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Europa Medicophysica 1998 September;34(3):111-9


language: English

The Functional Independence Measure in the rehabilitation of elderly patients after orthopaedic surgery

Procicchiani D. 1, Bianchini D. 1, La Bruna S. 1, Mammana S. 2, Camurri G. B. 1

1 Divisione Recupero Rieducazione Funzionale, Ospedale Santa Maria Nuova - Reggio Emilia; 2 Statistics consultant


PURPOSE: To assess the utility of the Functional Independence Measure (FIM) to rate disability and the outcome of rehabilitation in elderly patients who underwent orthopaedic surgery. To compare our results with Italian samples and American UDSMR data.
METHODS: Assessment study with no follow-up.
SETTING: A 23-bed rehabilitation unit within a standard multidisciplinary structure.
PATIENTS: Ninety consecutive patients admitted for rehabilitation after hip or knee replacement, or internal fixation of the proximal femur. The mean age was 76.7 years, and 55% of the sample were females.
TREATMENT: Medical rehabilitation and functional tasks.
MEASUREMENT: Functional Independence Measure.
RESULTS: The mean time between surgery and admission was 25 days. The mean FIM scores were 74.5 at admission and 91.6 at discharge. The mean motor FIM scores were 45.1 at admission and 61.7 at discharge. The mean FIM gain was 17.1. The mean length of stay (LOS) was 17.7 days. LOS efficiency was 0.96. Both admission and discharge FIM scores were lower than the Italian and American data; a difference possibly accounted for by the older age of our sample. The mean time between onset and admission, mean length of stay and LOS efficiency were between the Italian and American data. There was a significant correlation between admission and discharge FIM scores. The total FIM admission score showed a direct linear relationship with functional outcome. Age was related to a worse functional status at admission, but did not have a direct influence on outcome. The more elderly patients improved as much as the younger ones (on average, 17 FIM points in 18 days).
CONCLUSIONS: It is now part of our routine practice to use the FIM to assess disability in our patients with orthopaedic impairments. We deem it an invaluable tool not only for rating disability and assessing disability but also for evaluating the outcomes of treatment. It allows us to compare our results with those reported in the literature, which provides an impetus to improve our rehabilitation programme.

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