Feasibility, reliability, and agreement of the WeeFIM instrument in Dutch children with burns

Anuschka S Niemeijer, Heleen A Reinders-Messelink, Laurien M Disseldorp, Marianne K Nieuwenhuis

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Burns occur frequently in young children. To date, insufficient data are available to fully describe the functional consequences of burns. In different patient populations and countries, the WeeFIM instrument ("WeeFIM") often is used to measure functional independence in children.

OBJECTIVE: The purpose of this study was to examine the psychometric properties of the WeeFIM instrument for use in Dutch burn centers.

DESIGN: This was an observational study.

METHODS: The WeeFIM instrument was translated into Dutch. All clinicians who rated the children with the instrument passed the WeeFIM credentialing examination. They scored consecutive children (n=134) aged 6 months to 16 years admitted to Dutch burn centers with acute burns during a 1-year period at 2 to 3 weeks, 3 months, and 6 months postburn. To examine reliability, 2 raters scored a child at the same time (n=52, 9 raters) or the same rater scored a child twice within 1 week (n=7, 3 raters).

RESULTS: After a few weeks, the WeeFIM assessment could be administered in less than 15 minutes. Clinicians thought it was difficult to rate a child aged between 2 and 4 years as well as the cognitive items. Nevertheless, reliability was good (all intraclass correlation coefficients [1,1] were above .80). The standard error of measurement was 3.7.

LIMITATIONS: Intrarater reliability was based on only 7 test-retest measurements. Within our clinical setting, it turned out to be difficult to schedule the same rater and patient twice in one week for repeated assessments. Assessments for interrater reliability, on the other hand, worked out well.

CONCLUSIONS: The WeeFIM instrument is a feasible and reliable instrument for use in children with burns. For evaluation of a child's individual progress, at least 11 points' improvement should be observed to state that a child has significantly improved.

Original languageEnglish
Pages (from-to)958-966
Number of pages9
JournalPhysical Therapy & Rehabilitation Journal
Issue number7
Publication statusPublished - 30 Mar 2012


  • Activities of Daily Living
  • burns
  • physiopathology
  • children
  • disabilities
  • evaluation
  • rehabilitation
  • feasibility studies
  • injury severity score
  • tests
  • predictability
  • psychometrics
  • quality of life
  • Netherlands
  • reproducibility of results
  • measuring instruments


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