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)

Clinical Considerations

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

ICF Domain

Activity ▶ Mobility


2 versions:

1) performance (clinician-administered through observation of task performance); can be conducted.

  • In-person assessment takes approximately 35 minutes.

2) Self-report (telephone interview – TCOVS).

  • Assessment via telephone interview takes approximately 5 minutes (subjects are given the questions ahead of time).

Number of Items



  • 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.



Training Required

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


Can be found in Appendix of publication linked here.


  • 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 Clinical Summary).

MCID: not established

SEM: not established

MDC: not established


  • Test-retest reliability is high for the telephone-administered COVS (TCOVS) (Intraclass Correlation Coefficient = 1.00).
  • Equivalence reliability is high between TCOVS and COVS (Intraclass Correlation Coefficient = 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

22 August 2020

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.