Title of Resource: Rivermead Post-Concussion Symptom Questionnaire (RPQ)

Reference: 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; 242(9):587–92.  

Description: A questionnaire that can be administered to someone who sustains a concussion or other form of traumatic brain injury to measure the severity of symptoms. The RPQ is used to determine the presence and severity of post-concussion syndrome symptoms (i.e., a set of somatic, cognitive, and emotional symptoms).

Resource Criteria:

Population
Traumatic Brain Injury (Mild or Moderate)

Reliability/ Validity
High reliability was found for the total PCS scores for both test-retest (+ 0.91) and inter-rater (+ 0.87) experimental conditions.¹

Factor analysis supports the existence of separate cognitive, emotional and somatic factors, although there was a high degree of co-variation between the three factors.²

As currently used, the RPQ does not meet modern psychometric standards. Its 16 items do not tap into the same underlying construct and should not be summated in a single score. When the RPQ is split into two separate scales, the RPQ-13 and the RPQ-3, each set of items forms a unidimensional construct for people with head injury at three months post injury. These scales show good test-retest reliability and adequate external construct validity.³

Proprietary?
Yes (Varied)

Time to Administer
3-5 minutes

Method to Administer
Self-administered or given by an interviewer (in-person or over the phone).

Formal Instructions (Mention if special environment/ equipment is needed)
Asks patients to rate the severity of 16 different symptoms commonly found after a mild traumatic brain injury (MTBI). Patients are asked to rate how severe each of the 16 symptoms has been over the past 24 hours. In each case, the symptom is compared with how severe it was before the injury occurred (premorbid). These symptoms are reported by severity on a scale from 0 to 4: not experienced at all, no more of a problem, mild problem, moderate problem, and severe problem.

Instructional Video Available?
No

Ease of Use (By Patient)
Very Difficult   1     2     3     4     5   Very Easy

Ease of Administration (By Administrator)
Very Difficult   1     2     3     4     5   Very Easy

Other Comments
None

^{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; 242(9):587–92. 
2 Potter S, Leigh E, Wade D, Fleminger S. The Rivermead Post Concussion Symptoms Questionnaire: a confirmatory factor analysis. J Neurol. 2006 Dec;253(12):1603-14. Epub 2006 Oct 24.
3 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.}

Title of Resource: Barrow Neurological Institute (BNI) Fatigue Scale

Reference: Borgaro SR, Gierok S, Caples H, Kwasnica C. Fatigue after brain injury: Initial reliability study of the BNI Fatigue Scale. Brain Injury 2004;18:685–690. 

Description: An 11-item self-report questionnaire designed to assess fatigue in brain injured patients during the early stages of recovery – focuses more on the difficulty of fatigue (e.g., staying alert, maintaining energy). 

Resource Criteria:

Population
Brain injured patients

Reliability/ Validity
Preliminary findings of the BNI Fatigue Scale revealed acceptable 1-day test–re-test reliability on a heterogeneous sample (n=30) of neurologic patients (r=0.96).1 Principle components factor analysis yielded a one-factor solution. Acceptable internal consistency was calculated for the scale items. Overall index of fatigue correlated significantly with the total scale score. 1

In another recent study, mTBI patients had significantly greater total scores on the BNI-FS than the control group (p<0.005, Cohen’s d=0.40). The internal consistency reliability for the BNI-FS, as measured by Cronbach’s alpha, was 0.96 for the mTBI
group and 0.87 for the control group.2 

Proprietary?
No

Time to Administer
< 5 minutes

Method to Administer
Self-administered

Formal Instructions (Mention if special environment/ equipment is needed)
The BNI Fatigue Scale asks patients to describe their level of difficulty on 10 fatigue-related items (e.g. staying awake during the day; staying alert during activities) (see
Appendix). The scale ranges from 0–1 (rarely a problem), 2–3 (occasional problem, but not frequent), 4–5 (frequent problem) and 6–7 (a problem most of the time). A final item (item 11) asks patients more generally to provide an overall rating of their level of fatigue.

Instructional Video Available?
No

Ease of Use (By Patient)
Very Difficult   1     2     3     4     5   Very Easy

Ease of Administration (By Administrator)
Very Difficult   1     2     3     4     5   Very Easy

Other Comments
None

^{1 Borgaro SR, Gierok S, Caples H, Kwasnica C. Fatigue after brain injury: Initial reliability study of the BNI Fatigue Scale. Brain Injury 2004;18:685–690.} 

^{2 Wäljas M, Iverson G, Hartikainen KM, Liimatainen S, Dastidar P, Soimakallio S, et al. Reliability, validity and clinical usefulness of the BNI fatigue scale in mild traumatic brain injury. Brain Injury 2012;26(7–8):972–978.}