Functional Independence Measure FIM (adults) and WEE FIM (children) Ratings

With my students

Since I’ve been working with kids on wheelchairs I was curious to learn how the Functional Independence Measure is used with those students. Below is the link I used to make self-notes in case I need the reference. What’s more, I love the clarity and explanation I found there.

Thank you Physiopedia!

https://www.physio-pedia.com/home/

 The FIM  https://www.physio-pedia.com/Functional_Independence_Measure_(FIM)

The FIM uses the level of assistance an individual needs to grade functional status

• from total independence
• to total assistance.

FIM™ is comprised of 18 items, grouped into 2 subscales - motor and cognition.

The MOTOR Subscale includes:

• Eating
• Grooming
• Bathing
• Dressing, upper body
• Dressing, lower body
• Toileting
• Bladder management
• Bowel management
• Transfers - bed/chair/wheelchair
• Transfers - toilet
• Transfers - bath/shower
• Walk/wheelchair
• Stairs

The COGNITION Subscale includes:

• Comprehension
• Expression
• Social interaction
• Problem-solving
• Memory

FIM scores range from 1 to 7.

• 1 = "total assistance with helper” to
• 7 = "complete independence with no helper".
• Scores falling below 6 require another person for supervision or assistance.

Tasks that are evaluated using the FIM include:

• bowel and bladder control,
• transfers,
• locomotion,
• communication,
• social cognition as well as the

following six self-care activities:

• Feeding
• Grooming
• Bathing
• Upper Body Dressing
• Lower Body Dressing
• Toileting

The FIM measures what an individual can perform and not what that person could do under certain circumstances.

FIM Levels:

No Helper

• 7. Complete Independence  (Timely, Safety)
• 6. Modified Independence (Device)

Helper - Modified Dependence

• 5. Supervision (Subject = 100%)
• 4. Minimal Assistance (Subject = 75% or more)
• 3. Moderate Assistance (Subject = 50% or more)

Helper - Complete Dependence

• 2. Maximal Assistance (Subject = 25% or more)
• Total Assistance or not Testable (Subject less than 25%)

The WeeFIM II® System, a pediatric version of the Functional Independence Measure™ (FIM) System; also provides a method to evaluate outcomes for pediatric rehabilitation programs.

The WeeFIM II System measures several metrics of functional ability including 

• Self-care refers to how well a child can feed, groom, bathe, dress, and complete toileting tasks including the management of bowel and bladder.
• Mobility refers to how well a child can transfer in/out of a chair or wheelchair, on/off a toilet, or in/out of a tub or shower. Mobility also includes a child's ability to walk, crawl, or use a wheelchair, and to go up/downstairs.
• Cognition refers to how well a child understands information, expresses themselves, interacts with peers, solves daily problems, and recalls information.

With my students