{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:57:50Z","timestamp":1790035070512,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"Background<\/jats:title>The High-Level Mobility Assessment Tool (HiMAT) was developed to quantify balance and mobility problems after traumatic brain injury (TBI). Measurement properties of the HiMAT have not been tested in the mild TBI (MTBI) population.<\/jats:p><\/jats:sec>Objective<\/jats:title>The aim of this study was to examine the reliability, validity, and responsiveness of the HiMAT in a sample of the MTBI population.<\/jats:p><\/jats:sec>Design<\/jats:title>A cohort, pretest-posttest, comparison study was conducted.<\/jats:p><\/jats:sec>Methods<\/jats:title>Ninety-two patients (69% men, 31% women) with a mean age of 37.1 years (SD=13.8) and a mean Glasgow Coma Scale score of 14.7 (SD=0.7) were recruited from Oslo University Hospital. All patients were tested with the HiMAT (range of scores=0 [worst] to 54 [best]) at 3 months postinjury. Fifty-one patients were retested at 6 months. A subgroup of 25 patients was selected for the reliability testing. Balance function reported on the Rivermead Post Concussion Symptoms Questionnaire was chosen as a criterion and anchor. Criterion-related validity was studied with correlation analysis. Intraclass correlation coefficients (ICCs) were used for assessing interrater and intrarater reliability. Minimal detectable change (MDC) for the HiMAT was estimated. Responsiveness was assessed with receiver operating characteristic curve analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>The mean HiMAT sum score was 46.2 (95% confidence interval=44.4 to 48.1). The HiMAT had a ceiling effect of 22.8%. The correlation between HiMAT scores and self-reported balance problems was large (r=\u2212.63, P&lt;.001). Interrater and intrarater reliability of the HiMAT sum score was high (interrater ICC=.99, intrarater ICC=.95). The MDC was \u22123 to +4 points. Responsiveness was good, and the HiMAT discriminated well between patients with self-perceived improved balance function versus unchanged balance function (area under the curve=0.86).<\/jats:p><\/jats:sec>Limitations<\/jats:title>The small sample size, a ceiling effect, and lack of a gold standard were limitations of the study.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The HiMAT demonstrated satisfactory measurement properties for patients with MTBI. The HiMAT can be used as an outcome measure of balance and mobility problems in patients with MTBI.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20120381","type":"journal-article","created":{"date-parts":[[2013,3,16]],"date-time":"2013-03-16T08:26:48Z","timestamp":1363422408000},"page":"900-910","source":"Crossref","is-referenced-by-count":18,"title":["Measurement Properties of the High-Level Mobility Assessment Tool for Mild Traumatic Brain Injury"],"prefix":"10.1093","volume":"93","author":[{"given":"Ingerid","family":"Kleffelgaard","sequence":"first","affiliation":[{"name":"I. Kleffelgaard, PT, MSc, Department of Physical Medicine and Rehabilitation, Oslo University Hospital, PO Box 4956, Nydalen N-0424, Oslo, Norway, and Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Roe","sequence":"additional","affiliation":[{"name":"C. Roe, MD, PhD, Department of Physical Medicine and Rehabilitation, Oslo University Hospital, and Faculty of Medicine, University of Oslo."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiv","family":"Sandvik","sequence":"additional","affiliation":[{"name":"L. Sandvik, PhD, Unit of Biostatistics and Epidemiology, Oslo University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torgeir","family":"Hellstrom","sequence":"additional","affiliation":[{"name":"T. Hellstrom, MD, Department of Physical Medicine and Rehabilitation, Oslo University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene L.","family":"Soberg","sequence":"additional","affiliation":[{"name":"H.L. Soberg, PT, PhD, Department of Physical Medicine and Rehabilitation, Oslo University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2019123011485332400_B1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1159\/000120025","article-title":"Incidence of hospital-treated traumatic brain injury in the Oslo population","volume":"30","author":"Andelic","year":"2008","journal-title":"Neuroepidemiology"},{"key":"2019123011485332400_B2","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1080\/02699050050203568","article-title":"The identification by physiotherapists of the physical problems resulting from a mild traumatic brain injury","volume":"14","author":"Quinn","year":"2000","journal-title":"Brain