HiMAT Training & Testing

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 rating forms. Further guidance can be sought from the User Manual (Williams et al., 2004b) or from the developers of the HiMAT.

Three practice cases incorporating test data have been included for the reader to demonstrate how the HiMAT is scored.

Case 1
A 21 year-old male who sustained a TBI 15 months ago. His test results were:
•Walking forward – 6.3 seconds (Score 2)
•Walking backward – 13.5 seconds (Score 1)
•Walk on toes – 7.9 seconds, occasional heel contact (Score 0)
• Walk over an obstacle – 7.0 seconds (Score 2)
• Run – unable to run (Score 0)
• Skip - unable to skip (Score 0)
• Hop forward – unable to hop (Score 0)
• Bound (landing on more affected leg) – Average 62cm on three trials (Score 1)
• Bound (landing on less affected leg) – Average 69cm on three trials, but no consistent flight phase (Score 0)
• Up stairs – 13.1 seconds, reciprocal but used a rail (Score 3)
• Down stairs – 21.2 seconds, used a rail, two feet on each step (Score 2)

Adding each score results in a total of 11/54 for the HiMAT. Walking on toes is scored 0 because heel-contact was made during the trial. Bounding onto the less-affected leg was also scored 0 because of an inconsistent flight phase. The Up stair item was only scored ‘dependent’ because of use of a rail, therefore no score was recorded for ‘Up stairs independent’. The Down stair item was also scored ‘dependent’ because a rail was used and the pattern was not reciprocal. No score was recorded for Down stairs independent.

Case 2
A 17 year-old female who sustained a TBI 3.5 years ago. Her test results were:
•Walking forward – 4.3 seconds (Score 3)
•Walking backward – 5.7 seconds (Score 4)
•Walk on toes – 5.9 seconds (Score 3)
•Walk over an obstacle – 4.9 seconds (Score 3)
•Run – 2.1 seconds (Score 2)
•Skip – 3.4 seconds (Score 3)
•Hop forward – 7.0 seconds (Score 2)
•Bound (landing on more affected leg) – Average 105cm on three trials (Score 3)
•Bound (landing on less affected leg) – Average 105cm on three trials (Score 2)
•Up stairs – 7.4 seconds, reciprocal, no rail (Score 3 + 5)
•Down stairs – 6.7 seconds, reciprocal, no rail (Score 2 + 5)

Adding each score results in a total of 40/54 for the HiMAT. Successful performances were attempted at each item. The performances for both stair items are scored on the independent level because a reciprocal pattern was used without use of a rail. An extra 5 points are scored for each ‘dependent’ stair item (far right-hand column) because a reciprocal pattern was used without use of a rail.

Case 3
A 37 year-old male who sustained a TBI 14 years ago. His test results were:
•Walking forward – 6.6 seconds (Score 2)
•Walking backward – 17.3 seconds (Score 1)
•Walk on toes – 9.0 seconds (Score 1)
•Walk over an obstacle – 9.7 seconds (Score 1)
•Run – unable to run (Score 0)
•Skip – unable to skip (Score 0)
•Hop forward – unable to hop (Score 0)
•Bound (landing on more affected leg) – Average 87cm on three trials (Score 1)
•Bound (landing on less affected leg) – unable to bound (Score 0)
•Up stairs – 10.5 seconds, reciprocal, no rail (Score 1 + 5)
•Down stairs – 7.9 seconds, reciprocal but occasionally used a rail to steady themselves (Score 4)

Adding each score results in a total of 16/54 for the HiMAT. Performances were unsuccessful for running, skipping, hopping and bounding onto the less-affected leg because of inconsistent presence of a flight phase. The Up stair item was performed slowly, but reciprocally without use of a rail, so an extra 5 points were scored. The Down stair item was performed relatively quickly, but the rail was used so the extra 5 points were not scored.