Kim, Min-Seok;Jung, Seung-Hyun;Shin, Gil-Cho;Lee, Won-Chul
The Journal of Internal Korean Medicine
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v.19
no.1
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pp.97-113
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1998
BACKGROUND The purpose of this study was to investigate disability of the patients after stroke, clinical applicability and usefulness of the FIM in evaluating the functional abilities and to assess the characteristics of the patients after stroke. And this study examined difference by predictive factors on the treatment outcome. METHOD The study was composed of 31 stroke patients who were within 1 week after stroke and had been treated in hospital more than 4 weeks. Improving rate was measured by using the Functional Independence Measure(FIM), and the correlation was analyzed between Motor FIM and Cognitive FIM. We analyzed significant meaning statistically in the mean value of FIM. RESULT 1. There was no significant meaning statistically in the mean value of FIM that was between both at admission and after 2 weeks. But there was proportional correlation between both at admission and after 4 weeks, and significant meaning statistically. 2. There was proportional correlation between both FIM and Motor FIM, and significant meaning statistically. But there was no significant meaning statistically between both FIM and Cognitive FIM. 3. There was no significant meaning statistically between both FIM and sex, age, side of weakness, stroke subtype, hypertension, hypercholesterolemia, diabetes mellitus, heart disease, starting point of rehabilitation therapy and past history of cerebral vascular accident. While dysarthria affected functional recovery in stroke patients, and significant meaning statistically. CONCLUSION 1. FIM appeared to be a valid and reliable method to measure the functional abilities of the patients after stroke. 2. Only one thing between Motor FIM and score didn't influence FIM score. 3. Dysarthria affected functional recovery in stroke patients, and it is the statistically significant factor.
The purpose of this study was to determine the relationship between activities of daily living and health-related quality of life in ambulatory stroke patients. This was a cross-sectional survey study of 60 patients who had survived one year or more after a stroke in community. Activities of daily living were assessed using the Functional Independence Measure (FlM) and health-related quality of life using the Stroke Impact Scale (SIS). The association between FIM and SIS was examined using Pearson' s correlation. The FIM score was higher than the SIS score. Most domains of FIM exhibited a high rate (45-85%) of ceiling effects. However, only the communication and memory domain of SIS exhibited of ceiling effects. The correlation coefficients were .835 (p<.01) for FIM-motor vs. SIS-ADL, .257 (p<,05) for FIM-motor vs. SIS-communication, .596 (p<.01) for FIM-motor vs. SIS-social participation, .635 (p<.01) for FIM-cognition vs. SIS-memory, .369 (p<.01) for FIM-cognition vs. SIS-ADL, and .289 (p<.05) for FlM-cognition vs. SIS-social participation. In conclusion, the correlation between FIM-motor and SIS-social participation was higher than that of FlM-cognition and SIS-social participation. The domains of emotion and hand function of SIS showed no correlation coefficients with FIM-total. To examine the activities of daily living and the quality of life in ambulatory stroke patients in community, it is necessary to use both the FIM and SIS.
Purpose: This study was to identify the whether there is any correlation between Gross Motor Function Measures (GMFM) and Functional independence Measurement for children (WeeFIM) in order to identify a relevance of daily life motor with gross motor function of children with cerebral palsy. Methods: Subjects were instructed to evaluated by an occupational therapist using WeeFIM (reliability 0.83-0.99) and by a physical therapist using GMFM (reliability 0.93). 10 male children and 13 female children among 23 children being diagnosed as cerebral palsy were targeted for this study. A correlation between GMFM and WeeFIM was analyzed with Kendall correlation. Results: Participants showed significant correlation between GMFM and WeeFIM in all categories, except in the GMFM's walking running jumping category, standing category of GMFM and self care, sphincter control, communication category of WeeFIM. Lying rolling and sitting and crawling kneeling area of GMFM showed a significant correlation with self care(r=0.35, 0.39, 0.4), sphincter control (r=0.45, 0.43, 0.61), mobility transfer (r=0.44, 0.36, 0.64), locomotion (r=0.41, 0.35, 0.74), communication (r=0.4, 0.44, 0.51), and social cognition (r=0.43, 0.51, 0.64) area of WeeFIM (p<0.05). Standing of GMFM and mobility transfer (r=0.74), locomotion (r=0.47) and social cognition (r=0.4) area of WeeFIM showed a significant correlation (p<0.05). Conclusion: These findings indicated significant correlation between activity of daily living (ADL) and gross motor function of children with cerebral palsy. However, because there are a few results that are not significant, both assessment tools should be used for evaluations so that treatment can be achieved with an accurate assessment and establish a therapeutic plan.
