Quality of Life after Brain Injury

Last Updated

April 26, 2024

Purpose

The Quality of Life after Brain injury (QOLIBRI) is the first instrument specifically developed to assess health-related quality of life (HRQoL) of individuals after traumatic brain injury (TBI) that includes the person’s perspective on their health condition, functioning and wellbeing. The QOLIBRI comprises 37 items associated with four scales (Cognition, Self, Daily Life and Autonomy, and Social Relationships). Part A comprises items measuring satisfaction with various aspects of HRQoL and Part B measures issues (Feelings and Physical Problems) that individuals feel bothered by after TBI.

Link to Instrument

Instrument Details

Acronym QOLIBRI; QOLIBRI-OS; QOLIBRI-KID/ADO

Area of Assessment

Activities of Daily Living
Cognition
General Health
Insight
Life Participation
Mental Health
Occupational Performance
Patient Satisfaction
Quality of Life
Reasoning/Problem Solving
Self-efficacy
Social Relationships

Administration Mode

Paper & Pencil

Cost

Free

Cost Description

The QOLIBRI questionnaire is free to use for researchers and non-profit organizations. There is a charge for commercial use.

Diagnosis/Conditions

Brain Injury Recovery

Brain Injury

The QOLIBRI is a comprehensive questionnaire with 37 items covering six dimensions of HRQoL after TBI. The instrument consist of six scales. Part 1 assesses “satisfaction” and is composed of 4 subscales: Cognition, Self, Daily life and Autonomy and Social Relationships. Part 2 assesses “feeling bothered” and is composed of 2 subscales: Emotions and Physical Problems.
Responses to the “satisfaction” items (i.e., items on the Cognition, Self, Daily Life & Autonomy, and Social Relationship subscales) are coded on a 1 to 5 scale, where 1 = “Not at all”, and 5 = “Very”. Responses to the “bothered” items (i.e., items on the Emotions and Physical Problem subscales) are reverse scored to correspond with the satisfaction items, where 1 = “Very” and 5 = “Not at all”.
The responses on each scale are summed to give a total, and then divided by the number of responses to give a scale mean. The scale means have a maximum possible range of 1 to 5. The mean can be computed when there are some missing responses but should not be calculated if more than one third of responses on the scale are missing. In a similar manner the QOLIBRI total score is calculated by summing all the responses, and then dividing by the actual number of responses. Again, a total score should not be calculated if more than one third of responses are missing.
The scale means are converted to the 0-100 scale by subtracting 1 from the mean and then multiplying by 25. This produces scale scores which have the lowest possible value of 0 (worst possible quality of life) and a maximum value of 100 (best possible quality of life).
QOLIBRI Overall Scale (QOLIBRI-OS) was developed in 2012. It is a 6-item scale of overall judgment of different aspects of HRQoL (available in online appendix; Von Steinbuechel et al., 2012). Areas covered include physical condition, cognition, emotions, function in daily life, personal and social life, and current situations and future prospects. Responses to each item are coded on a 1 to 5 scale, where 1 = “Not at all”, and 5 = “Very”.
QOLIBRI in children and adolescents (QOLIBRI-KID/ADO) is a TBI-specific HRQoL self-report questionnaire for children and adolescents aged 8-17 years, containing 35 items on six scales (Von Steinbuechel et al., 2023). Satisfaction with cognitive and social functioning, self-concept, and perceived autonomy are assessed using a five-point Likert-type scale, where 1 = “Not at all”, and 5 = “Very”.

