Rivermead Mobility Index: Difference between revisions

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== Objective  ==
== Objective  ==
 
[[File:Gait rehabilitation.png|thumb]]
The '''Rivermead Mobility Index''' assesses functional mobility in gait, balance and transfers after stroke  
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<ref name=":0">Collen FM, Wade DT, Robb GF, Bradshaw CM. [https://pubmed.ncbi.nlm.nih.gov/1836787/ The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment]. Int Disabil Stud. 1991;13(2):50-4</ref>.


== Intended Population  ==
== Intended Population  ==


Those with a diagnosis of Stroke, Spinal Cord Injury, Acquired Brain Injury, Lower Limb Amputees
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  ==


<u>Description:</u>  
The Rivermead Mobility Index consists of 15 items (14 self reported items and 1 direct observation)<ref name=":0" />. 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<ref>Shirley Ryan Ability Lab. Rivermead Mobility Index. Available from: https://www.sralab.org/rehabilitation-measures/rivermead-mobility-index (Accessed 23/06/2022)</ref>.


*The Rivermead Mobility Index is appropriate for a range of disabilities that include anything from being bedridden to being able to run
The items are<ref>Donato S, Halliday Pulaski K, Gillen G. [https://www.sciencedirect.com/science/article/pii/B9780323172813000198 Chapter 19 - Overview of Balance Impairments: Functional Implications]. In: Gillen G. Stroke Rehabilitation (Fourth Edition) Mosby, 2016. p394-415.</ref>:


15 items:  
<nowiki>1. Turning over in bed: Do you turn over from your back to your side without help?</nowiki>


*14-self-reported items
<nowiki>2. Lying to sitting: From lying in bed, do you get up to sit on the edge of the bed on your own?</nowiki>
*1 direct observation item
*Items progress in difficulty
*Items are coded as either 0 or 1, depending on whether the patient can complete the task according to specific instructions
*Items receive a score of 0 for a "No" response and 1 for a "Yes" response
*Total scores are determined by summing the points for all items
*A maximum of 15 points is possible; higher scores indicate better mobility performance
*A score of "0" indicates an inability to perform any of the activities on the measure


<br> {{#ev:youtube|NZbnUehNUrw|300}}
<nowiki>3. Sitting balance: Do you sit on the edge of the bed without holding on for 10 seconds?</nowiki>


<br>  
<nowiki>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?</nowiki>
 
<nowiki>5. Standing unsupported: Ask client to stand without aid and observe standing for 10 seconds without any aid.</nowiki>


== Evidence  ==
<nowiki>6. Transfer: Do you manage to move from bed to chair and back without any help?</nowiki>


=== Reliability  ===
<nowiki>7. Walking inside (with an aid if necessary): Do you walk 10 meters, with an aid if necessary, but with no standby help?</nowiki>


<u>Test-retest Reliability:</u>  
<nowiki>8. Stairs: Do you manage a flight of stairs without help?</nowiki>


''Chronic Stroke:''
<nowiki>9. Walking outside (even ground): Do you walk around outside, on pavements, without help?</nowiki>


(Chen et al, 2007; Green, Foster &amp; Young, 2001; n = 22; 1 year post-stroke, assessed twice, with one week between assessments)&nbsp;<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>  
<nowiki>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?</nowiki>


*Excellent overall test-retest reliability (ICC = 0.96)
<nowiki>11. Picking up off floor: Do you manage to walk 5 meters, pick something up from the floor, and then walk back without help?</nowiki>
*Excellent test-retest reliability for the following subcategories:


Kappa for turning in bed = 1.0<br>Kappa for walking inside without aid = 0.89<br>Kappa for walking outside on uneven ground = 0.83<br>Kappa for bathing = 0.81<br>Kappa for picking objects off the floor = 0.79
<nowiki>12. Walking outside (uneven ground): Do you walk over uneven ground (grass, gravel, snow, ice, etc.) without help?</nowiki>


