Long-term prediction of functional independence using adjusted and unadjusted single items of the functional independence measure (FIM) at discharge from rehabilitation

This study aimed to identify if single activities of daily living (ADL) assessed at discharge from rehabilitation after a spinal cord injury (SCI) can predict long-term functional independence (3–6 years post-injury). The researchers wanted to see if these ADL items could help identify individuals who may need intensive follow-up care. The Functional Independence Measure (FIM) was used to measure functional independence. The FIM assesses various domains, including self-care, sphincter control, transfers, locomotion, communication, and social cognition. The study found that certain FIM items, particularly those related to toileting, bowel control, and transfers, were strong predictors of long-term functional independence. These findings suggest that focusing on these specific areas during rehabilitation discharge planning could help improve long-term outcomes for individuals with SCI.

• 1
  The top three predictors of total FIM score at chronic phase were Toilet (Transfers domain), Toileting (Self-care domain), and Bowel (Sphincter control domain).
• 2
  These three items were also predictors of “good” functional independence (FIM motor score ≥ 65) and their predictive power increased when adjusted by age, paraplegia, time since injury, and length of stay.
• 3
  The highest predictive power was obtained with the Toilet item from the Transfers domain (adjusted R2 = 0.53).