Functional Independence Score in Hemophilia (FISH) – 2007
Poonnoose PM, Padankatti S, Macaden AS, Srivastava A; Christian Medical College, Vellore, India.
N.B. These scores are posted with the permission of the developers.
The Functional Independence Score in Hemophilia (FISH) was developed as a performance-based assessment tool to objectively measure an individual’s functional ability. It is intended to measure what the person with disability actually does, not what he ought to be able to do, or might be able to do if circumstances were different, or thinks he can do. It can also be used to evaluate change in functional independence over time, or after a therapeutic intervention.
The FISH is relatively safe to perform. It is meant to complement other scores that measure body structure and function, such as clinical joint evaluation scores and radiological scores. Its major advantage is that it can be used with persons of different linguistic abilities, as it is an objective, performance-based instrument.
The FISH incorporates items that are perceived as important by persons with hemophilia. Patients with hemophilia, their relatives, and therapists were asked to list activities of daily living that were affected by the condition. Activities that were considered unsafe to perform were excluded from the assessment. Other activities such as education, employment, and participation in social events that could not be assessed objectively in the clinic were also excluded.
The current version of FISH includes the assessment of eight activities: eating, grooming, dressing, chair transfer, squatting, walking, step climbing, and running. Each activity is graded according to the amount of assistance required to perform it. The level of independence for each activity is clearly defined to reduce inter-observer variance.
Date of this review: February 22, 2011