Stineman et al developed a score for predicting how likely a patient recovering from a stroke will achieve partial functional independence. This can help to identify a patient who may benefit from more aggressive management or a novel therapy. The authors are from the University of Pennsylvania and State University of New York at Buffalo.
Assessment: Functional Independence Measure (FIM) with each item graded from 1 (complete dependence) to 7 (complete independence).
Parameters:
(1) age
(2) number of days since onset of disability
(3) living circumstances prior to being hospitalized
(4) work status prior to stroke
(5) activities of daily living (ADL) FIM score (8 items with total scores from 8 to 56: eating, grooming, bathing, dressing upper body, dressing lower body, toileting, bladder management, bowel management)
(6) cognitive FIM score (5 items with total scores from 5 to 35 - comprehension, expression, social interaction, problem solving, memory)
(7) mobility FIM score (5 items with total scores from 5 to 35 - bed/chair/wheelchair transfer, toilet transfer, bathing transfer, walking/wheelchair, stairs)
(8) factor for interaction between age and mobility
(9) factor for interaction between age and cognition
|
Parameter |
Finding |
Points |
|
age |
|
(-0.0948 * (years)) |
|
number of days |
< 60 days |
0 |
|
|
>= 60 days |
-1.2425 |
|
living circumstances |
alone |
0.2836 |
|
|
not alone |
0 |
|
work status |
employed |
0.7668 |
|
|
homemaker |
0.1915 |
|
|
not working |
0 |
|
|
retired |
0 |
|
ADL score |
|
(0.1161 * (ADL score)) |
|
cognitive score |
|
(-0.1276 * (cognitive score)) |
|
mobility score |
5 to 8 |
0 |
|
|
9 to 12 |
0.4284 |
|
|
13 to 16 |
0.6056 |
|
|
>= 17 |
-0.8921 |
|
age and mobility |
mobility 5 to 8 |
0 |
|
|
mobility 9 to 12 |
(0.00538 * (years)) |
|
|
mobility 13 to 16 |
(0.00531 * (years)) |
|
|
mobility >= 17 |
(0.0324 * (years)) |
|
age and cognition |
|
(0.00248 * (years) * (cognitive score)) |
X =
= SUM(points for all 9 parameters) - 0.0682
probability of achieving modified or partial functional independence =
= 1 / (1 + EXP((-1) * X))
Purpose: To estimate the probability that a patient recovering from a stroke will achieve at least partial functional independence.
Specialty: Sports Medicine & Rehabilitation, Neurology
Objective: severity, prognosis, stage, disability and performance, social activities, family and friends
ICD-10: I61, I62, I63, I64,
