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3) Follow up Post-Injury Evaluation
3.13 Responsiveness of the post-concussion symptoms scale to monitor clinical recovery following concussion
  1. Pierre Langevin1,2,3,
  2. Pierre Frémont1,
  3. Fait Philippe2,3,4,5,
  4. Roy Jean-Sébastien1,2
  1. 1Université Laval, Quebec City, Canada
  2. 2Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), Quebec City, Canada
  3. 3Clinique Cortex and Physio Interactive, Quebec City, Canada
  4. 4Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
  5. 5Research Center in Neuropsychology and Cognition (CERNEC), Quebec City, Canada

Abstract

Objective To evaluate the responsiveness to change and longitudinal validity of the Post-Concussion Symptom Scale (PCSS) in patients with persistent post-concussive symptoms (PCS). Responsiveness of other clinical outcome measures used to monitor clinical recovery was also explored.

Design Prospective cohort clinimetric study.

Setting Online questionnaires were collected by a blinded evaluator, and interventions were performed at an interdisciplinary rehabilitation concussion clinic.

Participants 109 patients with persistent PCS (between 3 and 12 weeks after the injury) were evaluated at baseline and 6 weeks after a rehabilitation program.

Interventions (or Assessment of Risk Factors) A 6-week program including individualized symptom-limited aerobic exercise program combined with education.

Outcome Measures Questionnaires included PCSS, Neck Disability Index (NDI), Headache Disability Inventory (HDI), Dizziness Handicap Inventory (DHI), and neck pain and headache Numerical Pain Rating Scales (NPRS). Internal responsiveness was evaluated using Effect Size (ES) and Standardized Response Mean (SRM). External responsiveness was determined with the Minimal Clinical Important Difference (MCID). Pearson correlations were used to determine the longitudinal validity.

Main Results PCSS is highly responsive (ES and SRM > 1.3) and has a MCID of 26.5/132 for total score and 5.5/22 for number of symptoms. Low to moderate correlations were found between changes in PCSS and changes in NDI, HDI and DHI. NDI, HDI, DHI and NPRS are also highly responsive (ES and SRM > 0.8).

Conclusions All questionnaires including the PCSS are highly responsive and can be used with confidence by clinicians and researchers to evaluate change over time in a concussion population with persistent symptoms.

https://doi.org/10.1136/bjsports-2023-concussion.229

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