Comparative assessment of Barthel index and functional independence measure in providing rehabilitation care for military personnel with combined injuries

In the structure of military traumatism, the number of multiple and combined wounds and injuries has increased significantly due to the expansion in the destructive properties of modern weapons. Establishing the correct rehabilitation diagnosis and subsequent stage-by-stage assessment of the results of rehabilitation therapy should be based on adequate functional assessment tools. The Barthel Index is the most widely used measure for assessing the ability to perform activities of daily living. However, recently, many authors have proposed using the Functional Independence Measure (FIM) for this purpose. Purpose. The study aims to investigate the possibility of using the Barthel Index and Functional Independence Measure to assess the effectiveness of rehabilitation of military personnel with combined injuries over a long period. Material & Methods. We conducted a retrospective study of 807 wounded military personnel with complex injuries of varying severity. Our examination included a meticulous analysis of medical records, a comprehensive physical examination, and a survey using the Barthel Index and FIM scale. Due to the nature of the injuries, the servicemen were provided with standard rehabilitation programs. Results. All patients were classified as lightly injured and moderately injured according to the Abbreviated Injury Scale. The initial data in evaluating functioning on the FIM scale made it possible to identify subgroups of patients with a predominance of motor function impairment and a predominant impairment of cognitive functions. Patients with combined TBI should receive more rehabilitation measures to improve cognitive and mental functions, socialization, and communication skills. Conclusions. The inclusion of the FIM scale in the recommended toolkit for assessing the effectiveness of rehabilitation will allow for additional objectification of rehabilitation care and the formulation of individual recommendations for achieving the best results.