Appendix D
APPENDIX D
Definitions of Motor Functional
Independence Measure Items
Item Definition
Eating Using suitable utensils to bring food to the mouth, chew the food, and swallow it once
presented in a customary manner. Dentures are an assistive device. Rate the burden of care
for the entire taskVassigning a percentage may result in an incorrect rating. Consider the
following when rating the burden of care: picking up a utensil, scooping food, bringing
hand to mouth, chewing and swallowing, and drinking from a cup or glass.
Grooming Oral care: 20%
Hair combing or brushing: 20%
Washing, rinsing, and drying the face: 20%
Washing, rinsing, and drying the hands: 20%
Shaving or applying makeup: 20%
If the patient doesn’t shave or apply makeup then grooming includes four tasks
(25% each). The patient performs all tasks safely. This item includes obtaining articles
necessary for grooming.
Bathing Washing, rinsing, and drying the body. Bathing can be rated in a tub, shower, or
sponge/bed bath. This item does not include the back or neck. Do not consider whether the
patient is sitting during this activity. ‘‘Lower leg’’ includes the foot.
Left arm: 10%
Right arm: 10%
Chest: 10%
Abdomen: 10%
Front perineal area: 10%
Buttocks: 10%
Left upper leg: 10%
Right upper leg: 10%
Left lower leg: 10%
Right lower leg: 10%
DressingYupper Dressing and undressing above the waist, including applying and removing a prosthesis
body or orthosis when applicable. Assess the steps performed, not the number of articles
of clothing. Steps will vary.
DressingYlower Dressing and undressing from the waist down, including applying and removing a
body prosthesis or orthosis when applicable. Assess the steps performed, not the number of
articles of clothing.
Toileting This item consists of three steps (33% each). (1) Adjusting clothing before using a toilet,
commode, bedpan, or urinal; (2) managing perineal hygiene; (3) adjusting clothing after
using the toilet, commode, bedpan, or urinal. The rating of this item is based on continent
episodes only. It does not include assistance provided to get on or off the toilet.
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Continued
Bladder level of Includes the complete and intentional control of the urinary bladder and equipment
assistance or medication used for control. The bladder management item does not include
getting to and from the bathroom or transferring on and off a toilet. It does include
the safe use of equipment or agents for bladder management and the amount of
assistance the patient needs to manage an assistive device to prevent accidents.
Medication (eg, tamsulosin, oxybutynin) counts as a device.
Bedpan Level 6: The patient obtains, uses, and empties the bedpan without assistance from a
helper. Level 5: A helper places the bedpan within reach, empties it, or performs both
tasks. Level 4: A helper positions the bedpan. Level 3: A helper positions the bedpan
and holds it in place. Level 2: A helper positions the bedpan, holds it in place, and assists
the patient in rolling on or off it. Level 1: A helper positions the bedpan, holds it in
place, and assists the patient in rolling on and off it, or two helpers are needed.
Urinal Level 6: The patient obtains, uses, and empties the urinal without assistance from a
helper. Level 5: A helper places the urinal within reach, empties it, or performs both
tasks. Level 4: A helper positions the urinal. Level 2: A helper positions the urinal,
holds it in place, and empties the urinal. Level 1: The patient is incontinent or spills
the urinal, and a helper changes the patient’s linen and clothing.
Bedside commode Level 6: The patient uses and empties the BSC bucket. Level 5: A helper empties the BSC
(BSC) bucket. Level 1: The patient is incontinent or spills the BSC bucket, and a helper must clean up.
Bladder accident Soiling of linen or clothing.
Bowel level of Include the complete and intentional control of bowel movements and the use of
assistance any necessary equipment or agents for bowel control The bowel management item
does not include getting to and from the bathroom or transferring on and off a
toilet. It does include the safe use of equipment or agents for bowel management
and the amount of assistance the patient needs to manage an assistive device to
prevent accidents. Medication (eg, stool softeners) counts as a device. Refer to the
bedpan, urinal, and BSC entries for help rating the use of these devices.
Bowel accident Soiling of linen or clothing.
Transfers: Bed, chair, Includes all aspects of transferring from a bed to a chair and back, or from a bed to a
wheelchair wheelchair and back, or coming to a standing position if walking is the usual mode
of locomotion. (These transfers start and end in a supine position and include bed
mobility.) Level 4: A helper must lift one limb. Level 3: A helper must lift both limbs
or provide lifting assistance in one direction only. Level 2: A helper must provide
lifting assistance in both directions.
Transfers: Toilet Includes safely getting on and off a standard toilet. A raised toilet seat or a
commode over a toilet is considered a device. If the patient uses such a device, do
not rate the patient higher than Level 6.
Transfers: Tub, shower Includes getting into and out of a tub or shower. Level 1: A helper pushes the
patient into a shower stall to a shower chair.
Locomotion: Walk Walking on a level surface once in a standing position. Document the distance traveled
and the amount of assistance required. Walkers and canes count as assistive devices.
Locomotion: Using a wheelchair on a level surface once in a seated position. Because a wheelchair
Wheelchair counts as a device, the highest possible rating is Level 6. Level 1: A helper pushes
the patient from one location to another.
Locomotion: Stairs Going up and down 12 to 14 stairs (one flight) indoors in a safe manner. When
rating this item, consider two factors: (1) the number of stairs and (2) the level of
assistance needed, including that provided by assistive devices.
B 2008, 2009 Uniform Data System for Medical Rehabilitation. All rights reserved. FIM is a trademark of Uniform Data System for Medical Rehabilitation, a
division of UB Foundation Activities, Inc.
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