Journal of Neurology

, Volume 242, Issue 9, pp 587–592

The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability

  • N. S. King
  • S. Crawford
  • F. J. Wenden
  • N. E. G. Moss
  • D. T. Wade
Original Communication

Abstract

After head injuries, particularly mild or moderate ones, a range of post-concussion symptoms (PCS) are often reported by patients. Such symptoms may significantly affect patients' psychosocial functioning. To date, no measure of the severity of PCS has been developed. This study presents the Rivermead Post Concussion Symptoms Questionnaire (RPQ) as such a measure, derived from published material, and investigates its reliability. The RPQ's reliability was investigated under two experimental conditions. Study 1 examined its test-retest reliability when used as a self-report questionnaire at 7–10 days after injury. Forty-one head-injured patients completed an RPQ at 7–10 days following their head injury and again approximately 24 h later. Study 2 examined the questionnaire's inter-rater reliability when used as a measure administered by two separate investigators. Forty-six head-injured patients had an RPQ administered by an investigator at 6 months after injury. A second investigator readministered the questionnaire approximately 7 days later. Spearman rank correlation coefficients were calculated for ratings on the total symptom scores, and for individual items. High reliability was found for the total PCS scores under both experimental conditions (Rs = +0.91 in study 1 andRS = +0.87 in study 2). Good reliability was also found for individual PCS items generally, although with some variation between different symptoms. The results are discussed in relation to the major difficulties involved when looking for appropriate experimental criteria against which measures of PCS can be validated.

Key words

Head injury Post-concussion symptoms Rivermead Post Concussion Symptoms Questionnaire 

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References

  1. 1.
    Alves WM, Colohan ART, O'Leary TJ, Rimel RW, John JA (1986) Understanding post-traumatic symptoms after minor head injury. Head Trauma Rehabil 1: 1–12Google Scholar
  2. 2.
    Binder LM (1986) Persisting symptoms after mild head injury: a review of the post-concussive syndrome. Clin Exp Neuropsychol 8: 323–346Google Scholar
  3. 3.
    Bohnen N, Twijnstra A, Jolles J (1992) Post-traumatic and emotional symptoms in different sub-groups of patients with mild head injury. Brain Injury 6: 481–486Google Scholar
  4. 4.
    Bohnen N, Twijnstra A, Jolles J (1992) Performance in the Stroop Colour Test in relationship to the persistence of symptoms following minor head injury. Acta Neurol Scared 85: 116–121Google Scholar
  5. 5.
    Bohnen N, Twijnstra A, Jolles J (1992) Neuropsychological deficits in patients with persistent symptoms six months after mild head injury. Neurosurgery 30: 692–696Google Scholar
  6. 6.
    Caprusso DX, Levin H (1992) Cognitive impairment following closed head injury. Neurol Clin 10: 879–893Google Scholar
  7. 7.
    Dikmen S, McLean A, Temkin N (1986) Neuropsychological and psychosocial consequences of minor head injury. J Neurol Neurosurg Psychiatry 49: 1227–1232Google Scholar
  8. 8.
    Dikmen SS, Temkin N, Armsden G (1989) Neuropsychological recovery: the relationship to psychosocial functioning and post-concussional complaints. In: Levin H, Eisenberg HM, Benton AL (eds) Mild head injury. Oxford University Press, New York, pp 229–241Google Scholar
  9. 9.
    Englander J, Hall K, Simpson T, Chaffin S (1992) Mild traumatic brain injury in an insured population: subjective complaints and return to employment. Brain Injury 6: 161–166Google Scholar
  10. 10.
    Evans RW (1992) The post-concussion syndrome and the sequelae of mild head injury. Neurol Clin 10: 815–847Google Scholar
  11. 11.
    Gronwall D (1976) Performance changes during recovery from closed head injury. Proc Aust Assoc Neurol 13: 143–147Google Scholar
  12. 12.
    Gronwall D (1977) Paced auditory serial addition task: a measure of recovery from concussion. Percept Mot Skills 44: 367–373Google Scholar
  13. 13.
    Jakobsen J, Baadsgaard SE, Thomsen S, Henriksen PB (1987) Prediction of post concussional sequalae by reaction time test. Acta Neurol Scand 75: 341–345Google Scholar
  14. 14.
    Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1: 480–484Google Scholar
  15. 15.
    Lishman WA (1988) Physiogenesis and psychogenesis in the “Post-Concussional Syndrome”. Br J Psychiatry 155: 460–469Google Scholar
  16. 16.
    McLean A, Temkin NR, Dikmen SS, Wyler AR (1986) The behavioural sequelae of head injury. J Clin Neuropsychol 5: 361–376Google Scholar
  17. 17.
    Medical Disability Society (1988) The management of traumatic brain injury. Medical Disability Society, LondonGoogle Scholar
  18. 18.
    Middelboe T, Anderson HS, Birket-Smith M, Friis ML (1992) Minor head injury: impact on general health after one year. A prospective follow up study. Acta Neurol Scand 85: 5–9Google Scholar
  19. 19.
    Minderhoud JM, Boelens MEM, Huizenga J, Saan RJ (1980) Treatment of minor head injuries. Clin Neurol Neurosurg 82: 127–140Google Scholar
  20. 20.
    Mittenberg W, Di Giulio DV, Perrin S, Bass AE (1992) Symptoms following mild head injury: expectation as aetiology. J Neurol Neurosurg Psychiatry 55: 200–204Google Scholar
  21. 21.
    Moss NEG, Crawford S, Wade DT (1994) Post-concussion symptoms: is stress a mediating factor? Clin Rehabil 8: 149–156Google Scholar
  22. 22.
    Rimel RW, Giordani MA, Barth JT, Boll TJ, Jane JA (1981) Disability caused by minor head injury. Neurosurgery 9: 221–228Google Scholar
  23. 23.
    Russell WR, Smith A (1961) Post traumatic amnesia after closed head injury. Arch Neurol 5: 16–29Google Scholar
  24. 24.
    Rutherford WH (1989) Post concussion symptoms: relationship to acute neurological indices, individual differences, and circumstances of injury. In: Levin H, Eisenberg HM, Benton AL (eds) Mild head injury. Oxford University Press, New York, pp 217–228Google Scholar
  25. 25.
    Rutherford WH, Merrett JD, McDonald JR (1977) Sequelae of concussion caused by minor head injuries. Injury 10: 225–230Google Scholar
  26. 26.
    Rutherford WH, Merrett JD, McDonald JR (1979) Symptoms at one year following concussion from minor head injuries. Injury 10: 225–230Google Scholar
  27. 27.
    27.Trenerry MR, Crosson B, DeBoe J, Leber WR (1989) Stroop Neuropsychological Screening Manual. Psychological Assessment Resources Inc., Odessa, FloridaGoogle Scholar
  28. 28.
    World Health Organisation (1978) Mental disorders: glossary and guide to their classification in accordance with the 9th revision of the international classification of diseases. WHO, GenevaGoogle Scholar
  29. 29.
    Wrightson P, Gronwall D (1981) Time off work and symptoms after minor head injury. Injury 12: 445–454Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • N. S. King
    • 1
  • S. Crawford
    • 1
  • F. J. Wenden
    • 1
  • N. E. G. Moss
    • 1
  • D. T. Wade
    • 1
  1. 1.Rivermead Rehabilitation CentreOxford Head Injury ServiceOxfordUK

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