Pre-validation of the Communication Independence Measurement (CIM) Scale. Preliminary results among 55 patients

Introduction/Background The assessment and rehabilitation of aphasia through a neurolinguistic approach is well known, so as its functional impairments to communicate, and its psycho-social consequences. We make the hypothesis that severe aphasia might leads gradually to a decrease of communication among inpatients whose needs are supplied by the institution. We propose to evaluate a new tool, the Communication Independence Measurement (CIM) scale, built like the Functional Impairment Measurement (FIM) scale. Material and method The CIM scale was used among aphasic's inpatients in a neurorehabilitation center, at baseline (M0) and 3 months (M3), by 4 different professionals (2 speech therapists and 2 nurses or carers). Four subdomains were evaluated, from 1 to 7 (motivation to communicate, expression, understanding, interaction). Psychometric properties and correlation to the Boston Diagnostic Aphasia Examination (BDAE) severity grade were analysed. Results Fifty-five patients (mean age 48 ± 11.8 years old, sex ratio 0.83) were consequently included, at 0.91 ± 1.49 months from stroke. Seventeen of them were evaluated at M3. Inter-rater validity was good, with no statistically difference between the 4 examiners at M0 (Kruskal–Wallis test P  = 0.77) and at M3 (Kruskal–Wallis test P  = 0.96). CIM was highly correlated to BDAE at M0 [intraclass correction (ICC) = 0.60–0.69] and at M3 (ICC = 0.82–0.85). We founded that patients who obtained a score less than the cut-off value of 35 had a bad daily communication. Conclusion The CIM scale seems to be a reliable tool to measure communication in aphasics in rehabilitation center. It might help identifying and thus helping patients with a negative prognosis of communication early during post-stroke rehabilitation time.