Model System:

TBI

Reference Type:

Journal

Accession No.:

J78468

Journal:


Journal of Neurotrauma

Year, Volume, Issue, Page(s):

, 33, 14, 1358-1362

Publication Website:

Abstract:

Study examined the psychometric properties of the Functional Independence Measure (FIM) using data from the Traumatic Brain Injury Model Systems (TBIMS) National Database (NDB), and demonstrated that the FIM comprises three subscales representing cognitive, self-care, and mobility domains. The TBIMS NDB is a longitudinal database that captures demographic and outcome information on individuals with moderate-to-severe traumatic brain injury (TBI) across the United States. TBIMS clinicians collect FIM data at admission and discharge from rehabilitation, and certified data collectors record scores by telephone interview 1, 2, and 5 years post-discharge and every 5 years thereafter. The FIM assesses problem solving; memory; expression; comprehension; social interaction; eating; grooming; bathing; dressing-upper body; dressing-lower body; toileting; bowel management; bladder management; transfers to bed, chair, or wheelchair; transfers to toilet; transfers to shower/tub; locomotion; and stair climbing. These subscales were analyzed simultaneously using a multivariate Rasch model in combination with a time dependent concurrent calibration scheme with the goal of creating a raw score-to-logit transformation that can be used to improve the accuracy of parametric statistical analyses. The bowel and bladder function items were removed because of misfit with the motor and cognitive items. Some motor items exhibited step disorder, which was addressed by collapsing Categories 1-3 for Toileting, Stairs, Locomotion, Tub/Shower Transfers; Categories 1 and 2 for Toilet and Bed Transfers; and Categories 2 and 3 for Grooming. The strong correlations among the resulting three subscales (cognitive, self-care, and mobility) suggest they should be modeled together. Coefficient alpha of 0.98 indicates high internal consistency.

Author(s):


Pretz, Christopher R., Kean, Jacob, Heinemann, Allen W., Kozlowski, Allan J., Bode, Rita K., Gebhardt, Eveline

Participating Centers: