Article

OBJECTIVE: To enable improved interpretation of the total score and faster
scoring of the Rivermead Mobility Index (RMI) by studying item ordering or
hierarchy and formulating start-and-stop rules in patients after stroke. DESIGN: Cohort study. SETTING: Rehabilitation center in the Netherlands; stroke
rehabilitation units and the community in the United Kingdom. PARTICIPANTS: Item
hierarchy of the RMI was studied in an initial group of patients (n=620; mean age
+/- SD, 69.2+/-12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269
[43%] right hemisphere lesion), and the adequacy of the item hierarchy-based
start-and-stop rules was checked in a second group of patients (n=237; mean age
+/- SD, 60.0+/-11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93
[39%] right hemisphere lesion) undergoing rehabilitation after stroke.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mokken scale analysis was
used to investigate the fit of the double monotonicity model, indicating
hierarchical item ordering. The percentages of patients with a difference between
the RMI total score and the scores based on the start-and-stop rules were
calculated to check the adequacy of these rules. RESULTS:
The RMI had good fit of
the double monotonicity model (coefficient H(T)=.87). The interpretation of the
total score improved. Item hierarchy-based start-and-stop rules were formulated.
The percentages of patients with a difference between the RMI total score and the
score based on the recommended start-and-stop rules were 3% and 5%, respectively.
Ten of the original 15 items had to be scored after applying the start-and-stop
rules. CONCLUSIONS: Item hierarchy was established, enabling improved
interpretation and faster scoring of the RMI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS