FIM

Question 1

Transfers: Bed, Chair, Wheelchair includes all aspects of _ from a _ to a _ and _, or from a _ to a _ and back, or coming to a _ _ if _ is the typical mode of _. The patient performs the activity _.

Answer 1

Transfers: Bed, Chair, Wheelchair includes all aspects of TRANSFERRING from a BED to a CHAIR and BACK, or from a BED to a WHEELCHAIR and back, or coming to a STANDING POSITION IF WALKING is the typical mode of LOCOMOTION.

The patient performs the activity SAFELY

Question 2

Transfers: Bed, Chair, Wheelchair- which 2 levels do not involve a helper?

Answer 2

Level 7- complete independence

Level 6- modified independence

Question 3

Definition of complete independence (level 7): if walking- patient safely _, _ _ on a regular _, and _ _ to a _ _ from a regular _. Patient also safely _ from _ to a _.

Answer 3

If walking- patient safely APPROACHES, SITS DOWN on a regular CHAIR, and GETS UP to a STANDING POSITION from a regular CHAIR.

Patient also safely TRANSFERS from BED to a CHAIR

Question 4

Definition of complete independence: if in a wheelchair- patient approaches a _ or _, _ _, lifts _ _, removes _ _ if necessary, and performs either a _ _ or _ _ (without a _) and _.

Patient performs this activity _.

Answer 4

If in a wheelchair- patient approaches a BED or CHAIR, LOCKS BRAKES, lifts FOOT RESTS, removes ARM RESTS if necessary, and performs either a STANDING PIVOT or SLIDING TRANSFER (without a BOARD) and RETURNS.

Patient performs this activity SAFELY

Question 5

Definition of modified independence (level 6): patient requires an _ or _ _ such as a _ , a , _ _ or a special _///_; or the activity takes _ than a _ _ of _; or there are _ _. In this case, a _ or _ is considered an _ _ if used for the transfer.

Answer 5

Patient requires an ADAPTIVE or ASSISTIVE DEVICE such as a SLIDING BOARD, a LIFT, GRAB BARS, or a special SEAT/ CHAIR/ BRACE/ CRUTCHES;

Or the activity takes MORE than a REASONABLE AMOUNT of TIME;

Or there are SAFETY CONSIDERATIONS

In this case, A PROSTHESIS OR ORTHOSIS is considered an ASSISTIVE DEVICE if used for the transfer

Question 6

Which FIM level is being described: patient requires more help than touching or performs 50-74% of the transferring tasks?

Answer 6

Level 3, Moderate assistance

Question 7

Which FIM level is being described: The patient performs less than 25% of the transferring tasks?

Answer 7

Total Assistance, Level 1

Question 8

Which FIM level is being described: The patient requires supervision (ex- stand by, cueing, or coaxing) or set up (positioning, slide board, moving foot rests, etc)?

Answer 8

Supervision or Set up, Level 5

Question 9

Which FIM level is being described: Patient requires no more help than touching and performs 75% or more of transferring tasks?

Answer 9

Minimal contact assistance- Level 4

Question 10

Which FIM level is being described: The patient performs 25 to 49% of the transferring tasks?

Answer 10

FIM level 2, maximum assistance

Question 11

FIM level 0 for Tranfers: Enter code 0 only for the _ _. The patient _ _ _ to or _ the _ or a _, and is _ _ to or from the _ or _ by a _ or _ _. Use of this code should _ _.

Answer 11

Enter code 0 only for the ADMISSION ASSESSMENT

The patient DOES NOT TRANSFER to or FROM the BED or a CHAIR, and is NOT TRANSFERRED to or from the BED or CHAIR by a HELPER or LIFTING DEVICE.

Use of this code should BE RARE

Question 12

FIM Transfers: During bed-to-chair transfer, the subject _ and _ in the _ _.

Answer 12

The subject BEGINS and ENDS in the SUPINE POSITION

Question 13

FIM locomotion- Walk: includes walking on a _ _ once in a _ _. The patient performs the _ _. This is the _ of _ locomotion function modifiers.

Answer 13

Walk: includes walking on a LEVEL SURFACE once in a STANDING POSITION.

The patient performs the ACTIVITY SAFELY

This is the FIRST OF TWO locomotion function modifiers

Question 14

Which FIM levels for locomotion-walk do no require a helper?

Answer 14

Level 7, complete independence

Level 6, modified independence

Level 5, exception for household locomotion

Question 15

In order to be a FIM level 7 the patient must walk a minimum of _ feet _ _ _.

Answer 15

Must walk a minimum of 150 feet WITHOUT ASSISTIVE DEVICES

Question 16

To be considered a FIM level 6, modified independence the patient must walk a minimum of _ feet, _ uses a _ (_) or _ on leg, special _ _, _, _ or _; or takes _ than a _ _ of _ to complete the activity; or there are _ _.

