Comparing the Reliability and Validity Characteristics of FIM and CARE Tool: How Do They Stack UP?

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Conference Proceeding

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PM & R


Objective: The Functional Independence Measure (FIM) had been the gold-standard for assessing patients’ function in rehabilitation for many years. However, as of October 2019, the Continuity Assessment Record and Evaluation (CARE) item set was implemented. Literature examining the measurement properties of the CARE item set are limited and there are no published studies comparing the FIM and the CARE tool functional scales. The primary aims of this study were to examine validity and reliability characteristics of both the FIM and CARE tool functional scales and to examine relationships between the two instruments. We expected strong relationships between mobility and self-care scores on FIM and CARE tool, but FIM cognitive items would have weaker relationships with the CARE Tool functional scales. We also expected both FIM and CARE Tool to be predictive of length of stay in inpatient rehabilitation.

Design: Retrospective descriptive or correlational study Setting : Inpatient rehabilitation hospital Participants : 3387 participants administered both FIM and CARE Tool over a 3-year period.

Interventions: Not applicable

Main Outcome Measures: FIM scores, CARE Tool functional scale scores, length of stay, and discharge disposition

Results: We found expected statistically significant correlations between FIM and CARE Tool, with strongest relationships between FIM motor scores and CARE Tool mobility scores (ranging from .76 to .84, p Conclusions: CARE Tool is a valid and reliable instrument for rehabilitation functional assessment that is comparable to FIM. Both FIM and CARE are predictive of length of stay in inpatient rehabilitation. Our results also suggest that cognitive variables measured by FIM were meaningful but are not accounted for in the CARE Tool functional scales.

Level of Evidence: Level II




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Annual Assembly of the American Academy of Physical Medicine and Rehabilitation (AAPM&R), Virtual, November 11-14, 2021.