The Use of Disability Outcome Measures in a Neurological Rehabilitation Unit

Disability levels in 100 patients were assessed at monthly intervals during early inpatient rehabilitation after single incident brain injury using the Functional Independence Measure (FIM; Guide for the Uniform Data System for Medical Rehabilitation, 1993) and a modified Barthel Index (Novak, Johnson, & Greenwood, 1996). We were particularly interested to evaluate the relative effectiveness of these measures in detecting improvements in patients in this rehabilitation setting. It was found that scores on both measures at admission correlated highly with length of stay on the unit and dependency levels on discharge. There was also little difference in floor and ceiling effects on the two measures, with both detecting change in 95% of patients. However, the modified Barthel Index had the added advantages of being quick and easy to administer, needed no special training to score and it had face validity. It is therefore suggested as the measure of choice in early National Health Service inpatient neurorehabilitation settings.