Number of Items

QOLIBRI: 37
QOLIBRI-OS: 6
QOLIBRI-KID/ADO: 35

7-10 minutes

Required Training

No Training

Child

8 - 12

years

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Anny de Joya, PT, MS, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 9/2012

Updated 4/26/2024 by Luis Filgueira, MS, OTR/L, LSVT BIG, CNS

ICF Domain

Participation
Body Function

Measurement Domain

Activities of Daily Living
Cognition
Emotion
General Health

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:
HR	Highly Recommend
R	Recommend
LS / UR	Reasonable to use, but limited study in target group / Unable to Recommend
NR	Not Recommended

Recommendations based on level of care in which the assessment is taken:

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

TBI EDGE

Recommendations for use based on ambulatory status after brain injury:

	Completely Independent	Mildly dependant	Moderately Dependant	Severely Dependant
TBI EDGE	N/A	N/A	N/A	N/A

Recommendations for entry-level physical therapy education and use in research:

	Students should learn to administer this tool? (Y/N)	Students should be exposed to tool? (Y/N)	Appropriate for use in intervention research studies? (Y/N)	Is additional research warranted for this tool (Y/N)
TBI EDGE	No	Yes	Yes	Not reported

Considerations

HRQoL construct is usually acquired via self-rating; since it involves intact or partly intact cognitive functioning, in certain cases – such as in persons with severe dementia with a Mini Mental State score below eight or TBI with severely impaired cognition – the measurement needs to be performed by observers (The QOLIBRI Group et. al, 2005a).
Appropriate for most literate people and has been translated for Danish, Dutch, English, Finnish, French, German, Italian, Norwegian, Spanish, Portuguese, Chinese and Swedish. Translations in Arabic, Hebrew, Hungarian, Latvian, Lithuanian, Romanian, Russian, Serbian, and Slovakian are available, and in the process of validation (Von Steinbuechel et. al, 2023).

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Standard Error of Measurement (SEM)

Traumatic Brain Injury (QOLIBRI): (von Steinbuechel et al., 2010; n = 380)

SEM = 5.34

Traumatic Brain Injury (QOLIBRI-OS): (Steinbeuchel et al, 2012; international data set = 9 countries, 6 languages; n = 792; age = 17-30 years: 34%, 31-44 years: 31%, 45-68 years: 35%; gender = 72% male; years since injury = <1 year: 12%, 1-<2 years: 13%, 2-<4 years: 26%, 4-18 years: 50%)

Confirmatory factor analysis demonstrated that a model with one underlying factor had a reasonable fit (comparative fit index =0.98; root mean square error of approximation = 0.07; X^2 = 39.62, df = 9, p(X^2) < 0.001), although, not unexpectedly with a large sample size, the p value of X^2 reached significance

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020; n = 304; Mean Age = 68.7 (11) years. Norwegian and Danish sample)

SEM = 6

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023; n = 302; Mean Age = 12.48 (2.71) years; Children and adolescents’ sample)

SEM for Total Score (n = 302) = 0.68

Minimal Detectable Change (MDC)

Traumatic Brain Injury (QOLIBRI): (von Steinbuechel et al., 2010)

MDC for entire group (n = 380): 14.80

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020)

MDC = 16.63

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023)

MDC for Total Score (n = 302): 1.88

Minimally Clinically Important Difference (MCID)

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020; calculated MCID)

MCID = 12 score units

Cut-Off Scores

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020)

Based on corrected item-total correlations and the cut-off of 10.

Traumatic Brain Injury (QOLIBRI): (Krenz et al., 2023; n = 256; Mean Age = 50.63 (20.75) years; Italian sample)

Based on corrected item-total correlations and the cut-off of 0.40, all items were considered consistent.

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023)

≤ 0.75 indicates acceptable cut-off for the MDC

Normative Data

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020; n = 304; Mean Age = 68.7 (11) years; Norwegian and Danish sample; SSS = Scandinavian Stroke Scale; IQR = interquartile range)

	All patients n = 304	Norwegian patients n =170	Danish patients n = 134	p-value
Total SSS, median IQR, n (%)	49 (12)	47 (11.5)	52 (12)
Very severe SSS, n (%)	3 (1)	1 (0.4)	2 (1.5)	0.08^*
Severe SSS, n (%)	10 (3)	5 (3)	5 (4)
Moderate SSS, n (%)	77 (25)	52 (31)	25 (19)
Mild SSS, n (%)	212 (71)	112 (66)	100 (75)

