Functional Status Rating System

Functional Status Rating System
Forer‚ 1981
Functional Status in Self-care
A.    Eating/feeding: Management of all aspects of setting up and eating food (including cutting of meat) with or without adaptive equipment.
B.    Personal hygiene: Includes set up‚ oral care‚ washing face and hands with a wash cloth‚ hair grooming‚ sha‎ving‚ and makeup.
C.    Toileting: Includes management of clothing and cleanliness.
D.   Bathing: Includes entire body bathing (tub‚ shower‚ or bed bath).
E.    Bowel management: Able to in‎sert suppository and/or perform manual evacuation‚ aware of need to defecate‚ has sphincter muscle control.
F.    Bladder management: Able to manage equipment necessary for bladder evacuation (may include intermittent catheterization).
G.   Skin management: Performance of skin care program‚ regular inspection‚ prevention of pressure sores‚ rashes‚ or irritations.
H.   Bed activities: Includes turning‚ coming to a sitting position‚ scooting‚ and maintenance of balance.
I.     Dressing: Includes performance of total body dressing except tying shoes‚ with or without adaptive equipment (also includes application of orthosis & prosthesis).
Functional Status in Mobility
A.    Transfers: Includes the management of all aspects of transfers to and from bed‚ mat‚ toilet‚ tub/shower‚ wheelchair‚ with or without adaptive equipment.
B.    Wheelchair skills: Includes management of brakes‚ leg rests‚ maneuvering and propelling through and over doorway thresholds.
C.    Ambulation: Includes coming to a standing position and walking short to moderate distances on level surfaces with or without equipment.
D.   Stairs and environmental surfaces: Includes climbing stairs‚ curbs‚ ramps or environmental terrain.
E.    Community mobility: Ability to manage transportation.
Functional Status in Communication
A.    Understanding spoken language
B.    Reading comprehension
C.    Language expression (non-speech/alternative methods): Includes pointing‚ gestures‚ manual communication boards‚ electronic systems.
D.   Language expression (verbal): Includes grammer‚ syntax‚ and appropriateness of language.
E.    Speech intelligibility
F.    Written communication (motor)
G.   Written language expression: Includes spelling‚ vocabulary‚ punctuation‚ syntax‚ grammar‚ and completeness of written response.
Functional Status in Psychosocial Adjustment
A.    Emotional adjustment: Includes frequency and severity of depression‚ anxiety‚ frustration‚ lability‚ unresponsiveness‚ agitation‚ interference with progress in therapies‚ motivation‚ ability to cope with and take responsibility for emotional behavior.
B.    Family/significant others/environment: Includes frequency of chronic problems or conflicts in patient’s relationships‚ interference with progress in therapies‚ ability and willingness to provide for patient’s specific needs after disch‎arge‚ and to promote patient’s recovery and independence.
C.    Adjustment to limitations: Includes denial/awareness‚ acceptance of limitations‚ willingness to learn new ways of functioning‚ compensating‚ taking appropriate safety precautions‚ and realistic expectations for long-term recovery.
D.   Social adjustment: Includes frequency and initiation of social contacts‚ responsiveness in one to one and group situations‚ appropriateness of behavior in relationships‚ and spontaneity of interactions.
Functional Status in Cognitive Function
A.    Attention span: includes distractibility‚ level of alertness and responsiveness‚ ability to concentrate on a task‚ ability to follow directions‚ immediate recall as the structure‚ difficulty and length of the task vary.
B.    Orientation
C.    Judgment reasoning
D.   Memory: Includes short- and long-term.
E.    Problem-solving
Self-care and mobility items
1.0 = Unable—totally dependent ‚ 1.5 = Maximum assistance of 1 of 2 people‚ 2.0 =Moderate assistance‚ 2.5 = Minimal assistance‚ 3.0 = Standby assistance‚ 3.5 = Supervised‚ 4.0 = Independent
1.0 = Extremely severe‚ 1.5 = Severe‚ 2.0 =Moderately severe‚ 2.5 =Moderate impairment‚ 3.0 = Mild impairment‚ 3.5 = Minimal impairment‚ 4.0 = No impairment

Forer‚ SK.‚ Miller‚ LS. (1980). Rehabilitation outcome: comparative analysis of different patient types. Arch Phys Med Rehabil‚61:359–365.

Forer‚ SK. (1981). Revised functional status rating instrument. Glendale‚ California: Rehabilitation Institute‚ Glendale Adventist Medical Center‚ December 1981.

McDowell‚ Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires‚ Third Edition. OXFORD UNIVERSITY PRESS