Interrater reliability of the functional assessment measure in a brain injury rehabilitation program

Objective: To examine the interrater reliability and completion time of the Functional Assessment Measure, which is the Functional Independence Measure (FIM(TM)) 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 FIMS 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. Conclusions: 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. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.