Rivermead Mobility Index

 

Original Editor - Sinead Greenan

Top Contributors - Sinead Greenan, Oyemi Sillo, Evan Thomas, Scott Buxton and Naomi O'Reilly

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) [1]

  • 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) [2]

  • 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) [3]

  • 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) [4]

  • 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) [5]

  • 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) [6]

  • 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) [7]

· 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) [8]

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

Lower limb amputees: (Franchignoni et al, 2003a) [9]

  • 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) [10]

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

Responsiveness

Acute Stroke: (Hsueh et al, 2003) [11]

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

  1. 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
  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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  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. 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
  11. 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