Session Information
Date: Saturday, November 16, 2019
Session Title: Neurological Rehabilitation Case and Research Report
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 5
Disclosures: Kathryn A. Altonji, MD: Nothing to disclose
Case Description: This patient began acute inpatient rehabilitation 1 month after the pontine hemorrhage and completed a 3-month comprehensive rehabilitation course. He made significant functional improvements demonstrated by improved scores on his Total Function in Sitting Test (FIST), Functional Independence Measure (FIM), and the Ability Quotient (AQ). The AQ is an outcome measure developed at our institution and used internally. It is a single number that represents performance on multiple standardized measures.
Setting: Acute inpatient rehabilitation hospital.
Patient: A 54-year-old male with incomplete locked-in syndrome due to pontine hemorrhage.
Assessment/Results: The AQ was able to graphically display a continuous, gradual improvement in areas not measured by the FIM especially balance which correlated closely with functional improvement. One component contributing to the AQ score is the FIST which improved over the hospital course from 0/56 at admission to 41/56 before discharge. He progressed from FIM scores of total assistance for all self-care items to close supervision for grooming and moderate assistance for bathing and upper body dressing. The patient improved from total assistance for transfers to maximal assistance. He also progressed from total assistance for bed mobility at admission to contact guard or moderate assistance for rolling. At discharge, he was operating a power wheelchair at a modified independent level.
Discussion: The use of the Ability Quotient to monitor functional improvement in a patient with severe activity limitations demonstrates meaningful gains not captured by the FIM score. Functional gains seen with the AQ matched similar gains in balance as measured by the FIST.
Conclusion: Patients with locked-in syndrome can make significant functional improvements with comprehensive inpatient rehabilitation. Improvement in some areas of performance not captured well by FIM, can be captured with a more comprehensive measure such as the Ability Quotient.
Level of Evidence: Level V
To cite this abstract in AMA style:
Altonji KA, Bodine A, Heinemann A, Bahroos N, Sliwa JA, Harvey R. The Ability Quotient and Documentation of Recovery in Incomplete Locked-in Syndrome: A Case Report [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/the-ability-quotient-and-documentation-of-recovery-in-incomplete-locked-in-syndrome-a-case-report/. Accessed May 22, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-ability-quotient-and-documentation-of-recovery-in-incomplete-locked-in-syndrome-a-case-report/