*Mild SSS compared with moderate, severe, and very severe SSS

Test/Retest Reliability

Traumatic Brain Injury: (Von Steinbuchel et al, 2005; German data set, n = 86; no information on age and gender)

Adequate to excellent test-retest reliability (above 0.73 for all scales)

Traumatic Brain Injury: (Von Steinbuchel et al, 2010; International Data Set = 6 languages; n = 343-381; age = 17-30 years: 34%, 31-44 years: 31%, 45-68 years: 35%; gender: 72% male; years since injury: <1 year: 12%, 1-<2 years: 13%, 2-<4 years: 26%, 4-18 years: 50%)

All participants
- Excellent test-retest reliability, Cognition (ICC = 0.81, n = 380)
- Excellent test-retest reliability, Self (ICC = 0.84, n = 381)
- Excellent test-retest reliability, Daily life and autonomy (ICC = 0.83, n = 379)
- Excellent test-retest reliability, Social relationships (ICC = 0.79, n = 381)
- Excellent test-retest reliability, Emotions (ICC = 0.78, n = 376)
- Excellent test-retest reliability, Physical problems (ICC = 0.84, n = 343)
- Excellent test-retest reliability, QOLIBRI total (ICC = 0.91, n = 380)

Low MMSE/TICS n = 84; High MMSE/TICS n = 121
	Low MMSE/TICS	High MMSE/TICS
Cognition	0.81 (Excellent)	0.80 (Excellent)
Self	0.84 (Excellent)	0.85 (Excellent)
Daily life & autonomy	0.85 (Excellent)	0.82 (Excellent)
Social relationships	0.70 (Adequate)	0.80 (Excellent)
Emotions	0.68 (Adequate)	0.69 (Adequate)
Physical problems	0.80 (Excellent)	0.88 (Excellent)
QOLIBRI total	0.87 (Excellent)	0.90 (Excellent)
MMSE, Mini Mental State Examination; TICS, Telephone Interview for Cognitive Status

	English		Finnish		French		German
	n	ICC	n	ICC	n	ICC	n	ICC
Cognition	56	0.80	48	0.76	130	0.79	119	0.84
Self	56	0.83	49	0.83	128	0.80	119	0.88
Daily Life & Autonomy	56	0.77	49	0.83	128	0.80	119	0.85
Social Relationships	56	0.79	49	0.75	130	0.79	119	0.77
Emotions	54	0.76	49	0.76	128	0.79	118	0.70
Physical Problems	55	0.83	49	0.79	94	0.80	118	0.89
QOLIBRI Total	56	0.88	49	0.87	129	0.91	119	0.90

Traumatic Brain Injury (QOLIBRI-OS): (Von Steinbeuchel et al, 2012; international data set = 9 countries, 6 languages; n = 375; age = 17-30 years: 32%, 31-44 years: 29%, 45-68 years: 39%; gender = 72% male; years since injury = <1 year: 10%, 1-<2 years: 12%, 2-<4 years: 30%, 4-18 years: 48%; test interval: 2 weeks; MMSE, Mini Mental State Examination; TICS, Telephone Interview for Cognitive Status)

Excellent test retest-reliability, total sample (ICC = 0.81)
Excellent test retest-reliability, Dutch version (ICC = 0.81)
Adequate test retest-reliability, English version (ICC = 0.69)
Excellent test retest-reliability, Finnish version (ICC = 0.86)
Excellent test retest-reliability, French version (ICC = 0.75)
Excellent test retest-reliability, German version (ICC = 0.86)
Excellent test retest-reliability, low MME/TICS (ICC = 0.81)
Excellent test retest-reliability, high MMSE/TICS (ICC = 0.82)

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020)

Excellent test-retest reliability at both 3 and 12 months (ICC = 0.92 and 0.93, respectively)

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023)

Poor test-retest reliability for Total Score (ICC = 0.58) and subscales (ICC = 0.42 to 0.64)