This study is designed to evaluate the effects of aggressive fine motor exercise of unaffected hand in the hemiplegic patients. The 36 hemiplegic patients were classified into two groups: The experimental 18, who were treated by aggressive fine motor exercise in unaffected hand and the control, 18, who were treated by conventional exercise program. We evaluate the effects of aggressive fine motor exercise by Functional Independence Measure(FIM) and Jebsen Hand Function Test(JHFT) after 6 weeks program. After exercise program, the experimental group showed score change from $43.05{\pm}15.68$ to $58.05{\pm}17.12$ in FIM score and from $24.12{\pm}22.03$ to $55.44{\pm}21.50$ in Jebsen, and the control showed score change from $51.11{\pm}22.61$ to $57.50{\pm}23.66$ in FIM score and from $40.88{\pm}21.17$ to $52.77{\pm}19.42$ in Jebsen. The experimental group had significantly higher score in FIM and JHFT than that of the control group. The aggressive fine motor exercise is beneficial in unaffected hand in the hemiplegic patients.
The purpose of this study was to determine the effects of home visiting physical therapy on the motor function and ADL in the person with chronic stroke. In this study, 50 individuals, lining in Ui-wang city, were chosen by Ui-wang city public health center and the home visiting physical therapy was performed once a week for 8 weeks and scored the MAS, the FIM and the MBI before and after. The results of this study were as follows. (1) The items with the highest score among subscales of the MAS was 'Sitting', the FIM was 'Comprehension', and the MBI was 'Ambulation' and the lowest were the MAS was 'Hand activities', the FIM was 'Bathing', and the MBI was 'Bathing self' respectively. (2) After 8 weeks home visiting physical therapy, average total score of MAS, FIM and MBI were 23.32, 89.00, and 61.72 and MAS and MBI a significant increment(p<0.05) but not FIM. Results shown here indicates that the home visiting physical therapy can result in changed the motor function and the ADL in the person with chronic stroke. Also, the results of this study can provide a reference for the successful therapeutic program in the persons with chronic stroke.
The WeeFIM is an outcome measure used worldwide to evaluate the functional abilities of children. The aim of this study was to evaluate the psychometric properties of WeeFIM in Korean children with cerebral palsy (CP) using the Rasch model. The mean age of the participants (92 boys and 53 girls) was 10.6 years (SD=2.3, range 5~15 years). The Winsteps software was used for analyzing the internal construct validity and reliability of WeeFIM. For analyzing the internal validity the motor and cognitive area items of the WeeFIM were analyzed both together and separately. When all 18 items were analyzed 4 were considered to be misfits; upper extremity dressing, lower extremity dressing, toileting, and comprehension. When only the 13 motor items were analyzed, toileting, bladder management, and bowel management were considered misfits. In addition, only comprehension was considered as a misfit among the 5 cognitive items. The most difficult motor items were stair climbing, and bathing. The simple ones were eating, bowel management, and bladder management. The most difficult cognitive item was problem solving, and the simplest one was comprehension. The person separation indexes and reliability for combined and divided instruments were reported as excellent. These results demonstrated the applicability of WeeFIM to Korean CP children with satisfactory reliability and validity. Further studies should include young children with CP and compare item difficulty among the different types of CP. In addition, the Korean normative data of nondisabled children should be used to compare the cultural differences between Korea and other countries.
Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.
