Functional Independence Measure (FIM)

Original Editor - Ajay Upadhyay

Top Contributors - Laura Ritchie, Gayatri Jadav Upadhyay, Ajay Upadhyay and Evan Thomas

Objective

The Functional Independence Measure (FIM) is an 18-item of physical, psychological and social function.[1] The tool is used to assess a patient's level of disability as well as change in patient status in response to rehabilitation or medical intervention.[1] [2]

Intended Population

In any motor impairment associated with any condition

Method of Use

The FIM is used by health care practitioners to assess and grade the functional status of a person based on the level of assistance he or she requires. Grading categories range from total independence to total assistance. Irrespective of the use of any assistive device, the person is considered complete independence.

Tasks that are evaluated using the FIM include bowel and bladder control, transfers, locomotion, communication, social cognition as well as the following six self-care activities:[1][1] [2]

  • Feeding
  • Grooming
  • Bathing
  • Upper Body Dressing
  • Lower Body Dressing
  • Toileting

The FIM measures what an individual can perform and not what that person could do under certain circumstances.

Functional Independence Measure.jpg

FIM Levels[1]


No Helper

7. Complete Independence 

(Timely, Safety)

6. Modified Independence

(Device)

Helper - Modified Dependence

5. Supervision 

(Subject = 100%)

4. Minimal Assistance

(Subject = 75% or more)

3. Moderate Assistance

(Subject = 50% or more)

Helper - Complete Dependence

2. Maximal Assistance

(Subject = 25% or more)

1. Total Assistance or not Testable

(Subject less than 25%)


  • Leave no blanks. Enter 1 if not testable due to risk.



Reliability

Inter-Rater Reliability (Intraclass co-relation coefficients ranging from 0.86 to 0.88)

Validity

The concurrent validity with Barthel Index (ICC > 0.83)


References

  1. 1.0 1.1 1.2 1.3 1.4 Linacre JM, Heinemann JW, Wright BD, Granger CV, Hamilton BB. The structure and stability of the functional independence measure. Arch Phys Med Rehabil. 1994. 75: 127-132.
  2. 2.0 2.1 Heinemann AW, Linacre JM, Wright BD, Hamilton BB, Granger C. Relationships between impairment and physical disability as measured by the functional independence measure. Arch Phys Med Rehabil. 1993. 74: 566-573.