Functional Independence Measure for Children (WeeFIM) 2019

Posted on: February 22, 2019 | By: kholder2 | Filed under: Functional Independence Measure for Children (WEEFIM)

The data reported here for the Functional Independence Measure for Children (WeeFIM) has been reviewed and is found to be up-to-date.

Below is a summary of an article in which the WeeFIM was used as the primary objective assessment of progress following an acquired brain injury (ABI).

Beretta E, Molteni E, Galbiati S, Stefanoni G, Strazzer S. Five-year motor functional outcome in children with acquired brain injury. Yet to the end of the story? Developmental Neurorehabilitation. 2017;21(7):449-456. doi:10.1080/17518423.2017.1360408.

Summary
In this study, researchers looked at retrospective data from pediatric patients with severe ABI at admission, discharge, and annually for 5 years to determine motor changes and clinical evolution over time. The functional independent measure for children (WeeFIM) was used to quantify function at the specified time points in 496 pediatric patients age 0-18 years. This was a retrospective study conducted in two stages, inpatient rehabilitation in the subacute phase and home-based treatment in the chronic phase. Of the 496 patients, sixty-six patients were evaluated with 3D gait analysis to assess gait velocity, stance length, and stance width. Correlations between gait analysis and mobility WeeFIM scores included increasing WeeFIM mobility scores and longer step and stride lengths with increase in velocity of gait. Overall, functional limitations decreased gradually after ABI; however, impairments were still present at the final data collection point. In conclusion, improvement is found in the mobility domain of the WeeFIM even five years after ABI and successfully describes the clinical evolution of a patient after ABI.

Strengths
Researchers considered WeeFIM scores to understand each patient’s function in a quantitative manner, and they calculated developmental functional quotients (DFQ) for all the WeeFIM scores. The data collection specifically focuses on the mobility WeeFIM scores, and the authors acknowledge the cognitive and behavioral domains are partially unexplored, which is why they are not included in a significant manner in the research. The researchers also explored the relationship between the WeeFIM scores of the mobility domain and the quality of gait in the children, including gait velocity, stance length, and stance width.

Weaknesses

This study included a very wide age range, 0-18 years, which makes it difficult to determine developmental trends. The authors discuss the limits of the WeeFIM in evaluating the youngest and most severely impacted patients, so another outcome measure may be more appropriate for these conditions. The study did not include any infection or neuroradiological findings, which could have an impact on recovery and WeeFIM scores. The specific rehabilitation treatments used over the 5-year period were not described in the article, which may indicate some variability in treatment as patients were most often receiving local and convenient services. Finally, functional description of gait was not included in this study with the 3D gait analysis performed.

Clinical Application
Significant improvements were noted in WeeFIM scores from admission to discharge and at every follow-up until year 5 for the mobility domain. This indicates the importance of continued rehabilitation in this population for the foreseeable future. WeeFIM scores can also help to facilitate where rehabilitation programs should focus for pediatric patients after ABI due to its successfulness in describing the clinical evolution of the population.

 

One response to “Functional Independence Measure for Children (WeeFIM) 2019”

  1. bmarino2 says:

    I like how there is a specific pediatric version of the ‘FIM’ for inpatient rehab. It makes a lot of sense to adapt the adult FIM to be used in pediatrics with their own outcome measure. I would be interested in an experimental research study using the WeeFIM as well to explore its continued effectiveness.

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