The Mayo Portland Adaptability Inventory-4 outcome measure is superior to UK FIM+FAM in a British military population

Abstract

Objective: The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury.

Methods: A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4.

Results: The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up.

Conclusions: This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.

Keywords:

• Traumatic brain injury
• outcome
• rehabilitation
• head injury
• assessment
• quality of life

Acknowledgements

The authors wish to thank Mr. Patrick Porter for his assistance with data collection.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.