Reliability of the functional independence measure for children in normal Thai children.

BACKGROUND: The Functional Independence Measure for children (WeeFIM) is a new instrument for evaluating functionality in disabled children aged 9-100 months. It was developed to determine a child's functional capacity and performance. With no baseline information about Thai children, it is difficult to assess whether a patient is initially high or low with respect to function. METHODS: The aim of this study, therefore, was to evaluate the interrater, intrarater reliability and appropriateness of the use of the WeeFIM and to establish a normative data profile suitable for Thai children. The WeeFIM is an instrument used to assess independence in self-care, sphincter control, transfer, locomotion, communication, and social cognition. RESULTS: Direct interviews were conducted in the communities for 569 normal Thai children (289 girls and 280 boys) aged 6-100 months. The interrater and intrarater reliability scores were examined. The WeeFIM total and domain scores increased progressively with age. Intraclass correlation coefficients for the reliability for the WeeFIM domain score ranged from 0.90 to 0.99. Total WeeFIM intraclass correlation coefficients values were greater than 0.97 for all analyses. The authors classified the 18 items into six groups according to the degree of correlation with age. Most items were highly correlated with age as indicated by a Spearman's correlation coefficient greater than 0.8. The interrater and intrarater reliability of the WeeFIM subscores was high. CONCLUSION: The current study demonstrated that WeeFIM could be employed as a useful and reliable instrument for assessing functional independence for Thai children. Therefore, usage of WeeFIM with different age criteria for achieving independence should be adopted. Normative functional independence measures for a large group of Thai children will enhance the knowledge base about their development measurement and provide a database for future investigations on clinical population in Thailand.

Functional independence and rehabilitation outcome in traumatic spinal cord injury.

The purpose of this study was to investigation functional independence and rehabilitation outcomes of traumatic spinal cord patients. The data were obtained for 38 patients with traumatic spinal cord lesions admitted to the physical therapy unit from 1997 to 2001. The mean age was 32 +/- 6.48 years. Functional improvement was presented in terms of progress in independence in six daily activities. Independence was rated on a four-point scale. From admission to six months, significant increases in functional independence were made in self-care, sphincter control, mobility and locomotion. Differences were found in the extent of functional improvement between subgroups of patients with different levels and extents of lesions. Contrary to expectations based on theoretical models, patients with complete paraplegia did not achieve maximal independence in self-care activities. Regarding the outcome of bladder management, poor results were found. Interestingly, independence in bowel management, independent mobility and locomotion were only attained by patients with incomplete lesions. This study provides insight into the functional outcomes of a group of patients with traumatic spinal cord injury. More research is needed to determine the optimal rehabilitation program for these patients.

Health-related quality of life after hip fracture in the elderly community-dwelling.

Hip fracture occurs commonly in older individuals and can have a considerable impact on the functional independence and quality of life for older patients living in the community. In a population-based case-control study six months after hip fracture, we investigated the association between functionality and quality of life. The Functional Independence Measure (FIM), the Frenchay Activities of Daily Living Index (FAI), and the Berg Balance Scale (BBS) were used to measure physical function, and quality of life was measured by completing a Short Form-36 (SF-36). With age and gender match, the hip fracture group scores were significantly lower (p < or = 0.05) than the control group in all measurements of physical function (FIM 95.54 vs 103.5; FAI 23.68 vs 30.76; BBS 46.21 vs 54.25). The quality of life was assessed by SF-36, which has eight domains: physical function, physical role, bodily pain, mental health, emotional role, social function, general health and vitality. All eight domains were significantly lower in the hip fracture group compared with the controls (p<0.05). The reduction in function was reflected in a reduction in the quality of life. Thus, clinically reported hip fracture impairs both the functionality and quality of life of these subjects. The adverse impact of hip fracture on quality of life and functionality needs to be recognized by health personnel in the community, so that adequate health resources can be devoted to preventing and treating this debilitating condition.

Measuring functional status in Thai children with disabilities.

OBJECTIVE: The purpose of this study was to compare normal children with age-appropriate functional abilities and children with identified disabilities in Thailand. SUBJECTS AND METHOD: Data were collected for 157 nondisabled children and 80 children with cerebral palsy. Their ages ranged from 6 to 100 months. The Functional Independence Measure for children (WeeFIM) is an instrument used to assess independence in self-care, sphincter control, transfers, locomotion, communication, and social cognition. RESULTS: The WeeFIM of the disabilities scored consistently lower in all areas than those of the nondisabled children (p<0.05). Total score, motor score, and cognitive subscores increased with age. When data from Thai children was compared with that from American and Japanese children, total WeeFIM mean scores for each age group and Pearson's correlation coefficients between each age group and total WeeFIM scores showed similar trends. CONCLUSION: WeeFIM can be used as a disability-measuring instrument for Thai children.