Motivations for TBI Rehabilitation Questionnaire

Last Updated

December 07, 2012

Purpose

Likert scale questionnaire developed to assess motivation to participate in post-acute rehabilitation, including factors of denial, anger, apathy, compliance, medical information seeking, and excessive enthusiasm (likely not genuine).

Link to Instrument

Acronym MOT-Q

Cost

Free

Diagnosis/Conditions

Brain Injury Recovery

Brain Injury

31 items in 4 subscales:
1) Lack of denial
2) Interest in rehabilitation
3) Lack of anger
4) Reliance on professional help
Maximum score of 62
Ratings are made based on agreement with statements:
-2 strongly disagree
-1 disagree
0 undecided
1 agree
2 strongly agree
Items are keyed on a scoresheet so that positive numbers represent greater motivation (negative statements reverse scored).
Scoresheet with clear scoring guidance is in the article from Chervinsky and colleagues.

Number of Items

Score Sheet

10 minutes

Required Training

No Training

Instrument Reviewers

Initially reviewed by Karen McCulloch, PT, PhD, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 7/2012

ICF Domain

Body Structure
Body Function

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:

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	No	Yes	Not reported

Considerations

(Chervinsky et al, 1998) Denial of deficits may be the most important component of motivation in TBI patients.
(Saltapidas et al, 2007; n= 70 (38 English speaking background (ESB), 32 culturally and linguistically diverse (CALD); mean age=39.06(14.85); time since TBI= 27 months (range=4-89 months); Australian sample). No significant difference between groups (ESB and CALD) on any rehab motivation variables on the MOT-Q.

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Internal Consistency

Traumatic brain injury: (Chervinsky et al 1998; n=174 military sample with TBI, n=139 moderate to severe injury, n=35 mild injury, all out of PTA)

Excellent internal consistency of total scale alpha=.91, (subscale alphas range = .73-.86)

Acquired Brain Injury: (Bains et al 2007; n=40 individuals with acquired brain injury, n=23 TBI, n=13 CVA, n=4 infectious and anoxic contiditions; mean 13.53 (3.94) months post-injury; mean age=40.55(13.31))

Excellent internal consistency of total scale (alpha=.86)
Excellent internal consistency of subscales except for reliance on professional help (alpha=.64)

Criterion Validity (Predictive/Concurrent)

Traumatic brain injury: (Chervinsky et al, 1998)

Adequate correlation of total MOT-Q score and lack of denial subscale score with MMPI indicators of hypochondriasis, depression, hysteria. Lack of denial subscale score also adequately correlated with MMPI indicators for paranoia, schizophrenia and psychasthenia.

Construct Validity

Traumatic Brain Injury: (Chervinsky et al, 1998)

MOT-Q variables had moderate linear relationships to a combination of MMPI variables based on regression analyses, with greatest magnitude to health concerns content scale, followed by the K, Inhibition of aggression and social alienation scales.

Content Validity

Traumatic brain injury: (Chervinsky et al, 1998)

The researchers began with 40 items based on statements made in rehabilitation by patients that reflect attitudes about rehabilitation. Items reduced to 31 based on items with correlation to total score <.3. Developed subscales based on factor analysis where all items demonstrated single loading on one subscale factor (specifics not reported).

Bibliography

Bains, B., Powell, D. T., et al. (2007). "An exploratory study of mental representations for rehabilitation based upon the Theory of Planned Behaviour." Neuropsychol Rehabil 17(2): 174-191.

Chervinsky, A. B., Ommaya, A. K., et al. (1998). "Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q):: Reliability, Factor Analysis, and Relationship to MMPI-2 Variables." Archives of Clinical Neuropsychology 13(5): 433-446.

Saltapidas, H. and Ponsford, J. (2007). "The influence of cultural background on motivation for and participation in rehabilitation and outcome following traumatic brain injury." J Head Trauma Rehabil 22(2): 132-139.

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