Comparison Of The Dizziness Handicap Inventory And Vestibular-ocular Motor Screening In Adolescents Following Sport-related Concussion

Abstract

Vestibular symptoms and impairment are common after sport-related concussion (SRC). The Dizziness Handicap Inventory (DHI) and the Vestibular/Ocular-Motor Screening (VOMS) tool both evaluate vestibular symptoms and impairment that may occur following SRC. However, we know little about how these two measures compare and complement each other in adolescents following SRC. PURPOSE: To compare concurrent responses to the DHI and VOMS in adolescents following SRC. METHODS: A total of 55 adolescents (F- 62%, 15.4 ± 1.6 years) within = 12.2 ± 4.4 days of a diagnosed SRC completed the DHI (self-report of impairment in daily activities due to dizziness) and VOMS (self-report of four symptoms following a series of vestibular and oculomotor examinations) during their initial visit at a sports medicine concussion clinic . Spearman correlations were used to evaluate associations among DHI individual item, subscale (physical, emotional, functional), and total scores; and VOMS individual item and total scores. Correlation strength was interpreted per Dancey and Reidey, 2004, and significance was set at p < .05. RESULTS: Several individual DHI items were moderate to strongly associated to individual VOMS items. The DHI item most strongly correlated to VOMS items was “Does looking up increase your problem?” (r = .51-.59, p < .01). Remaining associations among individual items on the DHI and VOMS ranged from r = .29-.52. Total DHI score was strongly correlated with overall VOMS score (r = .63). Ten individual DHI items had no significant correlations to VOMS items or overall score. DHI subscales (physical, emotional, functional) demonstrated weak to strong associations to individual VOMS items, with the strongest correlation between physical subscale and total VOMS score (r = .60) and the weakest correlation between emotional subscale and VOR (r = .34). CONCLUSION: Findings demonstrate good concurrent validity between the VOMS and DHI items and total scores, suggesting both measure similar constructs. However, the DHI subscales focused on impairment in daily activities were only moderately correlated with VOMS, suggesting these subscales measure a different construct. Overall, this study suggests that, although both DHI and VOMS measure vestibular symptoms and impairment, they complement each other in the aspects assessed.