Performance profiles of the functional independence measure

C. V. Granger*, B. B. Hamilton, J. M. Linacre, A. W. Heinemann, B. D. Wright

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

487 Scopus citations


The functional independence measure (FIM) is used to determine the degree of disability that patients experience and the progress that they make through programs of medical rehabilitation. Rasch analysis is a statistical technique for constructing interval measures from ordinal data that was applied to derive FIM measures. The major factors that are taken into account to produce FIM measures are the relative difficulty in performance of FIM items and the ability of the persons tested. Our analyses showed the relative difficulties that patients experienced in performing items in the FIM. There were two dominant patterns of difficulty, one for motor FIM items and the other for cognitive FIM items. The patterns were consistent across impairment groups, although not identical. Of the motor items, eating and grooming were easiest whereas stair climbing, tub/shower transfers and locomotion were most difficult. Of the cognitive items, expression and comprehension were easiest and problem solving was the most difficult. The patterns of difficulty in performing FIM items are illustrated by analysis of the following impairment groups: for motor items, orthopedic conditions, stroke with left hemiparesis and spinal cord dysfunction; for cognitive items, orthopedic conditions, brain dysfunction, stroke with right hemiparesis and spinal cord dysfunction. By understanding patterns of difficulty in performing FIM items according to types of impairment and levels of function, clinicians may more precisely design treatment programs, use services and predict outcomes of medical rehabilitation.

Original languageEnglish (US)
Pages (from-to)84-89
Number of pages6
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number2
StatePublished - 1993


  • Disability Evaluation
  • Functional Assessment

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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