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Home› Physical Therapy› Free Self-Checks› High-Level Mobility Assessment Tool (HiMAT)

High-Level Mobility Assessment Tool (HiMAT)

Score running, skipping, hopping, bounding and stairs after brain injury. Total 0 to 54.

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Reviewed by Dr. Richard Holsman, PT, DPT, NCS · Last reviewed November 14, 2026 · For clinicians

The High-Level Mobility Assessment Tool (HiMAT) measures advanced mobility such as fast walking, running, skipping, hopping, bounding and stairs. Gavin Williams and colleagues developed it for people with traumatic brain injury who walk independently but have not regained the mobility needed for work, sport and leisure. Enter each time or distance and this page scores it against the HiMAT score sheet. The maximum total is 54.

⚠️ For clinicians. Not a self-check.

  • Who can be tested: people who walk independently over 20 m without a gait aid. Orthoses are allowed.
  • Running, hopping, bounding and stairs carry a fall risk. Stay beside the patient during testing, and skip any item that is unsafe for them (it scores 0).
  • Allow 1 practice trial for each item. Patients perform at maximum safe speed, except for the bounding and stair items.

Equipment and setup

  • A 20 m walkway marked at the start, 5 m, 15 m and 20 m; the middle 10 m (5 m to 15 m) is timed.
  • A flight of 14 stairs, a stopwatch, a tape measure, and a house brick or similar-sized obstacle.
  • Testing takes about 5 to 15 minutes. COMBI suggests starting with the walking item.

Instructions

Enter the time in seconds for each timed item, the three bound distances in centimetres, and how the patient managed the stairs. Tick “Unable / fail” for any item the patient could not do or failed. Walking cannot score 0, because independent walking is required for testing.

Walk

Middle 10 m of a 20 m walk at maximum safe speed.

Score 1: >6.6 s · 2: 5.4–6.6 s · 3: 4.3–5.3 s · 4: <4.3 s

Walk backward

As for walking, walking backward.

Score 1: >13.3 s · 2: 8.1–13.3 s · 3: 5.8–8.0 s · 4: <5.8 s

Walk on toes

As for walking. Any heel contact during the middle 10 m is a fail.

Score 1: >8.9 s · 2: 7.0–8.9 s · 3: 5.4–6.9 s · 4: <5.4 s

Walk over obstacle

As for walking, stepping over a house brick placed across the walkway at the mid-point. Stepping around or touching the brick is a fail.

Score 1: >7.1 s · 2: 5.4–7.1 s · 3: 4.5–5.3 s · 4: <4.5 s

Run

Middle 10 m of a 20 m run. No consistent flight phase is a fail.

Score 1: >2.7 s · 2: 2.0–2.7 s · 3: 1.7–1.9 s · 4: <1.7 s

Skip

Middle 10 m of a 20 m skip. No consistent flight phase is a fail.

Score 1: >4.0 s · 2: 3.5–4.0 s · 3: 3.0–3.4 s · 4: <3.0 s

Hop forward (more affected leg)

Hop forward 10 m on the more affected leg; record the time.

Score 1: >7.0 s · 2: 5.3–7.0 s · 3: 4.1–5.2 s · 4: <4.1 s

Bound (affected)

Stand behind a line on the less affected leg, hands on hips, and jump forward landing on the more affected leg. Measure from the line to the heel of the landing leg. Record three trials; the average is scored.

Score 1: <80 cm · 2: 80–103 cm · 3: 104–132 cm · 4: >132 cm

Bound (less-affected)

Stand behind a line on the more affected leg, hands on hips, and jump forward landing on the less affected leg. Record three trials; the average is scored.

Score 1: <82 cm · 2: 82–105 cm · 3: 106–129 cm · 4: >129 cm

Up stairs (flight of 14 steps)

Walk up the stairs as the patient normally would, at normal speed. Time from the start until both feet are at the top.

Dependent item: 1: >22.8 s · 2: 14.6–22.8 s · 3: 12.3–14.5 s · 4: <12.3 s. Independent item: 1: >9.1 s · 2: 7.6–9.1 s · 3: 6.8–7.5 s · 4: <6.8 s, plus 5 points on the dependent item.

Down stairs (flight of 14 steps)

Walk down the stairs as the patient normally would, at normal speed. Time from the start until both feet are at the bottom.

Dependent item: 1: >24.3 s · 2: 17.6–24.3 s · 3: 12.8–17.5 s · 4: <12.8 s. Independent item: 1: >8.4 s · 2: 6.6–8.4 s · 3: 5.8–6.5 s · 4: <5.8 s, plus 5 points on the dependent item.

