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Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke
Lisa Rådman1, Anette Forsberg, Ylva Nilsagård
1Department of Physiotherapy, Örebro University Hospital , Örebro , Sweden .
Purpose:
The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke.
Method:
A cohort study with repeated measures within 24 h, on 37 patients, 1-14 d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (κ) statistics and internal consistency with Cronbach's alpha and intra-class correlation (ICC), 3.k.
Results:
Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; κ between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; κ 0.59-0.87. The internal consistency was high (α 0.96; ICC 3.k 0.99).
Conclusion:
The MRMI is a reliable measure of physical mobility in the early post-stroke phase.
Insights
The Modified Rivermead Mobility Index (MRMI) demonstrates excellent reliability for assessing physical mobility in patients within 14 days of stroke. This early assessment tool is highly dependable for both single-rater and multiple-rater evaluations.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Measurement
Background:
- The Modified Rivermead Mobility Index (MRMI) is a tool used to assess physical mobility.
- Its reliability in the acute phase following a stroke has not been previously established.
- Early and accurate mobility assessment is crucial for stroke patient management.
Purpose of the Study:
- To evaluate the inter-rater and intra-rater reliability of the MRMI.
- To assess the internal consistency of the MRMI.
- To determine the MRMI's utility in patients within the first 14 days post-stroke.
Main Methods:
- A cohort study design was employed with 37 patients assessed between 1-14 days post-stroke.
- Repeated measures were taken within a 24-hour period.
- Inter-rater and intra-rater reliability were analyzed using weighted kappa (κ) statistics, while internal consistency was assessed with Cronbach's alpha and intra-class correlation (ICC).
Main Results:
- Excellent inter-rater (ICC 0.97) and intra-rater (ICC 0.99) reliability was found for the MRMI summary score.
- High internal consistency was observed (Cronbach's alpha 0.96; ICC 0.99).
- Item-specific agreement was substantial to excellent for both inter-rater (κ 0.59-0.87) and intra-rater (κ 0.81-0.96) assessments.
Conclusions:
- The Modified Rivermead Mobility Index (MRMI) is a reliable and consistent measure for assessing physical mobility in the early stages after a stroke.
- The findings support the use of the MRMI for clinical evaluation and research in the acute post-stroke period.
