Franchignoni Franco, Tesio Luigi, Benevolo Emilio, Ottonello Marcella
Rehabilitation Institute of Veruno (NO), Unit of Occupational Rehabilitation and Ergonomics, Italy.
Clin Rehabil. 2003 May;17(3):273-82. doi: 10.1191/0269215503cr608oa.
To examine the internal consistency, validity, responsiveness and test scalability of the Rivermead Mobility Index (RMI) in Italian rehabilitation inpatients recovering from stroke.
Seventy-three stroke inpatients undergoing rehabilitation were assessed at admission (T0) and five weeks later (T1), using RMI, the motor (motFIM) and cognitive (cognFIM) subscales of the Functional Independence Measure, the 'leg' section of the Motricity Index and Trunk Control Test.
Cronbach's alpha of the RMI was 0.92. The item-to-total correlation coefficients (r(rb)) ranged from 0.36 to 0.83, all p < 0.003. All correlations between RMI scores and the other instruments, both at T0 and T1, were statistically significant (r > or = 0.49, all p < 0.0001), except those with cognFIM. The difference in RMI scores over the testing period was statistically significant (sign test: z = 7.1, p < 0.0001) and the effect size was 0.89. The coefficient of reproducibility was 0.95 at T0 and 0.93 at T1, and both coefficients of scalability were 0.67.
The study confirms the internal consistency, construct validity and responsiveness of the RMI, according to the classic psychometric indexes. However, some minor concerns arise regarding: (a) a floor effect of RMI in subacute rehabilitation stroke inpatients at admission and; (b) one item ('bathing') that seems sensitive to cultural and environmental factors. Moreover, even though RMI met the scaling criteria, the item hierarchy is not coincident with the one originally postulated. So, RMI should be considered only as a summated index with ordinal properties, and not a hierarchically ranked scale.
研究Rivermead运动指数（RMI）在意大利中风康复住院患者中的内部一致性、效度、反应性和测试可扩展性。
对73名接受康复治疗的中风住院患者在入院时（T0）和五周后（T1）进行评估，使用RMI、功能独立性测量的运动（motFIM）和认知（cognFIM）子量表、运动能力指数的“腿部”部分以及躯干控制测试。
RMI的Cronbach's α为0.92。项目与总分相关系数（r(rb)）范围为0.36至0.83，所有p < 0.003。在T0和T1时，RMI分数与其他工具之间的所有相关性均具有统计学意义（r ≥ 0.49，所有p < 0.0001），认知FIM除外。测试期间RMI分数的差异具有统计学意义（符号检验：z = 7.1，p < 0.0001），效应大小为0.89。T0时的再现性系数为0.95，T1时为0.93，两个可扩展性系数均为0.67。
根据经典心理测量指标，该研究证实了RMI的内部一致性、结构效度和反应性。然而，出现了一些小问题：（a）RMI在亚急性康复中风住院患者入院时存在地板效应；（b）一个项目（“洗澡”）似乎对文化和环境因素敏感。此外，尽管RMI符合量表标准，但项目层次结构与最初假设的不一致。因此，RMI应仅被视为具有顺序属性的求和指数，而不是层次排序量表。
