Evaluation of disability in multiple sclerosis patients: a comparative study of the Functional Independence Measure, the Extended Barthel Index and the Expanded Disability Status Scale

This study was conducted to compare the Extended Barthel Index (EBI) to the Functional Independence Measure (FIM) and the Expanded Disability Status Scale (EDSS) as a measure used to assess changes in a patient's need for help with activities of daily living. One hundred patients with multiple sclerosis were evaluated by the same person upon arrival in a rehabilitation clinic and four weeks later. EBI and FIM both proved to be far more sensitive in detecting changes than the EDSS (29% of patients changed their EBI score, 32% their FIM score, 5% their EDSS score). EBI and FIM showed a very high correlation (Spearman correlation coefficient r s = 0.9705). Both scales correlated somewhat less with the EDSS ( r s = -0.7624, resp. -0.7611). Considering the high correlation and equal sensitivity of EBI and FIM, the study recommends the use of the EBI, since it has a simpler rating system and the elimination of some redundant FIM items increases user-friendliness and compliance.