The high-level mobility assessment tool (HiMAT) for traumatic brain injury. Part 2: content validity and...

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Biostatistics

Background:

• Traumatic brain injury (TBI) often results in significant mobility impairments, affecting daily life and participation.
• Assessing high-level mobility is crucial for individuals with TBI to regain independence in social, leisure, and sporting activities.
• Existing assessment tools may not adequately capture the nuances of high-level mobility recovery post-TBI.

Purpose of the Study:

• To evaluate the measurement properties of the High-Level Mobility Assessment Tool (HiMAT) in adults with TBI.
• To determine if the HiMAT functions as a uni-dimensional, discriminative, and hierarchical outcome scale.
• To validate the HiMAT for quantifying therapy outcomes in TBI rehabilitation.

Main Methods:

• Content validity was assessed through internal consistency, factor analysis, and Rasch analysis.
• Uni-dimensionality and discriminability of HiMAT items were rigorously tested.
• A convenience sample of 103 adults with TBI participated in the study at a major rehabilitation facility.

Main Results:

• The HiMAT demonstrated very high internal consistency (Cronbach's alpha = 0.99) for high-level items.
• Factor analysis and Rasch analysis identified and excluded items not related to high-level mobility or those that were redundant.
• Raw scores showed a very high correlation (r = 0.98) with logit scores, confirming good discriminability.

Conclusions:

• The HiMAT is a uni-dimensional and discriminative scale suitable for quantifying therapy outcomes in individuals with TBI.
• The tool effectively assesses higher-level mobility requirements essential for returning to pre-accident activities.
• The HiMAT provides clinicians with a reliable measure for tracking recovery and guiding rehabilitation efforts.