Clinical Outcome Variables Scale (COVS)

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Tool Description

  • Measure of mobility that has been applied to specific diagnostic groups such as stroke, traumatic brain injury, amputations, and musculoskeletal injuries in a variety of settings (acute, inpatient/outpatient rehabilitation, and community settings).
  • Items include rolling, lying to sitting, sitting balance, transfers, ambulation, wheelchair mobility, and arm function.
  • 2 subscales have been reported for the COVS: 1) General Mobility subscale (7 items) and 2) Ambulation subscale (5 items)

ICF Domain:

Activity – subcategory: Mobility.

Number of Items:


Brief Instructions for Administration & Scoring


  • 2 versions:
    1) performance (clinician-administered through observation of task performance); can be conducted
    2) Self-report (telephone interview - TCOVS)
  • In-person assessment takes approximately 35 minutes.
  • Assessment via telephone interview takes approximately 5 minutes (subjects are given the questions ahead of time).


  • stopwatch
  • Bed sticks
  • bed ladders
  • lifting blocks
  • transfer boards
  • leg straps
  • exercise mat
  • ramp (1 inch to 12 inch rise)
  • 6 inch platform


  • Each item is scored on a 7-point scale ranging from 1 (fully dependent mobility) to 7 (normal independent mobility).
  • COV scores are generally reported as a summed total score ranging from 13 to 91. The general mobility subscale has scores that range from 7-49, while the ambulation subscale has scores ranging from 5-35.


MCID: not established
SEM: not established
MDC: not established

  • Lower scores reflect poorer levels of mobility.
  • No cut-points or normative data have been established for the SCI population
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Study Details sheet).



Training Required:

Raters should be trained in the administration of both the COVS and TCOVS (see Campbell & Kendall 2003 for further details).


A copy of the COVS can be found in the paper by Campbell and Kendall (2003).

Clinical Considerations

  • Both versions of this tool offer a more relevant and complete profile of mobility after SCI when compared with other mobility tools.

Measurement Property Summary

# of studies reporting psychometric properties: 2


  • Test-retest reliability of the TCOVS (telephone-administered COVS) is High (ICC=1.00).
  • Equivalence reliability between TCOVS and COVS was found to be High (ICC=0.98).

[Barket et al. 2007]


  • The COVS can discriminate across clinically distinct groups (by lesion level, completeness of injury and walking status) during discharge from hospital and admission to a transitional rehabilitation program.

[Campbell & Kendall 2003]


No values were reported for the responsiveness of the COVS for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the COVS for the SCI population.


Dr. William Miller, Christie Chan

Date Last Updated:

August 22, 2020

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Worksheet Document





Equipment Needed


Barker RN, Amsters DI, Kendall MD, Pershouse KJ, Haines TP. Reliability of the Clinical Outcome Variables Scale when administered via telephone to assess mobility in people with spinal cord injury. Arch Phys Med Rehabil 2007; 88: 632-7.

Campbell J, Kendall M. Investigating the suitability of the Clinical Outcome Variables Scale (COVS) as a mobility outcome measure in spinal cord in jury rehabilitation. Physiother. Can 2003; 55: 135-144.

Ekstrand E, Ringsberg KA, Pessah-rasmussen H. The physiotherapy clinical outcome variables scale predicts length of hospital stay, discharge destination and future home facility in the acute comprehensive stroke unit. J Rehabil Med. 2008;40(7):524-8.