Rivermead Motor Assessment (RMA)

Rivermead Motor Assessment (RMA) Evaluation Summary
  What does the tool measure? Motor performance
  What types of clients can the tool be used for? Patients with acute, sub-acute and chronic stroke.
  Is this a screening or assessment tool? Assessment
Time to administer The RMA takes approximately 45 minutes to administer to an ambulatory client with a recovering upper extremity (less time with more severely disabled patients).
  Versions Rivermead Mobility Index (RMI), developed from the RMA Gross Function subscale.
Other Languages None
Measurement Properties
  Reliability – One study examined the internal consistency of the RMA and reported excellent internal consistency for all subscales of the RMA.
– One study examined the test-rest reliability of the RMA and reported adequate test-retest reliability of the Gross Function subscale and excellent test-retest reliability for the Leg and Trunk, and Arm subscales.
– One study examined the inter-rater reliability of the RMA and reported that on the Gross Function and Leg and Trunk subscales, there were no significant differences on average scores for all patients across all raters. For the Arm subscale, there was significant difference across raters, attributed to only one of the raters.
– No studies have examined the intra-rater reliability of the RMA.
  Validity

Criterion: 
Concurrent: 
Excellent correlations with the Barthel Index at initial, 1 month and 1 year follow-up.

Predictive: 
A low RMA gross motor score at 6 weeks post-stroke has been reported as predictive of failure to walk at 18 months post-stroke.

Construct: 
Convergent/Discriminant:
Excellent correlations between the RMA Upper Extremity subscale and the Motricity Index Upper Extremity subscale. Excellent correlations between the RMA and the total score of the Functional Independence Measure (FIM) and with the FIM Motor subscale, and adequate correlations between the RMA and the FIM Cognitive subscale. Excellent correlations between the verbal method of completing the Gross Function subscale of the RMA and the typical performance method of completion.

  Floor/Ceiling Effects One study examined the ceiling effect of the Gross Function subscale of the RMA and reported a large ceiling effect.
  Does the tool detect change in patients? Two studies examined the responsiveness of the RMA. The RMA was found it to be responsive to change in clients with stroke and it was reported that a total score difference of plus or minus 3 is likely to represent a clinically relevant change in functional level.
  Acceptability The RMA should be used with caution with individuals with chronic stroke aged 65 and older as they may not be able to perform some of the specific tasks but may be able to perform subsequent tasks that are deemed more challenging. Guttman scaling may not be appropriate to assess function in the hemiplegic stroke client or to assess the loss in function owing to focal lesions that arise in stroke clients, in whom impairment of some functions may be unrelated to impairment of other functions.
Feasibility The RMA takes approximately 45 minutes to administer and is typically administered by a physical therapist. The measure is simple to administer and consists of test items in three sections (Upper Limb/Extremity; Lower Limb/Extremity and Trunk; Gross Function) that are ordered hierarchically does not require any formal training or specialized equipment.
How to obtain the tool? Please click here to obtain a copy of the RMA.