The Rivermead Post-Concussion Symptoms Questionnaire (RPQ): Difference between revisions

(Updated intro, population and method)
(Updated psychometric properties)
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* Restlessness
* Restlessness
* Finally, there is the option to list and score any other difficulties.  
* Finally, there is the option to list and score any other difficulties.  


'''''Scoring:'''''  
'''''Scoring:'''''  


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<ref>Balalla S, Krägeloh C, Medvedev O, Siegert R. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240882/#:~:text=The%20RPQ%20is%20a%2016,in%20the%20last%2024%20h. 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.</ref>.  
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<ref name=":2">Balalla S, Krägeloh C, Medvedev O, Siegert R. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240882/#:~:text=The%20RPQ%20is%20a%2016,in%20the%20last%2024%20h. 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.</ref>.  


In the modified version<ref>Rehabilitative Care Alliance. Rivermead Post Concussion Symptoms Questionnaire [Online]. Available from: https://mississaugahalton.rehabcareontario.ca/Uploads/ContentDocuments/Rivermead_Post_ConcussionSymptoms_Questionnaire_(RPC)1.pdf (Accessed 28/12/2022)</ref>:
In the modified version<ref>Rehabilitative Care Alliance. Rivermead Post Concussion Symptoms Questionnaire [Online]. Available from: https://mississaugahalton.rehabcareontario.ca/Uploads/ContentDocuments/Rivermead_Post_ConcussionSymptoms_Questionnaire_(RPC)1.pdf (Accessed 28/12/2022)</ref>:
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For Mild TBI: Adequate test re-test reliability, Adequate inter-rater reliability.
For Mild TBI: Adequate test re-test reliability, Adequate inter-rater reliability.


'''''Validity'''''<ref>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. doi: 10.1080/23279095.2015.1038747. </ref>''''':'''''
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<ref name=":2" />.
 
'''''Validity:'''''
 
The Rasch analysis above found the scale covers close to 90% of the traumatic brain injury sample, and items valid across varying age, sex, marital status, ethnicity, time since injury, and injury type.  


Excellent validity with Hospital Anxiety Depression Scale.
The RPQ had strong concurrent validity with the World Health Organization [[Quality of Life]] Brief Version ([[WHOQOL-BREF|WHOQoL-BREF]]) and was correlated with post-injury neurological and psychological comorbid illness<ref name=":2" />.
 
One study found the RPQ score had excellent validity with Hospital Anxiety Depression Scale<ref name=":3">de Guise E, Bélanger S, Tinawi S, Anderson K, LeBlanc J, Lamoureux J, Audrit H, Feyz M. [https://pubmed.ncbi.nlm.nih.gov/26571267/ 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.</ref>. 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<ref name=":3" />. 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<ref>Asselstine J, Kristman VL, Armstrong JJ, Dewan N. [https://pubmed.ncbi.nlm.nih.gov/31661628/ 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.</ref>.
 
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<ref>Brooks KJL, Sullivan KA. [https://pubmed.ncbi.nlm.nih.gov/34348079/ Validating the modified Rivermead Post-concussion Symptoms Questionnaire (mRPQ).] Clin Neuropsychol. 2021 Aug 4:1-20. </ref>.


== Clinical Significance ==
== Clinical Significance ==
The questionnaire can be repeated to monitor a patient’s progress over time with changes seen in severity of symptoms, or the range of symptoms. Management can be planned likewise<ref>Potter, S., Leigh, E., Wade, D., Fleminger, S. The Rivermead Post Concussion Symptoms Questionnaire. Journal of Neurology, October 2006.1-12.</ref>.<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span>
The questionnaire can be repeated to monitor a patient’s progress over time with changes seen in severity of symptoms, or the range of symptoms. Management can be planned likewise<ref>Potter, S., Leigh, E., Wade, D., Fleminger, S. The Rivermead Post Concussion Symptoms Questionnaire. Journal of Neurology, October 2006.1-12.</ref>.<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span>
== Additional Information  ==
== Resources ==
Find Additional details [https://www.sralab.org/rehabilitation-measures/rivermead-post-concussion-symptom-questionnaire#non-specific-patient-population here]
[http://www.tbi-impact.org/cde/mod_templates/12_F_06_Rivermead.pdf Rivermead Post-Concussion Symptoms Questionnaire]  
 
Find the [http://www.tbi-impact.org/cde/mod_templates/12_F_06_Rivermead.pdf Questionnaire] here
 
== References  ==
== References  ==


Revision as of 08:12, 28 December 2022

Original Editor - Rucha Gadgil

Top Contributors - Rucha Gadgil, Kim Jackson, Chloe Waller, Nupur Smit Shah and Carina Therese Magtibay  

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-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. The 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 concussion after a head trauma/ brain injury.[3]

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:  

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[4].

In the modified version[5]:

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]

Reliability[6][7]:

For Head Injury: Excellent test re-test reliability, Excellent inter-rater reliability.

For Mild TBI: Adequate test re-test reliability, Adequate inter-rater reliability.

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[4].

Validity:

The Rasch analysis above found the scale covers close to 90% of the traumatic brain injury sample, and items valid across varying age, sex, marital status, ethnicity, time since injury, and injury type.

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[4].

One study found the RPQ score had excellent validity with Hospital Anxiety Depression Scale[8]. 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[8]. 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[9].

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[10].

Clinical Significance[edit | edit source]

The questionnaire can be repeated to monitor a patient’s progress over time with changes seen in severity of symptoms, or the range of symptoms. Management can be planned likewise[11].

Resources[edit | edit source]

Rivermead Post-Concussion Symptoms Questionnaire

References[edit | edit source]

  1. ↑ 1.0 1.1 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. ↑ Crawford S, Wenden FJ, Wade DT. The Rivermead head injury follow up questionnaire: a study of a new rating scale and other measures to evaluate outcome after head injury. J Neurol Neurosurg Psychiatry. 1996 May;60(5):510-4. doi: 10.1136/jnnp.60.5.510.
  4. ↑ 4.0 4.1 4.2 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.
  5. ↑ Rehabilitative Care Alliance. Rivermead Post Concussion Symptoms Questionnaire [Online]. Available from: https://mississaugahalton.rehabcareontario.ca/Uploads/ContentDocuments/Rivermead_Post_ConcussionSymptoms_Questionnaire_(RPC)1.pdf (Accessed 28/12/2022)
  6. ↑ King NS, Crawford S, Wenden FJ, Caldwell FE, Wade DT. Early prediction of persisting post-concussion symptoms following mild and moderate head injuries. Br J Clin Psychol. 1999 Mar;38(1):15-25. doi: 10.1348/014466599162638. 
  7. ↑ 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. doi: 10.1080/02699052.2019.1682670
  8. ↑ 8.0 8.1 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.
  9. ↑ 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.
  10. ↑ Brooks KJL, Sullivan KA. Validating the modified Rivermead Post-concussion Symptoms Questionnaire (mRPQ). Clin Neuropsychol. 2021 Aug 4:1-20.
  11. ↑ Potter, S., Leigh, E., Wade, D., Fleminger, S. The Rivermead Post Concussion Symptoms Questionnaire. Journal of Neurology, October 2006.1-12.
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