Mortality rates from stroke have been declining. Because of this, more people are living with residual disability. Rehabilitation plays an important role in functional recovery of stroke survivors. In stroke rehabilitation, early prediction of the obtainable level of functional recovery is desirable to deliver efficient care, set realistic goals, and provide appropriate discharge planning. The purpose of this study was to identify predictors of functional outcome after stroke using inpatient rehabilitation as measured by Functional Independence Measure (FIM) total scores. Correlation and stepwise multiple regression analyses were performed on data collected retrospectively from two-hundred thirty-five patients. More than moderate correlation was found between FIM total scores at the time of hospital admission and FIM total scores at the time of discharge from the hospital. Significant predictors of FIM at the time of discharge were FIM total scores at the time of hospital admission, age, and onset-admission interval. The equation was as follows: expected discharge FIM total score = 76.12+.62×(admission FIM total score)-.38×(age)-.15×(onset-admission interval). These findings suggest that FIM total scores at the time of hospital admission, age, and onset-admission interval are important determinants of functional outcome.

The Functional Independence Measure (FIM) is widely used to determine the dependency of activity of daily living in rehabilitation patients. The purposes of this study were to evaluate the unidimentionality of the FIM physical items and to analyze the validity of cross-functional levels in stroke survivors in Korea. Thirteen physical items of FIM were rated according to an ordinal scale of a 7-level classification. Two hundred and seventy-nine patients participated in the study (age range 18~92 years and 57% male). Six items-eating, bladder control, bowel control, transfer to and from the bed/wheelchair, transfer to and from the toilet, and bathing-showed misfits with the Rasch model. The most difficult item was 'bathing', the easiest item was 'bowel control'. Although there were several differences within functional levels, the hierarchical order of item measures was rather similar. 'Bathing' was the most difficult in high level patients (above 60), however 'stairs' was most difficult in the middle level (41~60) group. In the low level group (below 40), 'toileting' was the most difficult. In conclusion, the present study has shown several differences of item difficulty among functional levels. This result will be useful in planning interventions, and developing rehabilitation programs for stroke survivors.

Objective : The purpose of the present study was to compare the Spinal Cord Independence MeasureⅡ (SCIMⅡ) and the Modified Barthel Index (MBI) to determine the evaluation tool in order to use the tool as an effective index for following these patients for functional changes and determining treatment and rehabilitation outcomes.Method : The present study was conducted with 20 patients who underwent there first time rehabilitation care at A hospital from December 2002 to April 2003. The patients were evaluated at a 2-week interval using the SCIMⅡ and the MBI.Collected data analysis were completed by using Total agreement and Kappa coefficient of agreement, McNemar test, t-test, Correlation analysis, and Wilcoxon rank sum test. Results : The following results were obtained from this study.1.A high correlation was seen in the results of evaluation made by two raters in the SCIMⅡ, showing high interrater reliability(r=0.99, p<0.01).2.When functional changes were compared, more changes in the common items including management in bladder sphincter muscle(p<0.01), toileting(p<0.05), and bathing(p<0.05) were seen in the SCIMⅡ compared with the MBI. Furthermore, among the non-common items in the SCIMⅡ, significant changes were estimated in breathing, prevention of bed sores and bed mobility, and outdoor movement, the SCIMⅡ well reflecting major func-tional changes in patients with spinal cord lesion.3.When the scores of the SCIMⅡ and the MBI were compared at the time of admission and discharge, significant correlation was revealed between the two evaluation tools. However, the SCIMⅡ admission scores were significantly higher than the MBI admission scores in patients with quadriplegia (p<0.05), due to the effects of non-common items such as breathing, prevention of bed sores, and bed mobility.4.When these tools were compared according to muscle strength change, the SCIMⅡ com-pared with the MBI well reflected upper extremity motor score and the ASIA motor score in patients with complete and incomplete quadriplegia(p<0.05), and lower extremity motor score in patients with incomplete spinal cord lesion(p<0.05).Conclusions : These results indicated that the SCIMⅡ is more sensitive compared with the MBI as a tool for functional evaluation in patients with spinal cord lesion, suggesting that the SCIMⅡ would be used to examine functional changes in patients with spinal cord lesion and to effectively follow-up patients for rehabilitation treatment outcome.

