.initials: E
authors.lastname: McGilloway
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: James
authors.initials: J
authors.lastname: Mitchell
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: Shreshth
authors.initials: S
authors.lastname: Dharm-Datta
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Roberts
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: Haydn
authors.initials: H
authors.lastname: Tilley
authors.affiliation: a Defence Medical Rehabilitation Centre (DMRC) Headley Court , Epsom , Surrey , UK.
authors.forename: John
authors.initials: J
authors.lastname: Etherington
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D000066530:Neurological Rehabilitation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Traumatic brain injury; assessment; head injury; outcome; quality of life; rehabilitation