Internal Consistency

Traumatic Brain Injury: (Von Steinbuchel et al, 2005; German data set, n = 86; no information on age and gender)

Adequate to Excellent: Cronbach’s alpha for Satisfaction subscales range from 0.75 to 0.95*
‘‘Bothered by’’ items not analyzed

Traumatic Brain Injury: (Von Steinbuchel et al, 2010; International Data Set = 6 languages; n = 795; age = 17-30 years: 34%, 31-44 years: 31%, 45-68 years: 35%; gender: 72% male; years since injury: <1 year: 12%, 1-<2 years: 13%, 2-<4 years: 26%, 4-18 years: 50%)

Cronbach's Alpha	All	Dutch	English	Finnish
Cognition	0.89	0.89	0.92*	0.92*
Self	0.89	0.84	0.90	0.90
Daily Life & Autonomy	0.87	0.82	0.93*	0.88
Social Relationships	0.83	0.74	0.88	0.87
Emotions	0.83	0.64	0.88	0.83
Physical Problems	0.75	0.69	0.80	0.79
QOLIBRI Total	0.95*	0.94*	0.97*	0.95*

Cronbach's Alpha	French	German	Low MMSE/TICS	High MMSE/TICS
Cognition	0.83	0.91*	0.91*	0.91*
Self	0.87	0.91*	0.88	0.89
Daily Life & Autonomy	0.76	0.90	0.88	0.90
Social Relationships	0.77	0.85	0.84	0.83
Emotions	0.79	0.84	0.86	0.76
Physical Problems	0.64	0.83	0.81	0.76
QOLIBRI Total	0.92*	0.96*	0.95*	0.96*
MMSE, Mini Mental State Examination; TICS, Telephone Interview for Cognitive Status

Traumatic Brain Injury (QOLIBRI-OS): (Von Steinbeuchel et al, 2012; international data set = 9 countries, 6 languages; n = 792; age = 17-30 years: 34%, 31-44 years: 31%, 45-68 years: 35%; gender = 72% male; years since injury = <1 year: 12%, 1-<2 years: 13%, 2-<4 years: 26%, 4-18 years: 50%)

Excellent internal consistency, total sample (Cronbach’s alpha = 0.86)
Adequate internal consistency, Dutch version (Cronbach’s alpha = 0.79)
Excellent internal consistency, English version (Cronbach’s alpha = 0.91*)
Excellent internal consistency, Finnish version (Cronbach’s alpha = 0.88)
Excellent internal consistency, French version (Cronbach’s alpha = 0.82)
Excellent internal consistency, German version (Cronbach’s alpha = 0.89)
Excellent internal consistency, Italian version (Cronbach’s alpha = 0.81)
Excellent internal consistency, low MMSE/TICS (Cronbach’s alpha = 0.88)
Excellent internal consistency, high MMSE/TICS (Cronbach’s alpha = 0.87)

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020; n = 304)

Excellent: Cronbach’s alpha = 0.93*

Traumatic Brain Injury (QOLIBRI): (Krenz et al., 2023; n = 256)

Good to Excellent: Cronbach’s alpha range from 0.87 to 0.92 for QOLIBRI domains

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023)

Excellent internal consistency for Total Scale (ICC = 0.89)
Adequate to Excellent internal consistency for subscales (ICC = 0.70 to 0.80)

Construct Validity

Traumatic Brain Injury: (Von Steinbuchel et al, 2005; German data set, n = 86; no information on age and gender)

Convergent correlations with the anxiety scale of the Hospital Anxiety Depression scale (HAD): coefficients between -0.37 and -0.68, and for HAD depression scale coefficients between -0.60 and -0.74

