Usefulness of the rivermead postconcussion symptoms questionnaire and the trail-making test for outcome prediction in patients with mild traumatic brain injury

Abstract

The aim of the study was to determine if the Rivermead Postconcussion Symptoms Questionnaire (RPQ) is a better tool for outcome prediction than an objective neuropsychological assessment following mild traumatic brain injury (mTBI). The study included 47 patients with mTBI referred to an outpatient rehabilitation clinic. The RPQ and a brief neuropsychological battery were performed in the first few days following the trauma. The outcome measure used was the Mayo-Portland Adaptability Inventory-4 (MPAI-4) which was completed within the first 3 months. The only variable associated with results on the MPAI-4 was the RPQ score (p < .001). The predictive outcome model including age, education, and the results of the Trail-Making Test-Parts A and B (TMT) had a pseudo-R(2) of .02. When the RPQ score was added, the pseudo-R(2) climbed to .19. This model indicates that the usefulness of the RPQ score and the TMT in predicting moderate-to-severe limitations, while controlling for confounders, is substantial as suggested by a significant increase in the model chi-square value, delta (1df) = 6.517, p < .001. The RPQ and the TMT provide clinicians with a brief and reliable tool for predicting outcome functioning and can help target the need for further intervention and rehabilitation following mTBI.

Post-Concussion Symptoms Rule: Derivation and Validation of a Clinical Decision Rule for Early Prediction of Persistent Symptoms after a Mild Traumatic Brain Injury

“…With regard to the outcome measurement tool, the RPQ has been criticized, but it is widely used in clinical settings and was found to be as useful as an objective neuropsychological assessment to help target patients who would most benefit from further intervention following their trauma. 52 , 100 It is an easy tool to use in the context of limited resources.…”

Diffusion Tensor Imaging (DTI) Correlates of Self-Reported Sleep Quality and Depression Following Mild Traumatic Brain Injury

“…Previous analyses of the RPCSQ have identified a two-factor structure, such that the first three questions (RPQ3) are sensitive to acute injury symptoms while the final 13 (RPQ13) are sensitive to chronic symptoms. These two scales have good test-retest reliability ( r > 0.70) and external validity [ρ > 0.60; ( 79 )], and the RPQ is a significant predictor of 3-month outcomes ( 80 ).…”

Symptom recovery and the relationship between post-injury symptom scores and neurocognitive performance in athletes with sport-related concussion

“…Our results are not dissimilar to other studies with the TMT-A and TMT-B, as a high degree of baseline and post-injury variability has been reported. 24,25,29 Performance on the PST was similar to the TMT-B, with post-injury performance better overall compared to baseline values. Nonetheless, these data provide considerable value in the interpretation of post-injury data, regardless of whether baseline testing is available by which to compare post-injury performance.…”

“…The TMT-A and TMT-B are digitized versions of standard neuropsychological tests that assess set-switching and working memory, and have been shown to be sensitive in determining recovery from mTBI. 24,25 The TMT-A requires individuals to connect a series of numbered dots in ascending order 1-25, and TMT-B requires the connection of letters and numbers in sequential but alternating order (1-A-2-B-3-C. . .).…”