Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure
Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure
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DOI：
10.1136/jnnp.66.4.480
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发表时间：
1999-04-01
影响因子：
11
通讯作者：
Thompson, AJ
中科院分区：
文献类型：
--
作者：
van der Putten, JJMF;Hobart, JC;Thompson, AJ
背景-评估残疾结果措施的重要性是公认的。功能独立性测量（Functional Independence Measure，简称FSI）是一种比Barthel指数（Barthel Index，简称BI）更全面、更敏感的残疾测量方法。尽管该试剂盒被广泛使用，并已被证明是可靠和有效的，但关于其响应性的信息有限，特别是与BI相比。本研究比较了这两个残疾措施的患者与多发性硬化症和stroke. Methods患者多发性硬化症（n=201）和中风后（n=82）患者进行住院神经康复的适当性和反应进行了研究。为BI和三个量表（总分、运动和认知）生成入院和出院评分。通过检查分数分布、下限和上限效应来确定研究样本的措施是否适当。响应性确定使用的效果大小calcium.Results-The BI，总，和ESTA运动量表显示良好的变异性，并有小的地板和天花板的影响，在研究样本。多发性硬化症患者的认知量表显示出显著的天花板效应。比较的影响大小被发现为BI，和两个量表（总和电机）在多发性硬化症患者和中风patients. Conclusion所有措施是适当的研究样本。然而，认知能力量表作为进展性多发性硬化症的结果测量的有用性有限。的BI，。总量表和运动功能量表显示出相似的反应性，表明在评估变化方面，运动功能量表和运动功能量表均没有优于BI的优势。
Background-The importance of evaluating disability outcome measures is well recognised. The Functional Independence Measure (FIM) was developed to be a more comprehensive and "sensitive" measure of disability than the Barthel Index (BI). Although the FIM is widely used and has been shown to be reliable and valid, there is limited information about its responsiveness, particularly in comparison with the BI. This study compares the appropriateness and responsiveness of these two disability measures in patients with multiple sclerosis and stroke.Methods-Patients with multiple sclerosis (n=201) and poststroke (n=82) patients undergoing inpatient neurorehabilitation were studied. Admission and discharge scores were generated for the BI and the three scales of the FIM (total, motor, and cognitive). Appropriateness of the measures to the study samples was determined by examining score distributions, floor and ceiling effects. Responsiveness was determined using an effect size calculation.Results-The BI, FIM total, and FIM motor scales show good variability and have small floor and ceiling effects in the study samples. The FIM cognitive scale showed a notable ceiling effect in patients with multiple sclerosis. Comparable effect sizes were found for the BI, and two FIM scales (total and motor) in both patients with multiple sclerosis and stroke patients.Conclusion-All measures were appropriate to the study sample. The FIM cognitive Scale, however, has limited usefulness as an outcome measure in progressive multiple sclerosis. The BI, FIM. total, and FIM motor scales show similar responsiveness, suggesting that both the FIM total and FIM motor scales have no advantage over the BI in evaluating change.