Projecting Function of Stroke Patients in Rehabilitation Using the AlphaFIM Instrument in Acute Care

Objectives: (1) To establish the reliability and validity of the AlphaFIM instrument; (2) To examine the hypotheses that the 6-item AlphaFIM instrument administered in acute care would closely approximate the full 18-item FIM instrument rating administered at admission to an inpatient rehabilitation facility (IRE); (3) to determine whether the acute AlphaFIM projected rating could predict the full FIM instrument ratings at discharge from the IRF; (4) to test whether the acute AlphaFIM projected rating could predict length of stay (LOS) in the IRF; (5) to determine if the acute AlphaFIM projected rating could predict the likelihood of patients being discharged from the IRF to the community. Design, Setting, and Participants: A prospective cohort study of 144 stroke patients in an acute care stroke unit with subsequent transfer to an IRF. Interventions: None. Main Outcome Measurements: IRF admission FIM rating, IRF discharge FIM ratings, LOS, and likelihood of discharge to community. Results: The AlphaFIM instrument displayed adequate reliability and validity. Results of a linear regression showed the acute AlphaFIM instrument ratings were significant in predicting IRF admission FIM instrument ratings, IRF discharge FIM instrument ratings, and IRF LOS. Results of a logistic regression indicated the ability of the acute AlphaFIM instrument ratings to predict the likelihood of patients being discharged from the IRF to the community was statistically significant but did not account for a great deal of the variance in the model. Conclusions: The AlphaFIM instrument, used in acute care, has utility in projecting FIM instrument ratings of stroke patients' function at admission to and discharge from the IRF.