Name: ___________________ Date: ___________________

ACUTE FUNCTIONAL MEASURE SCALE (AFMS)

COMPETENCY
20 points total. Can miss 3 points to pass (85%).

(2 points) A patient is considered mod assist if she is able to do ____% to ____% of the
task.

(1 point) If you provide only “contact guard assist” to a patient, what level would you rate
the patient? ___________________________

(1 point) Transfer (bed / chair / wheelchair)

If 2 people are providing assist to transfer a patient, with one therapist providing
mod assist and the other providing max assist, what would you rate the patient?
___________________________

(3 points) Toileting
What are the 3 components of toileting?
1. _________________________
2. _________________________
3. _________________________

(2 points) Locomotion (Gait)

When indicating AFMS level for locomotion, what 2 components must always be
documented?
1. _________________________
2. _________________________

(1 point) Supine to sit

Mr. K. is found in bed with HOB elevated 30 degrees and side rail up. He was
able to assume supine to sit without physical assistance of his therapist. What is
his AFMS level? ___________________________

(2 points) Locomotion (stairs)

Mr. K. goes up 5 stairs with ~10% assist from the therapist. He needs only verbal
cues to safely go back down. What should you document?
___________________________________________________

(1 point) LE Dressing
The OT brings Mr. Smith his pants, socks and shoes. Mr. Smith is then able to
dress himself using a reacher with no assist from the OT. What is his AFMS
level? ___________________________
(1 point) Grooming
Ms. P. brushed her teeth independently. She can wash and dry her face and hands
independently, but needs help combing her hair. What is her AFMS level?
___________________________

(1 point) Sit  Stand

Ms. T. is able to stand from sitting EOB with the therapist guarding her knee to
prevent buckling. What is her AFMS level? ___________________________

(1 point) True or False

Flattening the patient’s bed in order to replicate his home environment is
considered Standby assist. ___________________________

(1 point) Rolling
The therapist helps Mrs. B. reach her right arm across her body, after which she
can roll from supine to sidelying without assistance. What is her AFMS level?
___________________________

(1 point) Scooting
Mr. H. takes about 5 minutes to scoot to the edge of the bed. The therapist does
not provide any assistance. What is his AFMS level?
___________________________

(1 point) Transfer (commode)

Mr. D. ambulates to a standard toilet with raised toilet seat. He can get on
and off the toilet without assistance, but occasionally needs help with
perineal hygiene. What is his AFMS level for transfer (commode)?
__________________________________________________________
AFMS quick reference guide
Independent no assistance from therapist
Modified Independent no assistance BUT pt. uses assistive device OR takes >3X normal time
Standby Assist (SBA) no physical assist BUT pt. requires cues, coaxing, setup or is a safety risk
Minimal Assist pt. does 75% - 99% of task
Moderate Assist pt. does 50% - 74% of task
Maximal Assist pt. does 25% - 49% of task
Total Assist pt. does <25% of task

Reminder: for items that have a set number of components, if a patient needs assistance with any aspect of
that component, for rating purposes they should be considered to need assistance with that entire component.

Items WITH a set number of components:

Rolling Scooting Grooming Toileting
Head Initiate Clean teeth Pants down
Arms Lift hips Comb/brush hair Perineal hygiene
Trunk Shift body Wash face/hands (incl. Pants up
Pelvis rinse/dry) Identify whether voiding or BM
Legs

Items WITHOUT a set number of components:

Supine  Sit Sit  Stand
Rate based on total percentage that Rate based on total percentage that
patient is able to perform patient is able to perform

Transfers (bed / chair / wheelchair) Transfers (commode / toilet)

From what surface to what surface? Ability to get on or off commode / toilet
Give type (stand pivot, etc.) Approach from ambulatory or w/c
Indicate AD if any

Locomotion - Gait Locomotion - Stairs

Indicate distance ambulated Indicate # of steps up/down
Indicate AD if any Indicate AD if any
Indicate use of rails if appropriate
Dressing
Includes clothing retrieval
Includes dressing AND undressing
Can use hospital gowns / pants / slippers

General comments:
 Replicate home environment when possible. (Preparing the bed and/or room to do so DOES NOT
constitute setup/standby assist)
 Patient can be rated as an assist of 2. If assistants provide different levels of assist, use the greater
level of assist. Documentation should be as detailed as possible.