Abstract
BackgroundThe Rivermead Post Concussion Symptoms Questionnaire (RPQ) is a widely-used, 16-item measure of concussion symptoms yet its ability to assess change in the symptom experience over time has come under criticism. We applied Generalisability theory to differentiate between dynamic and enduring aspects of post-concussion symptoms and to examine sources of measurement error in the RPQ.Materials and MethodsGeneralisability theory was applied using the longitudinal design with persons as the object of measurement. Patients with a traumatic brain injury (n = 145; aged ≥16 years) were assessed at three time occasions (1, 6 and 12 months post-injury) using the RPQ.ResultsThe RPQ showed overall strong generalisability of scores (G = .98) across persons and occasions with a minor proportion of variance attributed to the dynamic aspect of symptoms reflected by interaction between person and occasion. Items measuring concentration, fatigue, restlessness and irritability reflected more dynamic patterns compared to more enduring patterns of sensitivity to noise, impatience, nausea and sleep disturbance.ConclusionThe RPQ demonstrated strong reliability in assessing enduring post-concussion symptoms but its ability to assess dynamic symptoms is limited. Clinicians should exercise caution in use of the RPQ to track dynamic symptom change over time. Further investigation is necessary to enhance the RPQ’s ability to assess dynamic symptoms and to address measurement error associated with individual items.
Highlights
The Rivermead Post-concussive Symptom Questionnaire (RPQ; King et al, 1995) is a widely used clinical assessment tool designed to measure symptoms occurring after a traumatic brain injury (TBI)
Rivermead Post Concussion Symptoms Questionnaire (RPQ) demonstrated strong internal consistency across all three occasions (α = .94) but test-retest r-scores compared to the baseline were slightly below .60 (CI ± .10) and intraclass correlation coefficient (ICC) for all three occasions was slightly higher at .63 (CI ± .08)
The study results show good generalisability of the RPQ (G = .98) indicating that the instrument can reliably be used across wide TBI populations and occasions to measure trait-like or enduring concussion symptoms only (Arterberry et al, 2014)
Summary
The Rivermead Post-concussive Symptom Questionnaire (RPQ; King et al, 1995) is a widely used clinical assessment tool designed to measure symptoms occurring after a traumatic brain injury (TBI). The RPQ is commonly used to measure severity of symptoms following mild or moderate traumatic brain injury by presenting 16 symptoms thought to be common consequences of such an injury. These symptoms, which include difficulties in cognition/thinking (e.g., memory, concentration), mood or affective complaints (e.g., depressed mood, irritability, anxiety), and somatic/physiological symptoms (e.g., dizziness, headache, fatigue, light sensitivity) are often referred to as ‘‘post concussive symptoms’’ (PCS) (McAllister, 2008). The Rivermead Post Concussion Symptoms Questionnaire (RPQ) is a widely-used, 16-item measure of concussion symptoms yet its ability to assess change in the symptom experience over time has come under criticism.
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