HiMAT Syllabus

The HiMAT has been specifically designed to be quick and easy to use without any formal training program. Any health professional or assistant may conduct testing following familiarization with the administration and scoring outlined in the User Manual (Williams et al., 2004b).

Guidelines for Administration

Equipment
Data collection for scoring the HiMAT is simple and requires only 5-15 minutes. Testing can take place in almost any clinical setting and requires minimal equipment. The equipment that is required includes a:

• 20m walkway: The walkway is marked by cones/markers at the start, 5m, 15m and at the end (20m mark). The middle 10m (from the 5m to the 15m markers) is used for recording client performances;
• 14 step staircase;
• Stopwatch;
• Inked moleskin markers;
• House brick or similar sized object; and,
• Tape measure.

Clients should wear suitable clothing and footwear for walking, running and hopping.

Item Administration
Each client should have a practice trial for each item before testing. Reliability testing shows that even long-term TBI clients improve on retesting, indicative of a practice effect or improved confidence. A practice trial before testing will enable a more ‘true’ measure of client ability. The tester should position himself or herself beside the client during testing to ensure client safety.

Items may be administered in any order, but since the minimal mobility requirement for the HiMAT is independent mobility, we advise that the testing commence with the “Walking item”. This ensures initial success for the client where many of the subsequent items may be beyond their ability. The items on the scoresheet are grouped together in testing location, not order of difficulty.

Detailed information regarding the testing procedure and client instructions are outlined in the manual, but a brief outline of each item is available for download. The scoresheet and instructions are designed to be printed out on one double sided sheet.

Download Scoresheet & Instructions (40K)

Although there are 13 items listed on the scoresheet, only 11 are tested. Ascending stairs has two components, ‘dependent’ and ‘independent’. A patient is tested ascending stairs only once, and scored on either the ‘dependent’ or the ‘independent’ item. The same scoring system is also applied for descending stairs which is explained in further detail below.

Scoring

The HiMAT total score is the sum of scores obtained on all the items successfully attempted by each client. Each item is rated on a 5-point scale from 0-4, except the two dependent ‘Stair’ items, which are rated on a 6-point scale from 0-5. The maximum score for the HiMAT is 54.

Each client has their scores recorded on the scoring sheet as the testing proceeds. If a client fails an item, they score a ‘0’ for that item. Performances are written in the performance column, and then the corresponding score is assigned in the adjoining column. For example, if a client scores 6.1 seconds for ‘Walking’, the second column is circled (5.4-6.7) indicating the client’s score for ‘Walking’ is a ‘2’.

The ‘Bound’ items are scored separately, designated ‘affected’ and ‘less-affected’ rather than left and right. ‘Bound – affected’ means the patient attempts a bound pushing off their less affected leg and landing on their more affected leg.

‘Up stairs’ and ‘Down stairs’ are scored separately. For each item, clients are scored according to how they attempted the stairs. If a client uses a handrail or is unable to ascend the stairs reciprocally, they are scored as ‘dependent’. Their time is recorded on the score sheet and they are scored only on the ‘Up stairs – dependent’ item. If a client successfully ascends the stairs reciprocally without use of a handrail, they are scored on the ‘Up stairs - independent’ item AND get an additional 5 points scored on the ‘Up stairs – dependent’ item. The same scoring procedure is followed for ‘Down stairs’.

Once testing is completed, scores in each column are summed. When all the columns are summed, the column scores are added to determine the total HiMAT score.

Examples of testing and scoring of results can be found under FAQ.