Answer 16

Patient must walk a minimum of 150 feet, BUT uses a BRACE (ORTHOSIS) or PROSTHESIS on leg, special ADAPTIVE SHOES, CANE, CRUTCHES, or WALKERETTE;

Or takes MORE than a REASONABLE AMOUNT of TIME to complete activity

Or there are SAFETY CONSIDERATIONS

Question 17

Level 5, Exception for Household locomotion: The patient walks _ _ _ (a minimum of _ feet) _, _ or _ a _. The activity takes _ than a _ _ of _. Or there are _ _.

Answer 17

The patient walks ONLY SHORT DISTANCES (a minimum of 50 feet) INDEPENDENTLY, WITH or WITHOUT a DEVICE

The activity takes MORE than a REASONABLE AMOUNT of TIME

Or there are SAFETY CONSIDERATIONS

Question 18

FIM Level 5- Supervision: the patient requires _ _, _ or _ to go a minimum of _ feet or _ meters

Answer 18

The patient requires STANDBY SUPERVISION, CUEING, or COAXING to go a minimum of 150 feet or 50 meters

Question 19

FIM level 4, Minimal Contact Assistance (locomotion-walk): the patient performs _ or _ of walking effort to go a minimum of _ feet.

Answer 19

The patient performs 75% or MORE of walking effort to go a minimum of 150 feet

Question 20

If a patient cannot walk a minimum of 150 feet, regardless of the level of assistance required what is the highest score possible? What if they cannot walk 50 feet?

Answer 20

Level 2 Max assist (if they can walk b/w 50-149 feet)

Level 1 Total Assist (less than 50 feet)

Question 21

FIM level 3, Moderate assistance: patient performs _ to _ of the walking effort to go a minimum of _ feet

Answer 21

Patient performs 50 to 74% of the walking effort to go a minimum of 150 feet

Question 22

FIM level 2, Maximum assistance- patient performs _ to _ of walking effort to go a minimum of _ feet, and requires assistance of _ _ _

Answer 22

Patient performs 25 to 49% of the walking effort to go a minimum of 50 feet, and requires assistance of ONE PERSON ONLY

Question 23

FIM Level 1, total assistance: patient performs _ than _ of effort, or requires _ of _ _, or walks _ than _ feet.

Answer 23

Patient performs LESS than 25% of effort, or requires ASSISTANCE of TWO PEOPLE, or walks LESS than 50 FEET.

Question 24

FIM Level 0 for locomotion- walk: Enter code 0 only for _ _. The patient _ _ _. For example, use 0 if the patient uses _ a _ for _ or the patient is _ _ _.

Answer 24

Enter code 0 only for ADMISSION ASSESSMENT

The patient DOES NOT WALK

For example, use 0 if the patient uses ONLY a WHEELCHAIR for LOCOMOTION or the patient is ON BED REST.

Question 25

Locomotion- walk FIM scale: if the patient requires an assistive device for locomotion (prosthesis, walker, cane, AFO, adapted shoe, etc.) the highest FIM score possible is?

Answer 25

Is a Level 6, modified independence.

Question 26

FIM Scale for Locomotion- Wheelchair: includes using a wheelchair on _ _ once in a _ _. The patient performs the _ _. This is the _ of _ function modifiers for locomotion.

Answer 26

Includes using a wheelchair on LEVEL SURFACES once in a SEATED POSITION.

The patient performs the ACTIVITY SAFELY

This the SECOND of TWO function modifiers for locomotion.

Question 27

FIM level 7, complete independence- locomotion/ wheelchair: this score _ _ _ _ if the patient uses a _ for _.

Answer 27

This score IS NOT TO BE USED if the patient uses a WHEELCHAIR for LOCOMOTION

Question 28

What levels of the FIM scale for locomotion- wheelchair do not require a helper?

Answer 28

Level 6, modified independence

Level 5, exception for household ambulation

Question 29

Level 6, modified independence for locomotion- w/c: the patient operates a _ or _ _ _ for a minimum of _ feet; _ around; maneuvers the chair to a _, _, _; negotiates at _ a _ _ _; and maneuvers on _ and _ _ _.

Answer 29

Patient operates a MANUAL or MOTORIZED WHEELCHAIR for a minimum of 150 feet; TURNS around;

Maneuvers the chair to a TABLE, BED, TOILET

Negotiates at LEAST a 3 PERCENT GRADE

And maneuvers on RUGS and OVER DOOR SILLS

Question 30

FIM level 5 exception for household locomotion- w/c: patient operates a _ or _ _ _ only _ _ with a minimum of _ feet.

Answer 30

Patient operates a MOTORIZED or MANUAL WHEELCHAIR INDEPENDENTLY only SHORT DISTANCES with a minimum of 150 FEET.

Question 31

FIM levels 1-5 are the _ for - and -. Except?

Answer 31

Are the SAME for LOCOMOTION-WALK and LOCOMOTION- WHEELCHAIR

Except one is done by walking and the other is in a w/c

Question 32

Level 0 FIM locomotion- w/c: Enter code 0 only for the _ _. The patient _ _ _ a wheelchair, and _ _ _ in a wheelchair by _ _.

