Assessment Overview

Purpose: The Rivermead Mobility Index (RMI) was created to assess mobility in individuals post-stroke. Since then it has also been used for individuals with head injury, MS, cerebellar degeneration, and spina bifida.

Summary: The RMI is a series of yes or no questions that can be answered by a patient or proxy of the patient. In addition, one question asks that the patient stand unsupported for 10 seconds. There are 15 items that ask about rolling in bed, transfers, walking, standing, picking up items, running, etc. Scores range from 0-15: a no receives a score of 0 and a yes receives a score of 1. The lower the score, the less mobile the patient.

Equipment: None

ICF Category: Activity

Assessment Handout

Assessment Psychometrics

According to the ICF model, the RMI is considered an activity level outcome measure. Specifically, it assesses tasks such as balance, bed mobility, gait, self-care, and transfers. It is both a performance-based and a self-report measure. NeuroPT EDGE recommends (3/4) that the RMI be used in all clinical settings with MS individuals of all disability levels. Students should learn to administer this tool because it is applicable to a variety of patient populations and has high clinical utility. While there have not been too many metrics established for the use of the RMI in the MS population, the published psychometrics are reported below.

• Concurrent Validity: Correlated significantly to Hauser’s Ambulation Index (rho=-0.45 to -0.96); Kurtzke’s EDSS (rho=-0.70 to -0.96); 10 meter walk (rho=-0.80)

• Discriminative Validity: Able to discriminate among inpatients with MS who have normal walking capability vs. slow walk vs. unable to walk; Able to discriminate among individuals with EDSS scores <3.5, 3.5-6.0, and >6.0

• Ceiling Effects: 2.5% of patients with MS score 15 points and 15% scored 14 points

• Floor Effects: 12% of inpatients with MS scored 0 points and 18% scored 1 point

• Predictive Validity: RMI was best predictor of handicap as measured by the London Handicap Scale; RMI was a predictor of quality of life impairment as measure by the Functional Assessment of MS.

• Responsiveness: RMI has been found to be more responsive to change in inpatients with MS as opposed to other measures; Able to detect changes in 39% of all patients