Pitfalls in Functional Assessment

Abstract

Functional meaningful gains that improve the level of independence in day-to-day activities are used to judge the benefit of rehabilitation. let, existing functional assessment tools lack reliability and validity. A study was conducted to compare the functional communication ratings of registered nurses and speech-language pathologists on the Functional Independence Measure (FIM). Fourteen patients with left hemisphere brain damage and fourteen patients with right hemisphere brain damage served as subjects. The nurses assigned significantly higher FIM scores than speech-language pathologists when rating the communication of left hemisphere-damaged patients. However, the average ranks of patients from least to most impaired were the same for nurses and speech-language pathologists. Follow-up analyses revealed potential reasons for the discrepancies including the fact that the nurses and speech-language pathologists were using different evaluation procedures. There is a need for additional research to evaluate functional assessment tools.