Rasch analysis of individual QOLIBRI scales showed that infit was in the required range for all items in each of the scales
Rasch analysis thus confirms that items have a satisfactory fit with their home scales
Weaker items are ‘‘self-perception,’’ with an infit value of 0.7 suggesting a certain amount of redundancy, and ‘‘run personal finances,’’ with an outfit value of 1.33, which indicates misfitting outliers in the data
Item difficulty measures ranged from -0.47 to 0.61 logits. Principal Components Analysis of the residuals showed that the Rasch model explained 38.2% of the variance, indicating that a unidimensional model explains only a moderate amount of the variance
The infit values indicated that the majority of QOLIBRI items fit an overall Rasch dimension, however, five items with infit values of 1.3 or more: ‘‘partner’’ (infit = 1.41), ‘‘sex life’’ (infit = 1.30), ‘‘other injuries’’ (infit = 1.30), ‘‘pain’’ (infit = 1.31), and ‘‘seeing/hearing’’ (infit = 1.36)
The results of this analysis give moderate support to a unidimensional model, but also indicate that some of the items in the ‘‘Social relationships’’ and ‘‘Physical problems’’ scales have a poor fit with a unidimensional model
Loadings on the first component of a single-factor solution indicate that items in the first three scales generally have a good fit (loadings>0.6) with a unidimensional HRQoL model descriptive system
Items in the last three scales have a weaker fit with this single-factor descriptive system, and two items (‘‘partner’’ and ‘‘see/hear’’) have a poor fit (loading<.45)
The single-factor PCA is consistent with the Rasch analysis conducted on all items combined, and indicates that there is a unidimensional component to the QOLIBRI, primarily based on the items in the first three scales, which are concerned with cognitive function, self-perception, and independent living
The items from the last three scales, with the two exceptions described above, have moderate fit with this descriptive system model

Traumatic Brain Injury: (Von Steinbeuchel et al, 2010; n = 795; mean age = 39 (13.3); mean period follow up = 5 years (3.9))

The SF-36 PCS has its highest correlation with the QOLIBRI Physical Problems scale (.63), Comorbid Health Conditions (.60)
The HADS anxiety scale correlates most strongly with the QOLIBRI Emotions scale (-.64)
HADS depression with the Self scale (-.62)
The SF-36 MCS correlates most highly with the Emotions (.62), and Self (.56) scales
Help needed with activities correlates most highly with the Daily Life (-.53) and Physical Problems (-.47) scales.
Strongest correlations with the GOSE are with Daily Life (.43) and Physical Problems (.40)
Overall relationship between the GOSE and the QOLIBRI was only moderate, indicating that people could have poor outcome on the GOSE and have good HRQoL and vice versa

Rasch analysis: person separation index =2.46 and reliability=0.86, indicating a good ability to sort respondents into different levels of HRQoL
All items correctly ordered category and threshold measures; values of infit and outfit are well within criteria for fit to the Rasch model
Item location measures ranged from -0.56 logits for the ‘Daily life item’ (ie, the easiest to endorse positively) to 0.29 logits for Cognition (ie, the hardest to endorse positively).
The relatively limited range of item locations indicates that distributions of responses to different items were similar
QOLIBRI-OS strongly correlated with QOLIBRI total (Spearman’s correlation = 0.87)
QOLIBRI-OS strongly correlated to all QOLIBRI scales:
- Self scale (Spearman’s correlation = 0.81, p < 0.001)
- Daily Life and Autonomy scale (Spearman's = 0.75, p < 0.001)
- Cognition scale (Spearman’s = 0.74, p < 0.001)
- Social Relationships scale (Spearman’s = 0.63, p < 0.001)
- Physical Problems (Spearman’s = 0.60, p < 0.001)
- Emotions scale (Spearman’s = 0.56 p < 0.001)
All QOLIBRI-OS items showed strong positive correlations with the QOLIBRI total score (Spearman’s = 0.64 -0.70), suggesting that the QOLIBRIOS items contributed equally to assessment of the HRQoL construct
German language sample, n = 153. Moderate to strong relationships were found among the QOLIBRI-OS and the Extended Glasgow Outcome Scale, Short-Form-36, and Hospital Anxiety and Depression scale (Spearman’s = 0.54 to -0.76)

