Rivermead Mobility Index

 

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

The Rivermead Mobility Index assesses functional mobility in gait, balance and transfers after stroke

Intended Population

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

Method of Use

Description:

• The Rivermead Mobility Index is appropriate for a range of disabilities that include anything from being bedridden to being able to run

15 items:

• 14-self-reported items
• 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

Evidence

Reliability

Test-retest Reliability:

Chronic Stroke:

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

• Excellent overall test-retest reliability (ICC = 0.96)
• Excellent test-retest reliability for the following subcategories:

Kappa for turning in bed = 1.0
Kappa for walking inside without aid = 0.89
Kappa for walking outside on uneven ground = 0.83
Kappa for bathing = 0.81
Kappa for picking objects off the floor = 0.79

• Adequate test-retest reliability for the following subcategories:

Kappa for stairs = 0.68
Kappa for lying to sitting = 0.64
Kappa for sitting balance = 0.64
Kappa for transfers = 0.64
Kappa for walking up and down 4 steps = 0.67

Lower Limb Amputees:

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

• Excellent test-retest reliability (ICC = 0.99)

Interrater/Intrarater Reliability:

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) 

• Excellent interrater reliability for total score (ICC = 0.92)
• Poor to excellent interrater reliability for individual subcategories (Weighted Kappa = 0.37 - 0.94)

Validity

Criterion Validity: 

Acute Stroke:

(Hsieh et al, 2000; n = 38 inpatients; Sommerfeld & vo Arbin, 2001; n = 115 inpatients aged > 65; Hsueh et al, 2003) 

• Excellent predictive validity with Barthel Index 24 days post stroke (r = 0.77)
• RMI scores of > 4 best predictor of early discharge home

Lower Limb Amputees:

(Ryall et al, 2003) 

• Adequate concurrent validity with TWT (r = -0.58)
• Only one value is outside the 95% limits of agreement

Construct Validity: 

Acute Stroke: (Hsueh et al, 2003) 

• 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) 

· Excellent correlation with motFIM at beginning of prosthetic training (r = 0.83)
· Excellent correlation with motFIM at end of prosthetic training (r = 0.69)
· Excellent correlation of the change scores for the RMI with changes in motFIM (r = 0.75)
· Excellent correlation with TWT (timed walking test) at end of prosthetic training (r = -0.70)

Content Validity:

Acute Stroke: (Hsieh et al, 2000) 

• Critical values for two indicess, coefficient of reproducibility (> 0.9) and coefficient of scalability (> 0.7), were all exceeded

Lower limb amputees: (Franchignoni et al, 2003a) 

• 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) 

• Coefficient of reproducibility was exceeded and ranged from 0.91-0.94

Responsiveness

Acute Stroke: (Hsueh et al, 2003) 

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)

RMI = Rivermead Mobility Index
MRMI = Modified Rivermead Mobility Index
STREAM = Mobility Subscale of the Stroke Rehabilitation Assessment of Movement
BI = Barthel Index

Links

Rivermead Mobility Index

References

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