The Functional Independence Measurement

Photo of a man with an amputation talking to a doctor.
The Functional Independence Measure can give you're PT an idea of your current functional needs.. Blend Images/ Getty Images.

The Functional Independence Measurement (FIM) is an outcome measurement tool used by physical therapists and other healthcare professionals to measure overall independence during specific functional tasks. It is most often used in acute hospitals and subacute rehabilitation settings.

The FIM is composed of 18 specific tasks that are commonly assessed and treated by physical therapists, occupational therapists, nurses, and other rehabilitation professionals.

These tasks include activities such as mobility, walking, self-care, and communication.

The FIM is divided into 6 major categories, with various tasks in each category that are assessed. The categories and sub-categories are as follows:


  • Feeding
  • Grooming
  • Bathing
  • Upper body dressing
  • Lower body dressing
  • Toileting

Sphincter Control

  • Bladder management
  • Bowel management


  • Transfer: bed to wheelchair
  • Transfer: toilet to wheelchair
  • Transfer: tub and shower mobility


  • Walking/wheelchair
  • Stairs


  • Comprehension
  • Expression

Social Cognition

  • Social interaction
  • Problem solving
  • Memory

Scoring the FIM

Each of the 18 items on the FIM is scored by your physical therapist on a scale of 1 to 7. A score of 7 indicates that you are completely independent in that particular activity. A score of 1 means that you require total assistance for the activity. Therefore, the minimal score on the FIM is 18, and the maximum score is 126, which indicates complete independence.

A complete list of scores for the FIM is as follows:

  1. Total assist needed
  2. Maximal assist (you can perform 25% of the task)
  3. Moderate assist (you can perform 50% of the task)
  4. Minimal assist (you can perform 75% of the task)
  5. Supervision needed
  6. Modified independence (you use an assistive device
  7. Independence in performing the task

    Using an outcome tool like the FIM is important for many reasons. First, understanding your current level of safety and functional mobility can help you and your PT set reasonable and attainable rehab goals. Second, your FIM score can be used to measure your personal progress through physical therapy. As you improve with your functional mobility, you FIM score will improve. This also helps your PT gauge your progress and gives creedence to what your PT is doing with you in therapy. Your PT may also use your FIM score in while working with other rehab providers like occupational therapists and speech language pathologists.

    Your physical therapist may also use your FIM score to assess your overall safety with mobility. The more assistance you need with a task, the lower your FIM score will be. Your PT can then use that score to assess your overall safety with moving around and functional mobility.

    If you are ever hospitalized, your healthcare team will likely use an outcome measurement tool to chart your progress and to determine your functional mobility and self-care independence.

    The FIM may be one tool that is used to help your physical therapist and other professionals determine your improvement during your episode of care. This outcome measurement can also give you a motivating morale boost - as your FIM score improves, you know that your overall mobility and functional are also improving. Be sure to ask your PT about the Functional Indepencence Measure and how it may be used in your own personal rehab journey. 

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