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Rehabilitation scales

FIM+FAM - Functional Independence Measure and Functional Assessment Measure

A common language in disability measurement in the UK

The Functional Independence Measure (FIM) is a global measure of disability, widely used as a common language measure of outcome across the Western world.

It is an 18-item measure of dependency for activities of daily living comprising 13 motor and 5 cognitive items – each measured on a scale of 1-7. It is suitable for assessing outcome across a wide range of conditions.

The Functional Assessment Measure (FAM) consists of the FIM together with 12 additional items addressing primarily psychosocial function (which are often the main factors limiting outcome in brain injury). Because the FAM items do not stand alone, the abbreviation of FIM+FAM is preferred.

The original FAM items were developed in the 1990s by a group led by Karyl Hall at the Santa Clara Valley Medical Center (SCVMC) in the US. Although still available from the COMBI website, however, the original US version is no longer maintained.

Subsequently a user group in the UK (led by Prof Lynne Turner-Stokes) adapted the FAM items to produce a UK version (FIM+FAM ), which was released in June 1997. Reliability studies demonstrate improvement in comparison with the original version.

The UK FIM+FAM continues to be actively maintained and developed and is now the principal common language outcome measure for specialist rehabilitation services in the UK. FIM+FAM data are collated along side other measures of needs and inputs in the UK Rehabilitation Outcomes Collaborative  (UK ROC) national clinical database.



Nayar M, Alexandrescu R, Siegert RJ & Turner-Stokes L. (2016) The UK FIM+FAM: A first formal psychometric evaluation in patients undergoing rehabilitation following stroke. PLOS One 2016; 29;11(1)

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