PTOTSLPCohortJournal of rehabilitation medicine2022

Responsiveness of the International Classification of Functioning, Disability And Health (ICF) Clinical Functioning Information Tool (ClinFIT) in Routine Clinical Practice in an Australian Inpatient Rehabilitation Setting.

Bhasker Amatya, Alaeldin Elmalik, Krystal Song and 3 others

PMID 35174870

WHAT IT FOUND

The ClinFIT tool detected significant improvements in patient functioning from admission to discharge and at 3 months.

Scores dropped from a median of 196 to 69 at discharge. It tracks broad disability changes alongside standard functional independence measures in inpatient rehab.

Key findings

01ClinFIT total raw scores showed significant improvement from admission to discharge and at 3-month follow-up, with medium effect sizes.

02The Extension Index (EI) for the total ClinFIT set showed large effect sizes for change from admission to discharge and to 3 months.

03Changes in ClinFIT scores correlated significantly, though weakly to moderately, with changes in Functional Independence Measure (FIM) scores.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Single-centre pilot study with no control group, so improvements cannot be definitively attributed to rehabilitation rather than natural recovery. Follow-up was only 3 months, limiting knowledge of long-term maintenance of function. 3-month assessments were self-reported via telephone, which may differ from clinician-rated inpatient assessments. The study was conducted during the COVID-19 pandemic, which disrupted services and may have affected recruitment and attrition. Most participants had neurological or musculoskeletal conditions, limiting generalizability to other rehab populations.

Declared interests

The authors declared no conflicts of interest. The study was part of a quality improvement initiative at the Royal Melbourne Hospital.

The easy way to misread this

Do not interpret the significant score changes as proof that ClinFIT is superior to or more sensitive than FIM. The correlation between the two was weak to moderate, and the study lacked a control group, so it cannot determine if ClinFIT detects clinically meaningful change better than existing tools.

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