Rivermead Mobility Index

 

Original Editor - Sinead Greenan

Top Contributors - Sinead Greenan, Chloe Waller, Kim Jackson, Oyemi Sillo, WikiSysop, Evan Thomas, Scott Buxton, Naomi O'Reilly and Amrita Patro

Objective[edit | edit source]

Gait rehabilitation.png

The Rivermead Mobility Index assesses functional mobility in gait, balance and transfers. It was developed in 1991 to be used after stroke or head injury[1].

Intended Population[edit | edit source]

Those with a diagnosis of Stroke, Acquired Brain Injury, Lower Limb Amputation or Multiple Sclerosis[2][3]. It can be used for a wide range of functional ability levels.

Method of Use[edit | edit source]

The Rivermead Mobility Index consists of 15 items (14 self reported items and 1 direct observation)[1]. The items are scored 0 if the patient is is not able to complete the task or 1 if they are able to complete it. The points are then added together, to score a maximum of 15, with higher scores stipulating better functional mobility[4].

The items are[5]:

1. Turning over in bed: Do you turn over from your back to your side without help?

2. Lying to sitting: From lying in bed, do you get up to sit on the edge of the bed on your own?

3. Sitting balance: Do you sit on the edge of the bed without holding on for 10 seconds?

4. Sitting to standing: Do you stand up from any chair in less than 15 seconds and stand there for 15 seconds, using hands and/or an aid, if necessary?

5. Standing unsupported: Ask client to stand without aid and observe standing for 10 seconds without any aid.

6. Transfer: Do you manage to move from bed to chair and back without any help?

7. Walking inside (with an aid if necessary): Do you walk 10 meters, with an aid if necessary, but with no standby help?

8. Stairs: Do you manage a flight of stairs without help?

9. Walking outside (even ground): Do you walk around outside, on pavements, without help?

10. Walking inside, with no aid: Do you walk 10 meters inside, with no caliper, splint, or other aid (including furniture or walls) without help?

11. Picking up off floor: Do you manage to walk 5 meters, pick something up from the floor, and then walk back without help?

12. Walking outside (uneven ground): Do you walk over uneven ground (grass, gravel, snow, ice, etc.) without help?

13. Bathing: Do you get into/out of a bath or shower to wash yourself unsupervised and without help?

14. Up and down four steps: Do you manage to go up and down four steps with no rail but using an aid if necessary?

15. Running: Do you run 10 meters without limping in 4 seconds (fast walk, not limping, is acceptable)?


This video gives a demonstration of using the Rivermead Mobility Index:



Evidence[edit | edit source]

Reliability[edit | edit source]

Test-retest reliability

Excellent for chronic stroke and lower limb amputees[6][7][3].

Interrater reliability

Excellent for acute stroke[8][9].

Intra-rater reliability

Excellent for acute stroke[8].

Internal consistency

Good in mixed neurological population[10].

Validity[edit | edit source]

Criterion Validity:

Found in acute stroke to have excellent predictive validity with Barthel Index and scores above 4 to be the best predictor of early discharge home[11].

Adequate concurrent validity with the timed walk test for lower limb amputees[3].

Construct Validity: 

Excellent correlation with Barthel Index at 14, 30, 90 and 180 days post stroke[9].

Excellent correlation with motFIM and Timed Walk Test at the end of prosthetic training for lower limb amputees[12].

Content Validity:

The Rivermead Mobility Index achieved reproducibility and scalability  [13]. It has good content validity and was significantly correlated with physical function variables in stroke patients[6] [14]. Moreover, it is also recommended for assessing ambulation levels in chronic stroke patients during rehabilitation.[15]

Predictive Validity: 

Adequate predictive validity in stroke patients[6].

Responsiveness[edit | edit source]

The Rivermead Mobility Index was found to be one of the most sensitive outcomes measures for detecting improvements in mobility in MS patients[16]. In acute stroke patients, it was found to be valid and sensitive to change over time[6][13].

