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RehabMeasures Instrument

Functional Self-Assessment Scale

Last Updated

Purpose

Measures perceived ability to accomplish common functional tasks independently versus need for assistance or supervision to do the tasks safely.

Acronym FSAS

Area of Assessment

Cognition

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Brain Injury

Key Descriptions

  • Patient rates self on a 4-step rating scale:
    A) can do alone
    B) needs someone present to supervise and provide occasional reminders to ensure safety and success
    C) needs someone present for hands on assistance and/or frequent cues to ensure safety and success
    D) totally dependent or unable to assist therapist at all
  • The therapist also rates the patient’s ability to perform these tasks using the same rating scale.
  • A numerical score is assigned to each response (e.g., A = 1, B = 2), and scores are summed resulting in a range of scores from 12-48.
  • Differences in patient and therapist scores are compared to indicate how well the patient self-rates abilities.
  • The measure is designed for use in an institutional setting.

Number of Items

12

Equipment Required

  • None

Time to Administer

2-10 minutes

Required Training

Reading an Article/Manual

Age Ranges

Adults

18 +

years

Instrument Reviewers

Initially reviewed by Karen McCulloch, PT, PhD, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 5/2012; Reviewed by Karen M., 11/27/16.

ICF Domain

Activity

Measurement Domain

Cognition

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group / Unable to Recommend

NR

Not Recommended

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

TBI EDGE

NR

LS

NR

NR

NR

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

LS

LS

LS

NR

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

TBI EDGE

No

No

No

Not reported

Considerations

  • Designed for use in inpatient settings

  • Examines possible self-awareness deficits that other assessments may not detect

  • Lack of study of reliability and minimal validation is a significant weakness

Mixed Populations

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Construct Validity

Inpatient TBI/Aneurysm: (Neuman et al., 2000; n = 37; mean age = 39.2 (17.9) years, mean time post admission = 24.5 days)

Inpatient orthopedic: (Garmoe et al., 2005; n = 28; mean age = 66.9 (10.3) years; mean time post-admission = 6.9 days)

  • Comparison of patients with TBI and orthopedic injury showed significant group differences (t = 4.7, p < .001)
  • Differences between therapist and patient ratings for those with TBI were greater (patients rate themselves as more independent than therapists).

  • Discrepancy ratios (number of items rated differently by therapist divided by total number of items) were greater for those with TBI.

  • Individuals with brain injury rated their performance better than therapists did.

Bibliography

Garmoe, W., Newman, A. C., et al. (2005). "Early self-awareness following traumatic brain injury: Comparison of brain injury and orthopedic inpatients using the Functional Self-Assessment Scale (FSAS)." J Head Trauma Rehabil 20(4): 348.

Newman, A. (2013). “Measuring self-awareness after brain Injury in the inpatient rehabilitation setting and at 6 months follow-up: Comparison of the Functional Self-Assessment Scale and Patient Competency Rating Scale in understanding outcome.” Archives of Clinical Neuropsychology 28(6): 601.

Newman, A. C., Garmoe, W., et al. (2000). "Self-awareness of traumatically brain injured patients in the acute inpatient rehabilitation setting." Brain Injury 14(4): 333-344.

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