The Rivermead Post-Concussion Symptoms Questionnaire (RPQ)

Introduction[edit | edit source]

The Rivermead Post-concussion Symptoms Questionnaire (RPQ) is a simple, freely available, and widely used tool for assessment of the presence and severity of various post-assessment and management of concussion symptoms. The questionnaire was first published in 1995 to assess patients' psychosocial functioning post-concussion[1]. It contains 16 questions targeting physical, cognitive and behavioral domains. A RPQ Modified Scoring System (RPQ 13/ RPQ-3) was presented by Eyres et al in 2005[2].

Intended Population[edit | edit source]

Individuals showing symptoms of assessment and management of concussion after a head trauma/ brain injury[1].

Method of Use[edit | edit source]

Equipment Required:

  • Questionnaire based: pen and paper

Training Required:

  • None

Time Required:

  • 5-10 mins

Instrument[edit | edit source]

The questionnaire is a self-reported questionnaire containing 16 questions[1]. Patients are asked the severity of the following symptoms over the past 24 hours, compared to before the injury:

  • Nausea and vomiting
  • Noise sensitivity (easily upset by loud noise)
  • Sleep disturbance
  • Fatigue (tiring more easily)
  • Being irritable (easily angered)
  • Feeling depressed or tearful
  • Feeling frustrated or impatient
  • Forgetfulness (poor memory)
  • Poor concentration
  • Taking longer to think
  • Blurred vision
  • Light sensitivity (easily upset by bright light)
  • Double vision
  • Restlessness
  • Finally, there is the option to list and score any other difficulties.

Scoring[edit | edit source]

The responses are scored on a ordinal rating system from 0 - 4, where 0 = never experienced at all, 1 = no more of a problem, 2 = a mild problem, 3 = a moderate problem, and 4 = a severe problem[3].

In the modified version[4]:

RPQ-3: Score of first three questions, Scoring is 0-12; if there is a higher score on the RPQ-3, earlier reassessment and closer monitoring is recommended.

RPQ-13: Score of next 13 questions, Scoring is 0-52; later cluster of symptoms; greater impact on participation, psychosocial functioning and lifestyle.

Psychometric Properties[edit | edit source]


Previous research supports that the PRQ has demonstrated moderate to good internal consistency, inter-rater and test-retest reliability[1][5].

More recently, a Rasch analysis found strong reliability (coefficient of 0.87) in both traumatic brain injury and orthopedic groups, supporting its use for group comparisons as well as for individual assessment[3]. In addition, it was found to have strong reliability in assessing enduring post-concussion symptoms, but limited ability to assess fluctuating symptoms[6].


The RPQ had strong concurrent validity with the World Health Organization Quality of Life Brief Version (WHOQoL-BREF) and was correlated with post-injury neurological and psychological comorbid illness[3].

One study found the RPQ score had excellent validity with Hospital Anxiety Depression Scale[7]. They also support the predictive validity when used in conjunction with Trail-Making Test to predict moderate-to-severe limitations following mild traumatic brain injury[7]. However, Asselstine et al (2021) found whilst it is valid in assessing a patient's post-concussive symptoms following mild traumatic brain injury, it may not predict long-term physical or mental health in older adults[8].

A modified Rivermead Post-concussion Symptoms Questionnaire was decided to have promising validity by being able to identify increased scores for "biased brain injury simulators" who were asked to exaggerate their response, compared to control participants[9].

Resources[edit | edit source]

Rivermead Post-Concussion Symptoms Questionnaire

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 King NS, Crawford S, Wenden FJ, Moss NE, Wade DT. The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. J Neurol. 1995 Sep;242(9):587-92.
  2. Eyres S, Carey A, Gilworth G, Neumann V, Tennant A. Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire. Clin Rehabil. 2005 Dec;19(8):878-87.
  3. 3.0 3.1 3.2 Balalla S, Krägeloh C, Medvedev O, Siegert R. Is the Rivermead Post-Concussion Symptoms Questionnaire a Reliable and Valid Measure to Assess Long-Term Symptoms in Traumatic Brain Injury and Orthopedic Injury Patients? A Novel Investigation Using Rasch Analysis. Neurotrauma Rep. 2020 Aug 11;1(1):63-72.
  4. Rehabilitative Care Alliance. Rivermead Post Concussion Symptoms Questionnaire [Online]. Available from: (Accessed 28/12/2022)
  5. Sullivan K, Garden N. A comparison of the psychometric properties of 4 postconcussion syndrome measures in a nonclinical sample. J Head Trauma Rehabil. 2011 Mar-Apr;26(2):170-6.
  6. Medvedev ON, Theadom A, Barker-Collo S, Feigin V; BIONIC Research Group. Distinguishing between enduring and dynamic concussion symptoms: applying Generalisability Theory to the Rivermead Post Concussion Symptoms Questionnaire (RPQ). PeerJ. 2018 Sep 28;6:e5676.
  7. 7.0 7.1 de Guise E, Bélanger S, Tinawi S, Anderson K, LeBlanc J, Lamoureux J, Audrit H, Feyz M. Usefulness of the rivermead postconcussion symptoms questionnaire and the trail-making test for outcome prediction in patients with mild traumatic brain injury. Appl Neuropsychol Adult. 2016;23(3):213-22.
  8. Asselstine J, Kristman VL, Armstrong JJ, Dewan N. The Rivermead Post-Concussion Questionnaire score is associated with disability and self-reported recovery six months after mild traumatic brain injury in older adults. Brain Inj. 2020;34(2):195-202.
  9. Brooks KJL, Sullivan KA. Validating the modified Rivermead Post-concussion Symptoms Questionnaire (mRPQ). Clin Neuropsychol. 2021 Aug 4:1-20.