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Measurement Characteristics and Clinical Utility of the High-level Mobility Assessment Tool Among Individuals With Traumatic Brain Injury

      Approximately 5.3 million Americans live with disabilities related to traumatic brain injury (TBI).1 TBI causes a wide range of impairments; even high-functioning individuals with TBI often have physical impairments that impede their ability to return to their prior activities, including accessing the community and employment. Many outcome measures do not detect high-level deficits because of a ceiling effect. The High-level Mobility Assessment Tool (HiMAT) is a free, 13-item, unidimensional scale that measures mobility in people who can ambulate independently at least 20m without an assistive device.2 It assesses high-level activities, such as running and jumping, which are not typically included in other measures. It is clinically feasible, as it requires minimal time and equipment, requiring only a stopwatch, a brick, and 14 stairs with handrails. A revised 8-item version of the HiMAT eliminating the stairs items exists, but more studies are needed before recommendations for its use can be made.3
      The HiMAT has excellent reliability and adequate to excellent concurrent validity with the FIM and Rivermead Mobility Assessment in individuals with mild to severe TBI.4-6 Standard error measurement and minimal detectable change data have been reported, which will allow clinicians to identify true change in an individual's performance.4,5
      A full review of the HiMAT and reviews of nearly 200 other instruments can be found at www.rehabmeasures.org.
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      • 1.
        Centers for Disease Control and Prevention. Saving lives and protecting people: preventing traumatic brain injuries (TBI). Available at: http://www.cdc.gov/injury/about/focus-tbi.html. Accessed June 21, 2013.
      • 2.
        The Center for Outcome Measurement in Brain Injury. HiMAT: High-level Mobility Assessment Tool. Available at: http://www.tbims.org/combi/himat/HiMAT.pdf. Accessed June 27, 2013.
      • 3.
        Williams GP, Pallant J, Greenwood K. Further development of the High-level Mobility Assessment Tool (HiMAT). Brain Inj 2010;24:1027-31.
      • 4.
        Williams GP, Greenwood KM, Robertson VJ, Goldie PA, Morris ME. High-level Mobility Assessment Tool (HiMAT): interrater reliability, retest reliability, and internal consistency. Phys Ther 2006;86:395-400.
      • 5.
        Kleffelgaard I, Roe C, Sandvik L, Hellstrom T, Soberg HL et al. Measurement properties of the High-level Mobility Assessment Tool for mild traumatic brain injury. Phys Ther 2013;93:900-10.
      • 6.
        Williams G, Robertson V, Greenwood K, Goldie P, Morris ME. The concurrent validity and responsiveness of the High-level Mobility Assessment Tool for measuring the mobility limitations of people with traumatic brain injury. Arch Phys Med Rehabil 2006;87:437-42.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, the United States Department of Education, or the Retirement Research Foundation. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (grant no. H133B09OO24) and the Retirement Research Foundation (grant no. 2011-027).