Interinstitutional agreement of individual functional independence measure (FIM) items measured at two sites on one sample of SCI patients.

Individual items of the Functional Independence Measure (FIM) were analyzed for interinstitutional agreement using a sample of 57 spinal cord injured (SCI) patients at discharge from an acute care rehabilitation setting (ACRS) and at admission to an ongoing rehabilitation setting (ORS). The two FIM ratings were performed within 6 days of each other. The reliability coefficient for total FIM scores was good: 0.83. Individual items were classified into four groups: (1) above average reliability coefficient, above average proportion agreement, which included the feeding items and items from the mobility category; (2) above average reliability coefficient, below average agreement, which included the majority of items in the selfcare category; (3) below average reliability coefficient, above average agreement, which included items in the sphincter control and communication categories; and (4) below average reliability coefficient, below average agreement, which included items in the social cognition category. Patients received significantly higher ratings on most selfcare items in the ACRS, and significantly higher ratings on social cognition items in the ORS. Implications of these results are discussed in terms of using individual FIM items for research purposes. Reliability coefficients were acceptably high for subgroups of complete and incomplete paraplegics and for complete quadriplegics, ranging from 0.74 to 0.87, but low for incomplete quadriplegics, r = 0.49. However, these sample sizes were small, ranging from 9 to 17 patients. Data collection will continue in order to increase sample size and permit further analysis of these subgroups.