Rivermead Mobility Index: Difference between revisions

(Updated evidence)
(Updated references)
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== Intended Population  ==
== Intended Population  ==


Those with a diagnosis of [[Stroke]], [[Overview of Traumatic Brain Injury|Acquired Brain Injury]], Lower Limb [[Amputations|Amputation]] or [[Multiple Sclerosis (MS)|Multiple Sclerosis]]<ref>Sabrina Figueiredo. Rivermead Mobility Index (RMI). Available from: https://strokengine.ca/en/assessments/rivermead-mobility-index-rmi/ (Accessed 23/06/2022)</ref><ref name=":1">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</ref>. It can be used for a wide range of functional ability levels.   
Those with a diagnosis of [[Stroke]], [[Overview of Traumatic Brain Injury|Acquired Brain Injury]], Lower Limb [[Amputations|Amputation]] or [[Multiple Sclerosis (MS)|Multiple Sclerosis]]<ref>Sabrina Figueiredo. Rivermead Mobility Index (RMI). Available from: https://strokengine.ca/en/assessments/rivermead-mobility-index-rmi/ (Accessed 23/06/2022)</ref><ref name=":1">Ryall, N. H., Eyres, S. B., et al. [https://www.tandfonline.com/doi/abs/10.1080/0963828021000024951 "Is the Rivermead Mobility Index appropriate to measure mobility in lower limb amputees?"] Disabil Rehabil 2003 25(3): 143-153</ref>. It can be used for a wide range of functional ability levels.   


== Method of Use  ==
== Method of Use  ==
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<u>Test-retest reliability</u>   
<u>Test-retest reliability</u>   


Excellent for chronic stroke and lower limb amputees<ref>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</ref><ref name=":1" />.
Excellent for chronic stroke and lower limb amputees<ref>Chen, H. M., Hsieh, C. L., et al. [https://pubmed.ncbi.nlm.nih.gov/17353463/ "The test-retest reliability of 2 mobility performance tests in patients with chronic stroke."] Neurorehabil Neural Repair 2007 21(4): 347-352</ref><ref name=":1" />.


<u>Interrater reliability</u>
<u>Interrater reliability</u>


Excellent for acute stroke<ref>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</ref>.
Excellent for acute stroke<ref name=":2">Hsueh, I. P., Wang, C. H., et al. [https://pubmed.ncbi.nlm.nih.gov/12775883/ "Comparison of psychometric properties of three mobility measures for patients with stroke."] Stroke 2003 34(7): 1741-1745</ref>.
=== Validity  ===
=== Validity  ===


<u>Criterion Validity:</u>
<u>Criterion Validity:</u>


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<ref>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</ref>.
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<ref>Hsieh, C. L., Hsueh, I. P., et al. [https://pubmed.ncbi.nlm.nih.gov/11028799/ "Validity and responsiveness of the rivermead mobility index in stroke patients."] Scandinavian Journal of Rehabilitation Medicine 2000 32(3): 140-142</ref>.


Adequate concurrent validity with the timed walk test for lower limb amputees <ref>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</ref>.
Adequate concurrent validity with the timed walk test for lower limb amputees<ref name=":1" />.


<u>Construct Validity:&nbsp;</u>  
<u>Construct Validity:&nbsp;</u>  


Excellent correlation with Barthel Index at 14, 30, 90 and 180 days post stroke&nbsp;<ref>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</ref>.  
Excellent correlation with Barthel Index at 14, 30, 90 and 180 days post stroke<ref name=":2" />.  


Excellent correlation with motFIM and Timed Walk Test at the end of prosthetic training for lower limb amputees<ref>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</ref>.
Excellent correlation with motFIM and Timed Walk Test at the end of prosthetic training for lower limb amputees<ref>Franchignoni, F., Brunelli, S., et al. [https://www.medicaljournals.se/jrm/content_files/download.php?doi=10.1080/16501970310010493 "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</ref>.


<u>Content Validity:</u>  
<u>Content Validity:</u>  
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The Rivermead Mobility Index was found to be valid and sensitive to change over time, and achieved reproducibility and scalability &nbsp;<ref name="Hsieh et al">Hsieh, C. L., Hsueh, I. P., et al. [https://pubmed.ncbi.nlm.nih.gov/11028799/ Validity and responsiveness of the rivermead mobility index in stroke patients]. Scandinavian Journal of Rehabilitation Medicine 2000 32(3): 140-142</ref>. It was significantly correlated with physical function variables in stroke  patients. <ref>Park GT, Kim M. [https://pubmed.ncbi.nlm.nih.gov/27630440/ 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. </ref>. Moreover, it is also recommended for assessing ambulation levels in chronic stroke patients during rehabilitation.<ref>Lim JY, An SH, Park DS. [https://pubmed.ncbi.nlm.nih.gov/31889763/ 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</ref>
The Rivermead Mobility Index was found to be valid and sensitive to change over time, and achieved reproducibility and scalability &nbsp;<ref name="Hsieh et al">Hsieh, C. L., Hsueh, I. P., et al. [https://pubmed.ncbi.nlm.nih.gov/11028799/ Validity and responsiveness of the rivermead mobility index in stroke patients]. Scandinavian Journal of Rehabilitation Medicine 2000 32(3): 140-142</ref>. It was significantly correlated with physical function variables in stroke  patients. <ref>Park GT, Kim M. [https://pubmed.ncbi.nlm.nih.gov/27630440/ 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. </ref>. Moreover, it is also recommended for assessing ambulation levels in chronic stroke patients during rehabilitation.<ref>Lim JY, An SH, Park DS. [https://pubmed.ncbi.nlm.nih.gov/31889763/ 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</ref>
=== Responsiveness  ===
=== Responsiveness  ===
 
For acute stroke:<ref name=":2" />
''Acute Stroke:'' (Hsueh et al, 2003)&nbsp;<ref name="Hsueh et al">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</ref>  
 
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Revision as of 14:17, 23 June 2022

 

Original Editor - Sinead Greenan

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

Objective[edit | edit source]

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][3].

Interrater reliability

Excellent for acute stroke[7].

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[8].

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[7].

Excellent correlation with motFIM and Timed Walk Test at the end of prosthetic training for lower limb amputees[9].

Content Validity:

The Rivermead Mobility Index was found to be valid and sensitive to change over time, and achieved reproducibility and scalability  [10]. It was significantly correlated with physical function variables in stroke patients. [11]. Moreover, it is also recommended for assessing ambulation levels in chronic stroke patients during rehabilitation.[12]

Responsiveness[edit | edit source]

For acute stroke:[7]

Days Post Stoke n Rivermead Mobility Index Modified Rivermead Mobility Index Mobility Subscale of the Stroke Rehabilitation Assessment of Movement Barthel Index
14-30 51 1.14 1.31 1.17 1.51
30-90 43 0.86 0.83 0.95 1.07
90-180 43 0.24 0.20 0.40 0.35
14-90 43 1.67 1.56 1.61 2.09
14-180 43 1.94 1.53 1.65 2.01

Values reported as SRM (Standardized Response Mean)

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. ↑ 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
  7. ↑ 7.0 7.1 7.2 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
  8. ↑ 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
  9. ↑ 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
  10. ↑ 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
  11. ↑ 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.
  12. ↑ 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


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