Age	GCS	Time Since Injury	GOSE	SF-36 PCS	SF-36 MCS	HADS Anxiety	HADS Depression
QOLIBRI Total	-0.06	0.08	-0.10	0.58*	0.58*	0.64*	-0.70*	-0.78*
QOLIBRI - OS	-0.06	0.10	-0.08	0.56*	0.53*	0.61*	-0.65*	-0.75*
SWLS	0.08	0.05	-0.03	0.45***	0.38****	0.54*	-0.51****	-0.70*
QOL-VAS	0.07	0.01	0.02	0.32****	0.43*	0.49*	-0.41****	-0.54****

*p<0.001. Steiger’s t test (two-tailed) for a difference with the QOLIBRI-OS correlation: **p<0.05, *** p<0.01. GCS, Glasgow Coma Scale; GOSE, Extended Glasgow Outcome Scale; HADS, Hospital Anxiety and Depression Scale; MCS, Mental Component Score; PCS, Physical Component Score; QOLIBRI-OS, Quality of Life after Brain Injury Overall Scale; QoL-VAS, Quality of Life Visual Analogue Scale; SF-36, Short-Form-36; SWLS, Satisfaction With Life Scale.

Traumatic Brain Injury: (Von Steinbuchel et al, 2005; German data set, n = 86; no information on age and gender)

High subscale intercorrelations (r between .54 and .79 for all subscales)

Convergent validity:

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023)

Excellent convergent validity between Total Score of QOLIBRI-KID/ADO and Total Score of Pediatric Quality of Life Inventory (PedsQL) (r = 0.67)
Excellent convergent validity between Psychosocial Score of QOLIBRI-KID/ADO and Psycho-Social Functioning Score of PedsQL (r = 0.60)
Adequate convergent validity between Social Relationships subscale of QOLIBRI-KID/ADO and Social Scale of PedsQL (r = 0.47)

Discriminant validity:

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023

Adequate discriminant validity between Total Score on QOLIBRI-KID/ADO and Total Score on GAD-7 (Generalized Anxiety Disorder 7) (r = -0.31)*
Adequate discriminant validity between Total Score on QOLIBRI-KID/ADO and Total Score on PHQ-9 (Patient Health Questionnaire 9) (r = -0.36)*

*Negative values indicate lower TBI-specific HRQoL (lower QOLIBRI-KID/ADO scores) associated with symptoms increase.

Content Validity

Traumatic Brain Injury: (Bullinger et al, 2002, Von Steinbuchel et al, 2005 and 2010)

In 1999, the conceptual model for the QOLIBRI was developed on the basis of a TBI literature review and consensus meetings of an international consortium composed of 15 task force members (including neurosurgeons, neurologists, neuropsychologists, psychologists, and other health care professionals working in neuro- rehabilitation)
In 2002, constructed an initial item bank of 148 items, and then reduced the item set through two successive multicenter validation studies
In 2004-2006, the draft instrument was subsequently administered to 1528 persons after TBI across the centers collaborating in the QOLIBRI Task Force; Analysis and reduction of the initial 56 items based on psychometric criteria to a 49-item questionnaire consisting of seven scales
In 2006-2008, second international validation study with 921 participants with TBI

Floor/Ceiling Effects

Traumatic Brain Injury (QOLIBRI): (Krenz et al., 2023; n = 256)

Floor effects were controlled by combining the response categories “Not at all” and “Slightly”, with a cut-off of 10%
Ceiling effects were controlled by choosing a cut-off of 40% for the highest category “Very”

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023; n = 302)

Floor effects were controlled by choosing a cut off of 42% for the lowest category “Mild.”
Ceiling effects were controlled by choosing a cut-off of 96% for the highest category “Moderate-severe”

Responsiveness

Traumatic Brain Injury (QOLIBRI-OS): (Heiberg et al., 2020; n = 304)

