726 - High Level Mobility Assessment Tool Expanded Use

Objectives: Traumatic brain injuries (TBI) are the leading cause of acquired disability in children in the United States. Musculoskeletal injury is a leading cause of emergency department visits. Both conditions struggle performing high level mobility tasks. High-Level Mobility Assessment Tool (HiMAT) can quickly assess rehabilitation of injuries and detect deficiencies. This study identified expanded uses of the HiMAT beyond its creation to assess impairment in adults with TBI. Expanded populations include pediatrics and orthopedic trauma populations.

Design: A narrative review of literature from 2005—2024 (peer-reviewed, English only) was conducted to assess HiMAT’s application in: children aged 5–12 years and adults with orthopedic trauma.

Results: Children demonstrated a direct relationship between age and HiMAT reference score with significant differences in trajectories between boys and girls. Only in 5-6 year olds, girls scored higher than boys. Children demonstrated local dependency between “walk”, and “walk over an obstacle” items. Revised HiMAT demonstrated excellent internal consistency, interrater reliability, and adequate content validity.
In adults with multi-orthopedic trauma, mean scores on the revised HiMAT were 1.7±3.2 for initial testing, 8.4±6.2, 6 weeks after the initial test, and 11.5±7.8, 12 weeks after initial testing. Tests demonstrated excellent internal consistency (Cronbach’s alpha = 0.93, Pearson Separation Index = 0.91), adequate concurrent validity with Functional Independence Measure (FIM) (r=0.49, P< 0.001), Lower Extremity Functional Scale (LEFS) (r=0.39, P=0.012) and Rasch analysis fit (P=0.29). HiMAT demonstrates better face validity, responsiveness, and ceiling effect than FIM and LEFS.

Conclusions: HiMAT has shown versatility in reliably assessing deficiencies in expanded populations of children and adults beyond original intended use. Future studies can assess whether HiMAT is efficacious in conditions like cerebral palsy. HiMAT (5-10 minutes) could be a faster alternative to FIM (30-45 minutes) and more responsive alternative to both FIM and LEFS.