An evaluation of multidisciplinary intervention governed by functional independence measure (FIMSM) in incontinent stroke patients

Abstract

Patients with acute hemispheric stroke and ensuring urinary incontinence were randomly allocated to a ward using conventional methods of rehabilitation (n = 13) or to a ward practicing rehabilitation governed by Functional Independence Measure (FIM) (n = 21). All patients were assessed on admission and on discharge using the Katz activities of daily living (ADL) index, the psychological general well-being index, item G of the FIM index (FIM-G), and a mobility score. Patients admitted to the ward utilizing FIM were additionally evaluated using the total FIM on admission, repeatedly during the rehabilitation period and on discharge. An individual rehabilitation programme based on the latest FIM score was used throughout rehabilitation. There were no differences on admission between groups regarding clinical and demographic characteristics, ADL, mobility and mood. Twenty patients in the intervention group regained continence before discharge compared to 3 (p < 0.01) in the control group. There was also a greater improvement in well-being in the intervention group compared to the control group (p < 0.01). This study has indicated that rehabilitation governed by the use of FIM reduced urinary incontinence and enhanced well-being better than conventional methods of rehabilitation. The results warrant a larger study to further investigate rehabilitation of incontinent stroke patients using FIM.