Moderate change in Total QOLIBRI-OS scores at 12 months post-stroke for Danish sample (p = 0.02, d = 0.26)
Moderate change between countries at the QOLIBRI-OS item score level for Cognitive Function (d = 0.41), Daily Activity (d = 0.28, and Emotions (d = 0.23)

Traumatic Brain Injury (QOLIBRI-KID/ADO): (von Steinbuechel et al., 2023; n = 302)

Moderate effect size for children vs. adolescents (d = 0.39), male vs. female (d = 0.31), and length of time since TBI (within last four years/more than four years ago) (d = 0.35)

Bibliography

Bullinger, M., et al. (2002). Quality of life in patients with traumatic brain injury-basic issues, assessment and recommendations. Restorative Neurology and Neuroscience 20(3-4): 111.

Bullinger, M., & Steinbuchel, N. (2001). Quality of Life-measurement of outcome. Current Problems In Epilepsy, 16, 277-292.

Hawthorne, G., et al. (2011). Traumatic brain injury and quality of life: Initial Australian validation of the QOLIBRI. Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia 18(2), 197.

Heiberg, G., et al. (2020). Post-stroke health-related quality of life at 3 and 12 months and predictors of change in a Danish and Arctic Norwegian region. Journal of Rehabilitation Medicine, 52. https://doi.org/10.2340/16501977-2716.

Krenz, U., et al. (2023). Reference values of the quality of life after brain injury (QOLIBRI) from a general population sample in Italy. Journal of Clinical Medicine, 12(2), 491. https://doi.org/10.3390/jcm12020491.

von Steinbuechel, N., et al. (2023). Quality of life after brain injury in children and adolescents (QOLIBRI-KID/ADO)--the first disease-specific self-report questionnaire after traumatic brain injury. Journal of Clinical Medicine, 12(15), 4898. https://doi.org/10.3390/jcm12154898.

von Steinbuechel, N., et al. (2012). QOLIBRI overall scale: A brief index of health-related quality of life after traumatic brain injury. Journal of Neurology, Neurosurgery, and Psychiatry, 83(11), 1041-1047. https://doi.org/10.1136/jnnp-2012-302361.

von Steinbüchel, N., et al. (2010). Quality of Life after Brain Injury (QOLIBRI): scale development and metric properties. J Neurotrauma 27(7): 1167-1185.

von Steinbüchel, N., et al. (2010). Quality of Life after Brain Injury (QOLIBRI): scale validity and correlates of quality of life. J Neurotrauma 27(7): 1157-1165.

von Steinbuechel, N., et al. (2005). Assessment of subjective health and health-related quality of life in persons with acquired or degenerative brain injury. Current Opinion in Neurology 18(6): 681-691.

The QOLOBRI Group, et al. (2005a). Assessment of health-related quality of life in persons after traumatic brain injury -- the development of the QOLIBRI, a specific measure. Re-Engineering of the Damaged Brain and Spinal Cord, 93, 43-49. https://doi.org/10.1007/3-211-27577-0.

Wheeler, S., & Acord-Vira, A. (2023). Occupational therapy practice guidelines for adults with traumatic brain injury. The American Journal of Occupational Therapy, 77(4), 7704397010. http://doi.org/10.5014/ajot.2023.077401.

Last Updated

Purpose

Link to Instrument

Area of Assessment

Administration Mode

Cost

Cost Description

Diagnosis/Conditions

Number of Items

Required Training

Instrument Reviewers

ICF Domain

Measurement Domain

Professional Association Recommendation

Considerations

Standard Error of Measurement (SEM)

Minimal Detectable Change (MDC)

Minimally Clinically Important Difference (MCID)

Cut-Off Scores

Normative Data

Test/Retest Reliability

Internal Consistency

Construct Validity

Content Validity

Floor/Ceiling Effects

Responsiveness

Bibliography

NIH Toolbox for Assessment...

Rowland Universal Dementia...

Behavioral Assessment Scre...