This is a performance test, not a diagnosis. A HiMAT score describes high-level mobility on the day of testing. Decisions about returning to sport, running or demanding work should be made with the treating team.

For patients and families

If you have recovered from a brain injury or other neurologic condition and want to get back to running, sport or a physical job, a physical therapist can test and train high-level mobility with you. If you or a family member would like help from a physical therapist, request an appointment with Holsman Physical Therapy or call 1-855-465-7626.

How it is scored

  • Each item scores 0 to 4 from the score sheet bands. A failed or unattempted item scores 0. Walking scores 1 to 4.
  • Bounds: the average of three trials is scored.
  • Stairs: a patient who uses a rail or does not climb reciprocally is scored on the “dependent” stair item only (1–4 by time). A patient who climbs reciprocally without a rail is scored on the “independent” item (1–4 by time) and gets 5 points on the dependent item. Up and down stairs are scored separately.
  • Fewer than 14 stairs: COMBI’s FAQ converts the time as time × 14 ÷ number of steps. Converted scores from flights of 11 or more steps appeared valid; flights of 6 steps can inflate the total by up to 2 points.
  • The total is the sum of all items, 0 to 54. Higher scores mean better high-level mobility.
  • This page rounds times to 0.1 s and bound averages to the nearest centimetre before scoring, to match the score sheet bands.

What the score means

  • Reliability: inter-rater ICC 0.99 and two-day retest ICC 0.99 in people with TBI, with an average 1-point improvement on retest; internal consistency (Cronbach’s alpha) 0.97 (Williams et al., 2006).
  • Change beyond measurement error: for the 13-item HiMAT in adults with TBI, the Rehabilitation Measures Database lists the minimal detectable change (MDC95) as an increase of 4 points or a decrease of 2 points (Williams et al., 2006).
  • Healthy young adults: in 18- to 25-year-olds, median scores were 54 for men and 51 for women (Williams et al., 2009, as summarized by the Rehabilitation Measures Database).
  • Revised 8-item HiMAT: a revised version without the stair items, scored 0 to 32 with an MDC95 of ±2 points, is valid where there are no stairs (Williams et al., 2010). This page scores the original 13-item version only.

Related tools: 10 Meter Walk Test · Functional Gait Assessment · Disability Rating Scale.

Sources. Williams G. The High Level Mobility Assessment Tool. The Center for Outcome Measurement in Brain Injury (COMBI), 2006 (score sheet, instructions, syllabus and FAQ). 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(3):395-400. 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(3):437-442. Williams G, Pallant J, Greenwood K. Further development of the High-level Mobility Assessment Tool (HiMAT). Brain Inj. 2010;24(7-8):1027-1031. Williams G, Eldridge BJ. Application and implementation of the High-Level Mobility Assessment Tool (HiMAT): an overview. Int J Phys Med Rehabil. 2021;9:591. Shirley Ryan AbilityLab, Rehabilitation Measures Database: High-level Mobility Assessment Tool. It is one of the measures reviewed in the Academy of Neurologic Physical Therapy (ANPT) TBI EDGE outcome measure recommendations; see neuropt.org for the task force’s recommendations.

Permissions. The HiMAT is free to use (Shirley Ryan AbilityLab Rehabilitation Measures Database; Williams & Eldridge, 2021). Score bands are from the HiMAT score sheet distributed by COMBI. The developer asks clinicians who use the HiMAT to let him know so its use can be tracked (contact details are on the score sheet).

Clinically reviewed by Dr. Richard Holsman, PT, DPT, NCS. Last reviewed: November 14, 2026. Holsman Physical Therapy is not affiliated with these authors, organizations or journals, and they do not endorse this website.

Common Questions

What is the HiMAT?

The High-Level Mobility Assessment Tool (HiMAT) is a clinician-scored performance test of advanced mobility: walking forward, backward, on toes and over an obstacle, running, skipping, hopping, bounding and stairs. It was developed by Gavin Williams and colleagues for people with traumatic brain injury.

Who is the HiMAT for?

People who can walk at least 20 meters independently without a gait aid (orthoses are allowed) but may still have trouble with demanding activities such as running, sport or physical work.

How is the HiMAT scored?

Each item scores 0 to 4 from time or distance bands on the score sheet. The dependent stair items can score 5 for people who use stairs reciprocally without a rail. The maximum total is 54, and higher scores mean better mobility.

How much change is meaningful?

For the 13-item HiMAT in adults with TBI, the Rehabilitation Measures Database lists the minimal detectable change as an increase of 4 points or a decrease of 2 points. People also improved by about 1 point on average when simply retested two days later.

Is my information saved?

No. Everything runs in your web browser. Nothing is sent to us or stored.

Want to Get Back to Running or Sport?

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