Validity of the functional independence measure for persons with traumatic brain injury

Objective: Replicate and extend studies of the construct validity of the Functional Independence Measure (FLM) for persons with traumatic brain injury (TBI). Design: A cross-sectional study of admissions to acute rehabilitation evaluated 6 months to 5 years after discharge. Setting: An inpatient brain injury rehabilitation unit in a large, academic medical center. Subjects: Ninety-five patients with primary diagnosis of TBI stratified by time postdischarge. Main Outcome Measures: Prediction of (1) average daily minutes of assistance and (2) supervision required in comparison to the Sickness Impact Profile (SIP) and SF-36. Results: The FIM was highly predictive of minutes of assistance (83% accuracy), supervision (82% accuracy), and the need for either type of assistance (78% accuracy). Prediction was only minimally improved by measures of neurobehavioral impairment. The accuracy of the FLM was superior to the SIP and SF-36. Conclusions: Results provided substantial support for the validity of the FLM as a measure of functional independence for persons with TBI. The importance of supervision as a type of assistance required after TBI was evident, with the FLM highly predictive of this need, as well. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.