Although the availability of home care rehabilitation services have been greatly increased since community-based rehabilitation was introduced to Korea, there is still a dearth of studies investigating the performance level of ADL (activities of daily living) for the physically disabled in the rural areas. The purposes of this study were to investigate the ADL performance level of disabled persons living at home in the rural areas of Wonju city, Korea, using FIM (functional independence measure) and to identify the specific areas of the ADL to be trained or evaluated by physical therapists or occupational therapists. 298 disabled people were interviewed by 10 physical therapy students. Analysis of the interviews indicated: 1) Forty seven point seven percent of the respondents were elderly-disabled persons whose ages were 61 years old or above, and 69.5% of respondents has the history of chronic disability period of 5 years or more. 2) FIM score of bathing, and stairs climbing showed severe dependent trend 3) FIM scores of self-feeding, urination, defecation, and comprehension ability were mildly dependent. These results revealed that functional evaluation/treatment for discharging from hospitals to the rural areas should be emphasized on the specific ADL performance areas such as bathing, and stairs climbing.

The purpose of this study is to evaluate the cognitive perceptual performance skills in relation to activities of daily living(ADL) by using Lowenstein Occupational Therapy Cognitive Assessment(L0TCA) to measure the cognitive perceptual performance and FIM to measure the ADL. The subjects in this study were 24 stroke patients who were admitted for intensive treatment at Department of Rehabilitation in Samsung Medical Center from December. 1997 to June. 1998. SAS was used to analyze data. Using simple regression analysis was used to measure influence of LOTCA on FIM at discharge and to measure influence of patient's concentration on both FIM and LOTCA. Stepwise multiple regression analysis was used to confirm the relationship of FIM to each subtest of LOTCA. The results of this study are as follow : 1. Statistically. LOTCA score at admission showed correlationship with FIM score at discharge. (R2 = 0.50. p<0.0001) 2. Visuomotor organization showed the most significant correlation between LOTCA on FIM at discharge. Motor FIM with perception and visuomotor organization, and cognitive FIM with perception showed significance. 3. The relationship between each subtest of FIM and each subtest of LOTCA. self-care was significantly correlated with visuomotor organization and perception. sphincter control was significantly correlated with orientation and perception, mobility and locomotion was significantly correlated with orientation and visuomotor organization, communication was significantly correlated with perception, social cognition was significantly correlated with perception and thinking operation. LOTCA is significantly correlated to FIM at discharge. Therefore, LOTCA can predict the ADL performance skills. Also, orientation and perception are the most predictable area of LOTCA throughout the entire subtests.

The purpose of this study is to validate of 5 scale-MBI as ADL asessment instrument for stroke patients. The subject was 34 patients following CVA on rehabilitation ther- apy in the rehabilitation hospital, Yonsei medical center. They were assessed with FIM, and 5 scale-MBI in a day. There scores were taken statistics through SAS package, so that we have Pearson's R score. The results is following. 1) FIM and 5 scale-MBI scores averaged 86. 21, 62. 32. 2) On Pearson's R score between FIM and 5 scale MBI was 0. 9345(p(0.001). Therefore there was a very high correlation. 3) On Pearson's R score between motorFIM and MBI was 0.8565(p(0.001), between cog- nitive FIM and MBI was 0.4641(p(0.01). There was significant. 4) On Pearson's R score between same category of FIM and MBI - self care, sphincter control, mobility, locomotion - each others was 0.8960, 0.6974, 0.8585, 0.8540 (p(0.001 ) . In conclusion, 5 scale MBI was found to be useful scale to assess the stroke patients.