Inj"},{"key":"2019123011485332400_B3","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.medengphy.2005.05.005","article-title":"Comparison of subjective and objective measurements of balance disorders following traumatic brain injury","volume":"28","author":"Kaufman","year":"2006","journal-title":"Med Eng Phys"},{"key":"2019123011485332400_B4","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/apmr.2003.50034","article-title":"An assessment of gait and balance deficits after traumatic brain injury","volume":"84","author":"Basford","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011485332400_B5","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1080\/02699050500188898","article-title":"Balance disorder and traumatic brain injury: preliminary findings of a multi-factorial observational study","volume":"19","author":"Campbell","year":"2005","journal-title":"Brain Inj"},{"key":"2019123011485332400_B6","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.csm.2010.09.004","article-title":"Balance assessment in the management of sport-related concussion","volume":"30","author":"Guskiewicz","year":"2011","journal-title":"Clin Sports Med"},{"key":"2019123011485332400_B7","first-page":"x","volume-title":"Motor Control: Theory and Practical Applications","author":"Shumway-Cook","year":"2000","edition":"2nd ed"},{"key":"2019123011485332400_B8","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1080\/02699050500058711","article-title":"The High-Level Mobility Assessment Tool (HiMAT) for traumatic brain injury, part 2: content validity and discriminability","volume":"19","author":"Williams","year":"2005","journal-title":"Brain Inj"},{"key":"2019123011485332400_B9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1080\/02699050500058687","article-title":"The High-Level Mobility Assessment Tool (HiMAT) for traumatic brain injury, part 1: item generation","volume":"19","author":"Williams","year":"2005","journal-title":"Brain Inj"},{"key":"2019123011485332400_B10","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.apmr.2005.10.028","article-title":"The concurrent validity and responsiveness of the High-Level Mobility Assessment Tool for measuring the mobility limitations of people with traumatic brain injury","volume":"87","author":"Williams","year":"2006","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011485332400_B11","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ptj\/86.3.395","article-title":"High-Level Mobility Assessment Tool (HiMAT): interrater reliability, retest reliability, and internal consistency","volume":"86","author":"Williams","year":"2006","journal-title":"Phys Ther"},{"key":"2019123011485332400_B12","doi-asserted-by":"crossref","first-page":"370","DOI":"10.12968\/ijtr.2009.16.7.43046","article-title":"Normative values for the High-Level Mobility Assessment Tool (HiMAT)","volume":"16","author":"Williams","year":"2009","journal-title":"Int J Ther Rehabil"},{"key":"2019123011485332400_B13","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1016\/S0003-9993(03)00274-0","article-title":"Reliability of the Dynamic Gait Index in people with vestibular disorders","volume":"84","author":"Wrisley","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"2019123011485332400_B14","doi-asserted-by":"crossref","first-page":"50","DOI":"10.3109\/03790799109166684","article-title":"The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment","volume":"13","author":"Collen","year":"1991","journal-title":"Int Disabil Stud"},{"key":"2019123011485332400_B15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/BF01405862","article-title":"Assessment and prognosis of coma after head injury","volume":"34","author":"Teasdale","year":"1976","journal-title":"Acta Neurochir (Wien)"},{"key":"2019123011485332400_B16","volume-title":"High-Level Mobility Assessment Tool for Traumatic Brain Injury","author":"Williams","year":"2004"},{"key":"2019123011485332400_B17","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"key":"2019123011485332400_B18","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/BF00868811","article-title":"The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability","volume":"242","author":"King","year":"1995","journal-title":"J Neurol"},{"issue":"pt 2","key":"2019123011485332400_B19","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.2044-8260.1997.tb01405.x","article-title":"Mild head injury: neuropathology, sequelae, measurement and recovery","volume":"36","author":"King","year":"1997","journal-title":"Br J Clin Psychol"},{"key":"2019123011485332400_B20","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","article-title":"Quality criteria were proposed for measurement properties of health status