Answer 32

Enter code 0 only for the ADMISSION ASSESSMENT

The patient DOES NOT USE a wheelchair, and IS NOT PUSHED in a wheelchair by A HELPER.

Question 33

Because there are 2 locomotion function modifiers: you should _ _ _ _ on admission and discharge. The mode of locomotion (walk or w/c) _ _ the _ on admission and discharge (Item 39L). If the patient _ the _ of _ between admission and discharge, record the admission mode and scores based on the _ _ _ of _ at discharge.

Answer 33

You should SCORE BOTH FUNCTION MODIFIERS on admission and discharge.

The mode of locomotion MUST BE THE SAME on admission/ discharge.

If the patient CHANGES the MODE OF LOCOMOTION b/w admission and discharge, record the admission mode and scores based on the MORE FREQUENT MODE of LOCOMOTION at discharge.

Question 34

Because there are 2 function modifiers for the FIM scale for locomotion you should indicate the _ _ mode of locomotion. If both are used _, code _. If both are _ _ at discharge use the score for _ to complete both the _ and _ _ of item 39L.

Answer 34

You should indicate the MOST FREQUENT mode of locomotion. If both are used EQUALLY, code BOTH.

If both are USED EQUALLY at discharge use the score for WALK to complete by the ADMISSION and DISCHARGE PORTIONS of item 39L

Question 35

FIM Locomotion-Stairs: includes going _ and _ _ to _ stairs (_ _) indoors in a _ _.

Answer 35

Includes going UP and DOWN 12 to 14 stairs (ONE FLIGHT) indoors in a SAFE MANNER.

Question 36

Which FIM levels for locomotion- stairs do not require a helper?

Answer 36

Level 7, complete independence

Level 6, modified independence

Level 5, exception for household ambulation

Question 37

Complete independence, level 7, location- stairs: the patient safety goes _ and _ at least _ _ of stairs without _ on any type of _ or _.

Answer 37

The patient safely goes UP and DOWN at least ONE FLIGHT of stairs without DEPENDING on any type of RAILING OR SUPPORT.

Question 38

Level 6, locomotion- stairs: patient goes up and down at _ _ _ of stairs but requires a _ _, _, _, or _ _; or the activity take more than a _ _ of _; or there are?

Answer 38

Patient goes up and down at LEAST ONE FLIGHT of stairs but requires a SIDE SUPPORT, HANDRAIL, CANE, OR PORTABLE SUPPORTS;

Or the activity takes more than a REASONABLE AMOUNT of TIME

Or there are SAFETY CONSIDERATIONS

Question 39

FIM LEVEL 5, household ambulation exception, locomotion- stairs: patient goes up and down _ to _ stairs _, _ or _ a _. The activity takes _ than a _ _ of _, or there are _ _.

Answer 39

Patient goes up and down 4 to 6 stairs INDEPENDENTLY, WITH or WITHOUT a DEVICE.

The activity takes MORE than a REASONABLE AMOUNT of TIME, or there are SAFETY CONSIDERATIONS.

Question 40

FIM level 5, supervision, locomotion- stairs: patient requires _ ( ex. _ by, _ or _) to go up and down _ _ of stairs.

Answer 40

Patient requires SUPERVISION (ex. STANDING by, COAXING, or CUEING) to go up and down ONE FLIGHT of stairs

Question 41

FIM Level 4, Minimal contact assistance- locomotion/ stairs: patient performs _ of the effort to go _ and _ _ _ of stairs.

Answer 41

Patient performs 75% of the effort to go UP and DOWN ONE FLIGHT of stairs

Question 42

FIM level 3, locomotion- stairs: Patient performs _ to _ of the effort to go up and down _ _ of stairs. _ assistance.

Answer 42

Patient performs 50 to 74% of the effort to go up and down ONE FLIGHT of stairs

MODERATE assistance.

Question 43

Level 2, locomotion- stairs: the patient performs _ to _ of the effort to go up and down _ to _ _, and requires the _ of _ _ _. _ assistance.

Answer 43

The patient performs 25 to 49% of the effort to go up and down 4 to 6 STAIRS, and requires the ASSISTANCE of ONE PERSON ONLY.

MAXIMUM assistance

Question 44

Level 1, locomotion-stairs: the patient performs _ than _ of the effort, or requires the _ of _ _, or goes up and down _ than _ _. _ assistance.

Answer 44

The patient performs LESS than 25% of the effort, or require the ASSISTANCE of TWO PEOPLE, or goes up and down FEWER than 4 STEPS.

TOTAL assistance.

Question 45

Level 0, activity _ _ _, locomotion-stairs: enter code 0 only for the _ _. The subject _ _ go up or down stairs, and a _ _ _ _ the subject up or down stairs.

Answer 45

Level 0, activity DOES NOT OCCUR, locomotion-stairs:

• enter code 0 only for ADMISSION ASSESSMENT
• The subject DOES NOT go up or down stairs, and a HELPER DOES NOT CARRY the subject up or down stairs.