Rivermead Mobility Index (RMI)

Rivermead Mobility Index Evaluation Summary
  What does the tool measure? The RMI measures mobility disability in clients with stroke
  What types of clients can the tool be used for? Clients with stroke, head injury or multiple sclerosis.
  Is this a screening or assessment tool? Assessment
Time to administer An average of 3 to 5 minutes.
  Versions Modified Rivermead Mobility Index.
Other Languages Italian and Dutch.
Measurement Properties
  Reliability – Two studies examined the internal consistency of the RMI and reported excellent internal consistency using Chronbach’s alpha and reliability coefficient rho.
– Three studies have examined the test-retest reliability of the RMI and reported adequate to excellent test-retest reliability using Intraclass Correlation Coefficient (ICC) and Kappa Statistics.
– One study, using Rasch Analysis reported that item difficulty on the RMI is the same across repeated measures.
– Two studies examined the inter-rater reliability of the RMI and reported poor to excellent inter-rater reliability using Bland and Altman Technique, ICC and weighted Kappa.
  Validity

Content: 
One study examined the content validity of the RMI by estimating its coefficient of reproducibility and scalability and confirmed the RMI fulfill the Guttmann scaling criteria.

Criterion:
Concurrent:
One study examined the concurrent validity of the RMI and reported excellent correlations between the RMI and the Modified Rivermead Mobility Index and the Stroke Rehabilitation Assessment of Movement (STREAM) using Spearman’s rho. When using ICC an adequate correlation between these 3 mobility measures was found.

Predictive:
Three studies examined the predictive validity of the RMI and reported that the RMI measured at admission or up to 90 days after stroke was able to predict Barthel Index scores at discharge from a rehabilitation program. Also, at admission, RMI scores > than 4 was an excellent predictor of an early discharge home.

Construct:
Convergenty: 
Four studies examined convergent validity of the RMI and reported excellent correlations between the RMI and the Barthel Index, the Berg Balance Scale, the 6-Minute Walk Test, the motor scales of the FIM, the Trunk Control Test and gait speed. Adequate correlations were reported between the RMI and the leg section of the Motricity Index. Poor correlations were reported between the RMI and number of falls and cognitive scales of the FIM. Correlations were calculated using Pearson correlation and Spearman’s rho. One study examined the convergent validity of the Dutch version of the RMI and reported excellent correlations between the Dutch RMI and the Dutch version on the Barthel Index using Spearman’s rho.

  Floor/Ceiling Effects Two studies examined the floor and ceiling effects of the RMI and reported that at earlier phases of the stroke, floor effects were poor. When the RMI is measured 180 days after stroke ceiling effects were adequate.
  Does the tool detect change in patients? Three studies have examined the responsiveness of the RMI and reported that the RMI has a large Standardized Response Mean, a large effect size and is able to detect minimal clinically important differences in clients with stroke.
  Acceptability The RMI should not be administered to clients with severe cognitive impairments due to the 14 self-reported items.
Feasibility The administration of the RMI is quick and simple.
How to obtain the tool? The RMI can be obtained from the studies by Antonucci et al. (2002), Forlander & Bohannon (1998) or Franchignoni et al. (2003).