*Adequate test-retest reliability for the following subcategories:
<nowiki>13. Bathing: Do you get into/out of a bath or shower to wash yourself unsupervised and without help?</nowiki>


Kappa for stairs = 0.68<br>Kappa for lying to sitting = 0.64<br>Kappa for sitting balance = 0.64<br>Kappa for transfers = 0.64<br>Kappa for walking up and down 4 steps = 0.67
<nowiki>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?</nowiki>


''Lower Limb Amputees:''
<nowiki>15. Running: Do you run 10 meters without limping in 4 seconds (fast walk, not limping, is acceptable)?</nowiki>


(Ryall et al, 2003; n = 62; mean age = 56.8 (18.8) years; mean time post amputation: 4.9 (14.7) years)&nbsp;<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>


*Excellent test-retest reliability (ICC = 0.99)
This video gives a demonstration of using the Rivermead Mobility Index:
:<br> {{#ev:youtube|NZbnUehNUrw}}


<br>  
<br>  


<u>Interrater/Intrarater Reliability:</u>
== Evidence  ==


''Acute Stroke:'' (Hsueh et al, 2003; n = 57; mean age of 64.2 (11.5) years; assessed at 14, 30, 90, and 180 days post stroke; Taiwanese sample)&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>  
=== Reliability  ===
<u>Test-retest reliability</u>


*Excellent interrater reliability for total score (ICC = 0.92)
Excellent for chronic stroke and lower limb amputees<ref name=":3">Tsang RC, Chau RM, Cheuk TH, Cheung BS, Fung DM, Ho EY. [https://pubmed.ncbi.nlm.nih.gov/24400683/ 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. </ref><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" />.
*Poor to excellent interrater reliability for individual subcategories (Weighted Kappa = 0.37 - 0.94)


=== Validity  ===
<u>Interrater reliability</u>
 
Excellent for acute stroke<ref name=":4">Rådman L, Forsberg A, Nilsagård Y. Modified [https://pubmed.ncbi.nlm.nih.gov/25238211/ Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke.] Physiother Theory Pract. 2015 Feb;31(2):126-9. </ref><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>.


<u>Criterion Validity:</u>  
<u>Intra-rater reliability</u>


''Acute Stroke:''
Excellent for acute stroke<ref name=":4" />.


(Hsieh et al, 2000; n = 38 inpatients; Sommerfeld &amp; vo Arbin, 2001; n = 115 inpatients aged &gt; 65; Hsueh et al, 2003)&nbsp;<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>  
<u>Internal consistency</u>  


*Excellent predictive validity with Barthel Index 24 days post stroke (r = 0.77)
Good in mixed neurological population<ref>Walsh JM, Barrett A, Murray D, Ryan J, Moroney J, Shannon M. [https://pubmed.ncbi.nlm.nih.gov/20131953/ The Modified Rivermead Mobility Index: reliability and convergent validity in a mixed neurological population.] Disabil Rehabil. 2010;32(14):1133-9</ref>.
*RMI scores of &gt; 4 best predictor of early discharge home
=== Validity  ===


''Lower Limb Amputees'':  
<u>Criterion Validity:</u>


(Ryall et al, 2003)&nbsp;<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>  
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 TWT (r = -0.58)
Adequate concurrent validity with the timed walk test for lower limb amputees<ref name=":1" />.
*Only one value is outside the 95% limits of agreement


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


''Acute Stroke: ''(Hsueh et al, 2003)&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 BI at 14 days post stroke (r = 0.72)
*Excellent correlation with BI at 30 days post stroke (r = 0.88)
*Excellent correlation with BI at 90 days post stroke (r = 0.86)
*Excellent correlation with BI at 180 days post stroke (r = 0.88)


''Lower Limb Amputees:'' (Franchignoni et al, 2003a, n = 140; mean age = 57 (18) years)&nbsp;<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>.
 
