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[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 [9].

Construct Validity: 

Excellent correlation with Barthel Index at 14, 30, 90 and 180 days post stroke [10].

Excellent correlation with motFIM and Timed Walk Test at the end of prosthetic training for lower limb amputees[11].

Content Validity:

The Rivermead Mobility Index was found to be valid and sensitive to change over time, and achieved reproducibility and scalability  [12]. It was significantly correlated with physical function variables in stroke patients. [13]. Moreover, it is also recommended for assessing ambulation levels in chronic stroke patients during rehabilitation.[14]

Responsiveness[edit | edit source]

Acute Stroke: (Hsueh et al, 2003) [15]

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 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. ↑ 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. ↑ 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
  10. ↑ 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
  11. ↑ 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
  12. ↑ 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
  13. ↑ 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.
  14. ↑ 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
  15. ↑ 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


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