Functional Independence Measure for Children (WEEFIM) – 2016

Posted on: March 6, 2016 | By: tcope | Filed under: Functional Independence Measure for Children (WEEFIM)


Data below is reviewed and up to date.

Below is a summary of an article that utilized the Functional Independence Measure for Children (WEEFIM):

Ko I-H, Kim J-H, Lee B-H. Relationships between lower limb muscle architecture and activities and participation of children with cerebral palsy.Journal of exercise rehabilitation. 2013;9(3):368-374. doi:10.12965/jer.130045

The purpose of this study was to examine how muscle strength and size of lower extremity muscles effects physical function, activity, and participation in children with cerebral palsy (CP). The study consisted of 38 infants with CP  and 13 infants with normal development. Diagnostic ultrasound was used to measure the structure of the gastrocnemius and rectus femoris muscle groups.  The Wee Functional Independence Measure (WeeFIM) was used to measure development condition, health, education standards and local community standards of the subjects. Manual muscle testing of the knee extensors and plantar flexors, the Gross Motor Function Classification System (GMFCS), the Gross Motor Function Measure (GMFM), and the ICF-CY check list were also utilized as outcome measures. The examiners performed diagnostic ultrasound and manual muscle testing on all subjects as well as conducted the various outcome measures, including the WeeFIM.

Significant differences in thickness of muscle was found in relation with GMFCS level, thickness of knee and ankle extensor muslces, and clauses of self-care, activity, mobility, ambulation, communication, and social acknolwedgement as measured via the outcome measures, including the WeeFIM. A higher total score of GMFM and WeeFIM resulted in higher activity and participation scores on the ICF-CY.

Strengths of the study included utilizing applicable outcome measures and having a good sample size for the study. Weaknesses included having a wide variety of musculature impairments in the subjects with CP. In addition, assessing strength via manual muscle testing on infants may not have the same reliability and validity as it does with adults. Overall, I believe the study identifies the importance of muscle size and strength in relation to differences in function, activity, and participation for children with cerebral palsy.



2 responses to “Functional Independence Measure for Children (WEEFIM) – 2016”

  1. pweber says:

    Although there is a lot of variability in the presentation of musculoskeletal impairments in patients with CP, I think the WeeFIM serves as a good evaluative tool to aid in discharge planning and aid in determining functional outcome goals. It is applicable for a variety of age groups from infancy to pre-adolescence and it is not time very time consuming, which makes it convenient to administer in multiple settings. I think it’s interesting to be able to draw an association between other outcomes measures such as the GMFM and translate scores to levels of activity and participations.

  2. mcole12 says:

    Below is a summary of an article that utilized the Functional Independence Measure for Children (WEEFIM):

    Kramer ME, Suskauer SJ, Christensen JR, et al. Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a pilot study. J Head Trauma Rehabil. 2013; 28(5):361-370.

    The purpose of the study was to examine patient outcomes and functional independence in children with severe traumatic brain injury (TBI) who demonstrated the lowest level of functional skills upon admission into inpatient rehabilitation. The retrospective study assessed 39 children and adolescents (ages 3-18) who sustained a severe TBI and scored the lowest (18) on the Functional Independence Measure for Children (WeeFIM) upon admission. Functional outcomes were quantified using the WeeFIM among a multitude of other outcome measures. The WeeFIM specifically evaluates mobility, self-care, and cognitive abilities in the following pediatric patient populations: normal developing children, adolescents with cerebral palsy, and older children with TBI. The WeeFIM ratings were obtained from the children’s primary therapist and administered at admission, at two-week intervals, and at discharge. A 3-month follow up interview performed by a trained interviewer was obtained after the patient’s discharge from the inpatient facility to evaluate continued patient progress and functional status. The results revealed that a majority of the children made gains in functional status as seen in 16/39 (40%) children scoring below 30 demonstrating the Dependence group and 23/39 (59%) of children scored above 30 demonstrating Partial Dependence group. The results of the study suggest that children with even the most severe of TBI who enter inpatient rehabilitation completely dependent can make significant gains in functional skills. The earlier a child demonstrated improvements in their WeeFIM scores, the likelihood of accomplishing partial dependence by discharge increased. The strengths of the article include the use of high validity outcome measures demonstrating a representation of a child’s functional mobility and independence. The main limitation of the study was the lack of interventions and specificity of each patient’s treatment protocol while in the inpatient rehabilitation facility. Overall, the study demonstrated the efficacy of the WeeFIM in assessing functional status of children; however, the lack of information and evidence regarding the children’s physical therapy program and its impacts on the scores remains.

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