# A FEASIBILITY STUDY OF DIGITAL SELF-REPORT MEASUREMENT FOR BRAIN INJURY PATIENTS UTILIZING AN ADAPTED VERSION OF THE MAYO-PORTLAND ADAPTABILITY INVENTORY – FOURTH EDITION

## TL;DR

This study shows that a digital version of a brain injury assessment tool is reliable and useful for patients with mild cognitive impairments.

## Contribution

The study demonstrates the feasibility of using a digital self-report version of MPAI-4 for patients with brain injuries and neurological disorders.

## Key findings

- The digital version of MPAI-4 showed high test-retest reliability with ICC values ranging from 0.86 to 0.93.
- Significant correlations were found between MPAI-4-S-dig and other clinical measures like MoCA, CIQ-R, and HADS.
- The digital tool was found to be clinically relevant and reliable for patients with mild cognitive impairments.

## Abstract

This study aimed to examine the clinical relevance and usability of the digital self-report version of the Mayo-Portland Adaptability Inventory – fourth edition, MPAI-4 (MPAI-4-S-dig). In its paper version, MPAI-4 is well validated for patients with acquired brain injuries (ABIs) and neurological disorders (NDs), but time consuming. An additional aim was to investigate whether MPAI-4-S-dig is reliable for repeated measurements.

Community neurorehabilitation in Stockholm, Sweden.

MPAI-4-S-dig was administered to 40 patients with ABI or ND 2 weeks apart. Test–retest reliability was assessed using the intraclass correlation coefficient (ICC); clinical relevance of data was assessed through Pearson’s Correlation Coefficient with Montreal Cognitive Assessment (MoCA), the Community Integration Questionnaire – Revised (CIQ-R), and Hospital Anxiety and Depression Scale (HADS).

ICC values ranged from 0.86 to 0.93 for total and subscales. Significant correlations were found between MPAI-4-S-dig participation and CIQ-R Total, social integration and home integration and MoCA naming, MPAI-4-S-dig adjustment and CIQ-R Social integration, MPAI-4-S-dig Total and all subscale scores and HADS Anxiety score, MPAI-4-S-dig Total, abilities and participation and HADS Depression.

The demonstrated reliability and clinical relevance of MPAI-4-S-dig for patients undergoing neurorehabilitation permits the implementation of digital data capture in patients with mild acquired cognitive impairment.

Brain injuries and neurological diseases such as stroke or Parkinson’s disease can cause many problems for those affected. To provide best possible rehabilitation and in order to study the consequences of the aforementioned conditions, self-report scales are commonly used to understand patients’ experiences. The Mayo-Portland Adaptability Inventory – fourth edition (MPAI-4) is an internationally well-established scale that exists in a self-report version. However, rehabilitation of brain injury is not equally available everywhere and internet-based versions must be evaluated so information is not lost on the way. In this study, we examined the measurement properties of a digital version of MPAI-4, MPAI-4-S-dig, and found that it gives reliable measurements over 2 time points. Patient responses were consistent with theoretical assumptions, indicating usefulness in a clinical context. This study demonstrates potential to use internet-based self-rating for persons with mild impaired cognitive functions.