The reliability and validity of a self-report version of the FIM instrument in persons with neuromuscular disease and chronic pain

Objective: To evaluate the reliability and validity of a self-report version of the FIM instrument (FIM-SR). Design: Survey study. Setting: Rehabilitation research program. Participants: Adults with neuromuscular disorders (NMD) and chronic pain (N = 14 1). Interventions: Not applicable. Main Outcome Measures: The FIM-SR and Medical Outcomes 36-Item Short-Form Health Survey (SF-36). Results: The internal consistency coefficients of the FIM-SR scales were all adequate to excellent (Cronbach alpha range, .73.98; median, .96). Correlations between the FIM-SR scales and SF-36 scales supported the concurrent validity of the former. Also, the FIM-SR scales associated with motor function discriminated between those subjects who reported being ambulatory and those who reported requiring use of a wheelchair or other assistive device for getting around. Finally, FIM-SR scales discriminated between different types of NMDs, with patients with amyotrophic lateral sclerosis showing significantly lower scores on the FIM-SR self-care, motor, and total scores than all other NMD diagnostic groups, and showing significantly lower scores on the FIM-SR sphincter control, mobility, and locomotion scales than most of the other diagnostic groups. Conclusions: The FIM-SR scales appear to be reliable and valid measures of independence in 6 specific (self-care, sphincter control, mobility, locomotion, communication, social cognition), and 3 global (motor, cognition, total) areas of functioning in persons with NMD.