Rivermead and Trail-Making Tests Reliably Predict Concussion Recovery

TAKE-HOME MESSAGE

• Concussion diagnosis and management continues to be a source of concern for clinicians and there remains a need for valid instruments to predict concussion recovery
• The Rivermead Post Concussion Symptom Questionnaire (RPQ) and the Trail-making test (TMT) have been proven by this study to substantially predict moderate to severe limitations.
• The RPQ and TMT instruments are easy to administer and may be helpful to clinicians who diagnose and manage concussion.

RPQ can be Downloaded here

TMT can be Downloaded here.

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-R² of .02. When the RPQ score was added, the pseudo-R² 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.

Citation

de Guise E^1,2, Bélanger S³, Tinawi S⁴, Anderson K¹, LeBlanc J³, Lamoureux J⁵, Audrit H¹, Feyz M³. 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. 2015 Nov 16:1-10. [Epub ahead of print]

Author information:

• ¹a Psychology Department , University of Montreal , Montreal , Quebec , Canada.
• ²b Neurology and Neurosurgery Department , McGill University , Montreal , Quebec , Canada.
• ³c Traumatic Brain Injury Program , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada.
• ⁴d Rehabilitation Medicine Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada.
• ⁵e Social and Preventive Medicine Department , University of Montreal , Montreal , Quebec , Canada.