Abstract
The purpose of this study was to compare the quadriplegia index of function (QIF) to the functional independence measure (FIM) in assessing the daily performance of selfcare activities by individuals with cervical spinal cord injury. This study evaluated feeding, grooming and bathing activities in 22 C4-C7, Frankel A-D spinal cord injury patients between 3 and 12 months postinjury. The manual muscle test (MMT) was performed on 17 of these subjects during the same window of time as the QIF and the FIM. An upper extremity motor score (UEMS) was derived from the MMT. In order to relate motor power to functional ability, the UEMS was used as a measure of neurological function to test the hypothesis that the QIF scores are more highly correlated to motor power than are the FIM scores for this population. Spearman coefficients were calculated to correlate the QIF, the FIM and the UEMS. For the bathing and grooming categories, both the QIF and the FIM showed significant and similar correlations to the UEMS. For the feeding category, however, the QIF had a significantly better correlation to the UEMS than did the FIM (Rho = 0.90 vs 0.53, p < 0.01). Use of the QIF feeding scale may allow the detection of changes in function as individuals recover that the FIM scale would miss. Further evaluation of the remaining selfcare and mobility scales is needed. Modification of the FIM with more sensitive portions of the QIF would improve the discriminative ability of outcome studies and program evaluations.
Similar content being viewed by others
Article PDF
References
Heinemann A, Yarkony G, Roth E et al (1989) Functional outcome following spinal cord injury. A comparison of specialized spinal cord injury center vs. general hospital short-term care. Arch Neurol 46: 1098–1102.
Cole T M, Egerton V (1990) Report of the Task Force on Medical Rehabilitation Research, Hunt Valley, Maryland: June 28-29, 1990: 43–56.
Meinecke F (1985) Some thoughts about neurologic recovery in spinal cord injuries: a philosophical review. Paraplegia 23: 78–81.
Granger C V, Albrecht G L, Hamilton B B (1979) Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel index. Arch Phys Med Rehabil 60: 145–154.
Uniform Data Set for Medical Rehabilitation Version 3.0 March 1990. Data Management Service of the Uniform Data System for Medical Rehabilitation and the Center for Functional Assessment Research. SUNY Buffalo, 82 Fuher Hall; SUNY Main St, Buffalo, NY 14214.
Gresham G E, Labi M, Dittmar S, Hicks J, Joyce S, Phillips Stehlik M (1986) The quadriplegic index of function (QIF): sensitivity and reliability demonstrated in a study of thirty quadriplegic patients. Paraplegia 24: 38–44.
Yarkony G, Roth E, Lovell L, Heinemann A, Katz R, Wu Y (1988) Rehabilitation outcomes in complete C5 quadriplegia. Am J Phys Med Rehabil 1: 73–76.
Yarkony G, Roth E, Heinemann A, Lovell L (1990) Rehabilitation outcomes in C6 tetraplegia. Paraplegia 26: 177–185.
Stover S (1990) National Spinal Cord Injury Statistical Center Annual Report No 8. University of Alabama at Birmingham, Oct 1989 through Sept 1990: 83: 93–94.
Roth E, Davidoff G, Haughton J, Ardner M (1990) Functional assessment in spinal cord injury: a comparison of the modified Barthel index and the ‘adapted’ functional independence measure. Clin Rehabil 4: 277–285.
Ditunno J, Graziani V (1989) Motor recovery and functional prognosis in spinal cord injury. Rehabil Report 5: 1–4.
Welch R, Lobley S, O'Sullivan S, Freed M (1986) Functional independence in quadriplegia: critical levels. Arch Phys Med Rehabil 67: 235–240.
Lazar R, Yarkony G, Ortolano D, Heinemann A, Perlow E, Lovell L et al (1989) Prediction of functional outcome by motor capability after spinal cord injury. Arch Phys Med Rehabil 70: 819–822.
Bracken M B, Shepard M J, Collins W F, Holford T R, Young W, Baskin D S, Eisenberg H M et al (1990) A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury: results of the Second National Acute Spinal Cord Injury Study. N Engl J Med 322: 1405–1411.
Geisler F H, Dorsey F C, Coleman W P (1991) Recovery of motor function after spinal-cord injury - a randomized, placebo-controlled trial with GM-1 ganglioside. N Engl J Med 324: 1829–1838.
American Spinal Injury Association (1992) Standards for neurological and functional classification of spinal cord injury, revised 1992. ASIA, Chicago: 1–26.
Walker H, Joseph L (1953) Statistical Inference. Holt, Rinehart, and Winston, NY: 256–257.
Zafonte R D, Demangone D A, Herbison G J, Ditunno JF J r (1991) Daily self-care in quadriplegic subjects. Neuro Rehabil 1(4): 17–24.
Yarkony G, Roth E, Heinemann A, Lovell L, Wu Y (1988) Functional skills after spinal cord injury rehabilitation: three year longitudinal follow-up. Arch Phys Med Rehabil 69: 111–114.
Yarkony G, Roth E, Heinemann A, Wu Y, Katz R, Lovell L (1987) Benefits of rehabilitation for traumatic spinal cord injury. Multivariate analysis in 711 patients. Arch Neurol 44: 93–96.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Marino, R., Huang, M., Knight, P. et al. Assessing selfcare status in quadriplegia: comparison of the quadriplegia index of function (QIF) and the functional independence measure (FIM). Spinal Cord 31, 225–233 (1993). https://doi.org/10.1038/sc.1993.41
Issue Date:
DOI: https://doi.org/10.1038/sc.1993.41
Keywords
This article is cited by
-
Cross-diagnostic validity in a generic instrument: an example from the Functional Independence Measure in Scandinavia
Health and Quality of Life Outcomes (2006)