questionnaires","volume":"60","author":"Terwee","year":"2007","journal-title":"J Clin Epidemiol"},{"key":"2019123011485332400_B21","volume-title":"Fundamentals of Biostatistics","author":"Rosner","year":"2005","edition":"6th ed"},{"key":"2019123011485332400_B22","doi-asserted-by":"crossref","first-page":"231926","DOI":"10.4061\/2011\/231926","article-title":"Definition of nonresponse to analgesic treatment of arthritic pain: an analytical literature review of the smallest detectable difference, the minimal detectable change, and the minimal clinically important difference on the pain visual analog scale","volume":"2011","author":"Stauffer","year":"2011","journal-title":"Int J Inflam"},{"key":"2019123011485332400_B23","doi-asserted-by":"crossref","first-page":"xii","DOI":"10.1002\/0471722146","volume-title":"Applied Logistic Regression","author":"Hosmer","year":"2000","edition":"2nd ed"},{"key":"2019123011485332400_B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09638280802532720","article-title":"Post-concussion symptoms after mild traumatic brain injury: influence of demographic factors and injury severity in a 1-year cohort study","volume":"31","author":"Roe","year":"2009","journal-title":"Disabil Rehabil"},{"key":"2019123011485332400_B25","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/01.ta.0000222916.30253.ea","article-title":"Long-term multidimensional functional consequences of severe multiple injuries two years after trauma: a prospective longitudinal cohort study","volume":"62","author":"Soberg","year":"2007","journal-title":"J Trauma"},{"key":"2019123011485332400_B26","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/TA.0b013e3181eff54f","article-title":"Returning to work after severe multiple injuries: multidimensional functioning and the trajectory from injury to work at 5 years","volume":"71","author":"Soberg","year":"2011","journal-title":"J Trauma"},{"key":"2019123011485332400_B27","doi-asserted-by":"crossref","first-page":"788","DOI":"10.3109\/09638288.2011.619624","article-title":"Associations among self-reported balance problems, post-concussion symptoms and performance-based tests: a longitudinal follow-up study","volume":"34","author":"Kleffelgaard","year":"2012","journal-title":"Disabil Rehabil"},{"key":"2019123011485332400_B28","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/02699050500488041","article-title":"Dizziness after traumatic brain injury: overview and measurement in the clinical setting","volume":"20","author":"Maskell","year":"2006","journal-title":"Brain Inj"},{"key":"2019123011485332400_B29","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1353\/cja.2007.0001","article-title":"Relationship between self-report and performance measures of function: a systematic review","volume":"25","author":"Coman","year":"2006","journal-title":"Can J Aging"},{"key":"2019123011485332400_B30","first-page":"ix","volume-title":"Physical Rehabilitation Outcome Measures: A Guide to Enhanced Clinical Decision-making","author":"Finch","year":"2002"},{"key":"2019123011485332400_B31","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.3109\/02699052.2010.490517","article-title":"Further development of the High-Level Mobility Assessment Tool (HiMAT)","volume":"24","author":"Williams","year":"2010","journal-title":"Brain Inj"},{"key":"2019123011485332400_B32","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1080\/02699050410001672314","article-title":"Test-retest reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study","volume":"18","author":"van Loo","year":"2004","journal-title":"Brain Inj"},{"key":"2019123011485332400_B33","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1191\/0269215503cr677oa","article-title":"Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury","volume":"17","author":"van Loo","year":"2003","journal-title":"Clin Rehabil"},{"key":"2019123011485332400_B34","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1471-2288-10-22","article-title":"The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content","volume":"10","author":"Mokkink","year":"2010","journal-title":"BMC Med Res Methodol"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/7\/900\/31640922\/ptj0900.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ptj\/article-pdf\/93\/7\/900\/31640922\/ptj0900.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:05:52Z","timestamp":1595549152000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/93\/7\/900\/2735366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,1]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7,1]]}},"URL":"https:\/\/doi.org\/10.2522\/ptj.20120381","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,1]]}}}