This study, whose subjects are forty stroke patients in discharging who have been using FIM Western medical (Neurology, Neurosurgery, Rehabilitation Medicine) and Chinese herb medical base of D Hospital in Pusan from the first of May to the eleventh of July, has been made to evaluate the patients' functional conditions and analyze the factors affecting them. The result of study is as followings: FIM total score in discharging is avarage $85.83{\pm}28.96$; the motor FIM score is $57.55{\pm}24.40$ and the cognitive FIM score $29.95{\pm}6.99$. The items recorded the highest score reveal the eating bowel management; the former is $5.68{\pm}1.73$, the latter $5.33{\pm}2.23$. The item recorded the lowest score reveal bathing and stairs, each $2.35{\pm}1.69$ and $3.23{\pm}2.13$. Analysis reveal it is in the case of age(p=.005) and durations of admission(p=.01) that there is significant difference of FIM score when stroke patients in discharging.
Kim, Yoon-Hwan;Kim, Chan-Kyu;Park, Jong-Hang;Lee, Seung-Yub;Choi, Won-Jye
Journal of Korean Physical Therapy Science
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v.15
no.1
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pp.11-20
/
2008
This study was designed to test the effects of comprehensive rehabilitation management on functional recovery after attack of cerebrovascular disease. 16 cerebrovascular disease patients applied comprehensive rehabilitation management of physical therapy at department of physical Therapy, C medical center in Gwang-ju. The collection of the data had been executed for 4months(April 15, 2007${\sim}$July 15, 2007). For evaluating, Functional Independence measure(FIM) and Somatosensory Evoked Potential(SSEP) were used to assess functional recovery. The results of this study were as follows: 1. In the comparison of latency of median nerve SSEP before and after treatment, the lat. N20 and P25 increased, the ampl. P25/N20 was decreased. In the comparison difference data of median nerve SSEP, however there was no significant difference in the group(p>0.05). 2. In the comparison of latency of Post Tibial nerve SSEP before and after treatment, the lat. P40, P50, P60 increased, the ampl. P40 was decreased. In the comparison difference data of post tibial nerve SSEP, however there was no significant difference in the group(p>0.05). 3. In the comparison of FIM scores of Self-care, Sphincter Control, Mobility: Transfer, Locomotion before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was significant difference(p<0.05). 4. In the comparison of FIM scores of Communication, Social Cognition before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was no significant difference in the group(p>0.05). Based on these results, it is concluded that the comprehensive rehabilitation management for cerebrovascular disease case was not significant difference in the SSEP, was significant difference in the motor part of FIM. Further study should be done to analyze the effect of intervention duration of treatment, optimal time to apply the treatment in more long period.
Objective: The purpose of this study was to evaluate the relationship between quality of life (QoL) of the caregiver and disease severity with motor function in children with cerebral palsy (CP). Design: Cross-sectional study. Methods: Research data were collected in the Rehabilitation Clinic of Daegu University. The Gross Motor Function Measure (GMFM-88) and the functional independence measure (FIM) were used for assessment by three occupational therapists, and the 36-item short form health survey (SF-36) were applied to the caregivers. One hundred six caregivers of under 18 years who were diagnosed with CP completed a survey and interview. The caregivers' QoL was evaluated using Medical Outcomes Study SF-36. The children's motor function was scored using GMFM-88 in five dimensions: lying and rolling; sitting; crawling and kneeling; standing and walking, running and jumping and CP's FIM scores. Results: Out of the 8 domains of the Medical Outcomes Study SF-36, the "physical functioning", "physical role functioning", "mental health", and "bodily pain" domains were significantly correlated to "total" percentage scores of the GMFM-88 (p<0.05). In addition, the "mental health" domain was correlated to each subdomain of the GMFM-88, which includes, "lying and rolling", and "crawling and kneeling". Similarly, of Medical Outcomes Study SF-36, "physical functioning", "bodily pain", and "mental health" domains were significantly correlated with "transfer" and "locomotion" of FIM scores (p<0.05). Conclusions: This study showed that the QoL of the caregivers were well correlated with the motor function of children with CP. It is also important to support not only physical health but also psychological health of caregivers of children with CP, especially those with severe motor function.
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