USE OF STANDARDIZED ACTIVITIES OF DAILY LIVING RATING-SCALES IN SPINAL-CORD INJURY AND DISEASE SERVICES

Objective. Although standardized activities of daily living (ADL) rating scales offer advantages in reliability and consistency of reporting, the literature has revealed that most occupational therapists tend to use informal assessments and reporting methods. This study investigated the use of standardized ADL rating scales by occupational therapists who treat patients with spinal cord injury and disease (SCI/D). Method. Fifty-two SCI/D rehabilitation sites were selected by stratified random sampling, and surveys were completed by the occupational therapist in each site who worked most extensively with patients with SCI/D. Occupational therapists at 49 of the sites completed the survey. Results. Survey results indicated that 68% of the respondents tend not to use standardized ADL rating scales in their work with SCI/D patients. Of those who used standardized ADL rating scales, the Functional Independence Measure (FIM) was more widely used than any other. Most respondents learned about this measure on the job. Many of the respondents indicated that a limitation of the FIM was its inability to detect progress in their patients with SCI/D. Discussion. The results indicate that although widely used, the FIM may need to be supplemented by other standardized ADL rating scales in order for a therapist to objectively document the progress made by patients with SCI/D. To be able to choose the most appropriate assessment tools, students and practicing therapists need to be educated in a variety of standardized ADL rating scales.