· Excellent correlation with motFIM at beginning of prosthetic training (r = 0.83)<br>· Excellent correlation with motFIM at end of prosthetic training (r = 0.69)<br>· Excellent correlation of the change scores for the RMI with changes in motFIM (r = 0.75)<br>· Excellent correlation with TWT (timed walking test) at end of prosthetic training (r = -0.70)


<u>Content Validity:</u>  
<u>Content Validity:</u>  


''Acute Stroke: ''(Hsieh et al, 2000)&nbsp;<ref name="Hsieh et al">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>  
The Rivermead Mobility Index 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 has good content validity and was significantly correlated with physical function variables in stroke  patients<ref name=":3" /> <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>
 
*Critical values for two indices, coefficient of reproducibility (&gt; 0.9) and coefficient of scalability (&gt; 0.7), were all exceeded
 
''Lower limb amputees:'' (Franchignoni et al, 2003a)&nbsp;<ref name="Franchignoni et al">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>  
 
*Coefficient of reproducibility was exceeded and ranged from 0.71-1.0
*Coefficient of scalability was not exceeded and ranged from 0.38-0.62
 
''Lower limb amputees:'' (Ryall et al, 2003)&nbsp;<ref name="Ryall et al">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>  
 
*Coefficient of reproducibility was exceeded and ranged from 0.91-0.94
 
=== Responsiveness  ===
 
''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>  
 
{| width="500" border="1" cellpadding="1" cellspacing="1"
|-
| Days Post Stoke
| ''n''
| RMI
| MRMI
| STREAM
| BI
|-
| 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)
<u>Predictive Validity:&nbsp;</u>


RMI = Rivermead Mobility Index<br>MRMI = Modified Rivermead Mobility Index<br>STREAM = Mobility Subscale of the Stroke Rehabilitation Assessment of Movement<br>BI = Barthel Index
Adequate predictive validity in stroke patients<ref name=":3" />.
=== Responsiveness ===
The Rivermead Mobility Index was found to be one of the most sensitive outcomes measures for  detecting improvements in mobility in MS patients<ref>Baert I, Smedal T, Kalron A, Rasova K, Heric-Mansrud A, Ehling R, et al. [https://pubmed.ncbi.nlm.nih.gov/30333161/ Responsiveness and meaningful improvement of mobility measures following MS rehabilitation.] Neurology. 2018 Nov 13;91(20):e1880-e1892</ref>. In acute stroke patients, it was found to be valid and sensitive to change over time<ref name=":3" /><ref name="Hsieh et al" />.


== Links  ==
== Links  ==


[http://www.rehabmeasures.org/PDF%20Library/Rivermead%20Mobility%20Index.pdf Rivermead Mobility Index]  
[https://www.sralab.org/sites/default/files/2017-06/Rivermead%20Mobility%20Index.pdf Rivermead Mobility Index]  


== References  ==
== References  ==
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<references /><br>  
<references /><br>  


[[Category:Outcome_Measures]]  
[[Category:Outcome_Measures]] [[Category:Assessment]]
[[Category:Neurology_Outcome_Measures]]  
[[Category:Neurology]] [[Category:Neurological - Assessment and Examination]] [[Category:Neurological - Outcome Measures]] [[Category:Neurological - Outcome Measures]]  
[[Category:Stroke]]  
[[Category:Stroke]]  [[Category:Stroke - Assessment and Examination]] [[Category:Stroke - Outcome Measures]]
[[Category:Head]] [[Category:Head - Assessment and Examination]] [[Category:Head - Outcome Measures]]
[[Category:Spinal Cord Injuries]]  
[[Category:Spinal Cord Injuries]]  
[[Category:Acquired Brain Injuries]]  
[[Category:Acquired Brain Injuries]]  
[[Category:Amputees]]
[[Category:Amputees]]
[[Category:Occupational Health]]
[[Category:Occupational Health]]

Latest revision as of 15:04, 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]

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


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