Links[edit | edit source]

Rivermead Mobility Index

References[edit | edit source]

  1. ↑ 1.0 1.1 Collen FM, Wade DT, Robb GF, Bradshaw CM. The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. Int Disabil Stud. 1991;13(2):50-4
  2. ↑ Sabrina Figueiredo. Rivermead Mobility Index (RMI). Available from: https://strokengine.ca/en/assessments/rivermead-mobility-index-rmi/ (Accessed 23/06/2022)
  3. ↑ 3.0 3.1 3.2 Ryall, N. H., Eyres, S. B., et al. "Is the Rivermead Mobility Index appropriate to measure mobility in lower limb amputees?" Disabil Rehabil 2003 25(3): 143-153
  4. ↑ Shirley Ryan Ability Lab. Rivermead Mobility Index. Available from: https://www.sralab.org/rehabilitation-measures/rivermead-mobility-index (Accessed 23/06/2022)
  5. ↑ Donato S, Halliday Pulaski K, Gillen G. Chapter 19 - Overview of Balance Impairments: Functional Implications. In: Gillen G. Stroke Rehabilitation (Fourth Edition) Mosby, 2016. p394-415.
  6. ↑ 6.0 6.1 6.2 6.3 Tsang RC, Chau RM, Cheuk TH, Cheung BS, Fung DM, Ho EY. The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients. Physiother Theory Pract. 2014 Jul;30(5):353-9.
  7. ↑ Chen, H. M., Hsieh, C. L., et al. "The test-retest reliability of 2 mobility performance tests in patients with chronic stroke." Neurorehabil Neural Repair 2007 21(4): 347-352
  8. ↑ 8.0 8.1 Rådman L, Forsberg A, Nilsagård Y. Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke. Physiother Theory Pract. 2015 Feb;31(2):126-9.
  9. ↑ 9.0 9.1 Hsueh, I. P., Wang, C. H., et al. "Comparison of psychometric properties of three mobility measures for patients with stroke." Stroke 2003 34(7): 1741-1745
  10. ↑ Walsh JM, Barrett A, Murray D, Ryan J, Moroney J, Shannon M. The Modified Rivermead Mobility Index: reliability and convergent validity in a mixed neurological population. Disabil Rehabil. 2010;32(14):1133-9
  11. ↑ Hsieh, C. L., Hsueh, I. P., et al. "Validity and responsiveness of the rivermead mobility index in stroke patients." Scandinavian Journal of Rehabilitation Medicine 2000 32(3): 140-142
  12. ↑ Franchignoni, F., Brunelli, S., et al. "Is the Rivermead Mobility Index a suitable outcome measure in lower limb amputees?--A psychometric validation study." J Rehabil Med 2003 35(3): 141-144
  13. ↑ 13.0 13.1 Hsieh, C. L., Hsueh, I. P., et al. Validity and responsiveness of the rivermead mobility index in stroke patients. Scandinavian Journal of Rehabilitation Medicine 2000 32(3): 140-142
  14. ↑ Park GT, Kim M. Correlation between mobility assessed by the Modified Rivermead Mobility Index and physical function in stroke patients. J Phys Ther Sci. 2016 Aug;28(8):2389-92.
  15. ↑ Lim JY, An SH, Park DS. Walking velocity and modified rivermead mobility index as discriminatory measures for functional ambulation classification of chronic stroke patients. Hong Kong Physiother J. 2019 Dec;39(2):125-132
  16. ↑ Baert I, Smedal T, Kalron A, Rasova K, Heric-Mansrud A, Ehling R, et al. Responsiveness and meaningful improvement of mobility measures following MS rehabilitation. Neurology. 2018 Nov 13;91(20):e1880-e1892


Retrieved from "https://www.physio-pedia.com/index.php?title=Rivermead_Mobility_Index&oldid=309763"