Background: Functional independence of persons recovering from a stroke is essential for successful re-integration into the community. The Functional Independence Measure (FIM) is a standardized assessment tool widely used to document change in functional independence of persons post-stroke, while the Functional Autonomy Measurement System (SMAF), developed for assessing the elderly, is less often used with this population. 
Objective: To compare the responsiveness of the SMAF and FIM in persons post-stroke admitted for inpatient rehabilitation. 
Methods: The FIM and SMAF were administered at admission (T1) and discharge (T2) in persons post-stroke admitted for inpatient rehabilitation in three rehabilitation centres in the province of Quebec. Internal responsiveness was assessed with the standardized response mean (SRM) and Pearson’s correlation coefficient(r), between changes in SMAF and FIM total scores. 
Results: A total of 143 persons post-stroke (67 ± 15 years) were evaluated. Results show that the SMAF and FIM total scores are strongly correlated at T1 and T2 (both r=0.90; p<0.001). The change in SMAF score (T2-T1) is significantly correlated with the change in FIM score (r=0.56; 95% CI=0.44-0.66). The internal responsiveness of the two total scores is good (SRM: 1.53 versus 1.45; p=0.25) but not different (p<0.05). 
Conclusion: Study results indicate that the SMAF and FIM total scores are strongly correlated and detect changes equally in the functional independence of persons post-stroke admitted for inpatient rehabilitation. This study suggests that the SMAF, initially designed for older adults with declining autonomy, can successfully be used to assess functional independence in persons undergoing post-stroke rehabilitation.

Comparing the responsiveness of the Functional Autonomy Measurement System (SMAF) with that of the Functional Independence Measure (FIM) in post-stroke rehabilitation