Alghwiri AA, Whitney SL, Baker CE, Sparto PJ, Marchetti GF, Rogers JC, Furman JM. The development and validation of the Vestibular Activities and Participation measure.
To develop and validate a new self-report outcome measure named the Vestibular Activities and Participation (VAP) for people with vestibular disorders to examine their activities and participation according to the International Classification of Functioning Disability and Health.
Delphi iterative survey for the development of the VAP and validation study.
Tertiary balance clinic.
A panel of worldwide experts (n=17) in vestibular dysfunction participated in the development of the VAP, and patients (N=58) with vestibular disorders were enrolled in the validation of the VAP.
Main Outcome Measures
For the development of the VAP, an Internet-based survey of 55 activities and participation items was presented to the panel of experts and the percentage agreement per item was calculated. For the validation of the VAP, the VAP was completed twice to examine the test-retest reliability, the World Health Organization Disability Assessment Schedule II (WHODAS II) was used to examine the concurrent validity with the VAP, and the Dizziness Handicap Inventory (DHI) was used to examine the convergent validity of the VAP.
After 2 rounds of the Delphi technique, the VAP was developed. The VAP total score had excellent test-retest reliability (intraclass correlation coefficient=.95; confidence interval=.91–.97) and good to excellent agreement per item indicated by the unweighted kappa (.41–.80) and the weighted kappa (.58–.94). The minimum detectable change at 95% confidence level of the VAP score was .58. The VAP had strong correlation (ρ=.70; P<.05) with the WHODAS II and moderate to strong correlations (ρ=.54–.74) with the DHI subscale and total scores. After adjustment for age, we found sex and self-reported imbalance to be independent explanatory variables of the transformed VAP total score.
The VAP measure was developed to examine the disabling effect of vestibular disorders on people's activities and participation based on a standardized framework (the International Classification of Functioning Disability and Health). The VAP demonstrated excellent reliability and was validated with external instruments in people with vestibular disorders.
List of Abbreviations:DHI (Dizziness Handicap Inventory), GLM (generalized linear model), ICC (intraclass correlation coefficient), ICF (International Classification of Functioning Disability and Health), MDC95 (minimum detectable change at 95% confidence level), NA (not applicable), VAP (Vestibular Activities and Participation), WHODAS II (World Health Organization Disability Assessment Schedule II)
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- International Classification of Functioning, Disability and Health.World Health Organization, Geneva, Switzerland2001
- Improving the quality of life in patients with vestibular disorders: the role of medical treatments and physical rehabilitation.Int J Clin Pract. 2008; 62: 109-114
- Content comparison of self-report measures used in vestibular rehabilitation based on the International Classification of Functioning, Disability and Health.Phys Ther. 2011; 19: 346-357
- An occupational perspective on the concept of participation in the International Classification of Functioning, Disability and Health—some critical remarks.Am J Occup Ther. 2005; 59: 569-576
- The Keele Assessment of Participation: a new instrument to measure participation restriction in population studies: combined qualitative and quantitative examination of its psychometric properties.Qual Life Res. 2005; 14: 1889-1899
- Factors associated with participation restriction in community-dwelling adults aged 50 years and over.Qual Life Res. 2007; 16: 1147-1156
- Development and initial psychometric evaluation of the Participation Measure for Post-Acute Care (PM-PAC).Am J Phys Med Rehabil. 2007; 86: 57-71
- Preliminary results for the PAR-PRO: a measure of home and community participation.Arch Phys Med Rehabil. 2006; 87: 1043-1051
- Development and validation of IMPACT-S, an ICF-based questionnaire to measure activities and participation.J Rehabil Med. 2008; 40: 620-627
- The Participation Scale: measuring a key concept in public health.Disabil Rehabil. 2006; 28: 193-203
- Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0).World Health Organization, Malta2010
- The development of the Dizziness Handicap Inventory.Arch Otolaryngol Head Neck Surg. 1990; 116: 424-427
- Outcome analysis of individualized vestibular rehabilitation protocols.Am J Otol. 2000; 21: 543-551
- Development of the vestibular disorders activities of daily living scale.Arch Otolaryngol Head Neck Surg. 2000; 126: 881-887
- Quantitative evaluation of dizziness characteristics and impact on quality of life.Am J Otol. 1996; 17: 595-602
- Measuring outcome from vestibular rehabilitation, part I: qualitative development of a new self-report measure.Int J Audiol. 2008; 47: 169-177
- Measuring outcome from vestibular rehabilitation, part II: refinement and validation of a new self-report measure.Int J Audiol. 2009; 48: 24-37
- The Activities-specific Balance Confidence (ABC) Scale.J Gerontol A Biol Sci Med Sci. 1995; 50A: M28-M34
- Quantitative analysis of factors contributing to handicap and distress in vertiginous patients: a questionnaire study.Clin Otolaryngol Allied Sci. 1992; 17: 231-236
- Development of a diagnostic protocol for dizziness in elderly patients in general practice: a Delphi procedure.BMC Fam Pract. 2009; 10: 12
- Intraclass correlations: uses in assessing rater reliability.Psychol Bull. 1979; 86: 420-428
- On the methods and theory of reliability.J Nerv Ment Dis. 1976; 163: 307-317
- Measurement reliability.J Am Acad Child Adolesc Psychiatry. 2001; 40: 486-488
- Interpreting change scores of tests and measures used in physical therapy.Phys Ther. 2006; 86: 735-743
- Research guidelines for the Delphi survey technique.J Adv Nurs. 2000; 32: 1008-1015
- The Delphi technique: a critique.J Adv Nurs. 1987; 12: 729-734
- Foundations of clinical research: applications to practice.3rd ed. Prentice-Hall, Upper Saddle River2008
- Measurement validity.J Am Acad Child Adolesc Psychiatry. 2001; 40: 729-731
- The Delphi method?.Nurs Res. 1997; 46: 116-118
- Relationship among balance impairments, functional performance, and disability in people with peripheral vestibular hypofunction.Phys Ther. 2000; 80: 748-758
- Vestibular rehabilitation and 6-month follow-up using objective and subjective measures.Acta Oto-laryngologica. 2006; 126: 259-266
- The effect of age on vestibular rehabilitation outcomes.Laryngoscope. 2002; 112: 1785-1790
- Balance function test correlates of the Dizziness Handicap Inventory.J Am Acad Audiol. 1991; 2: 253-260
- Usefulness of the Dizziness Handicap Inventory in the screening for benign paroxysmal positional vertigo.Otol Neurotol. 2005; 26: 1027-1033
- The Dizziness Handicap Inventory and its relationship with functional balance performance.Otol Neurotol. 2007; 28: 87-93
- Recovery of dynamic visual acuity in bilateral vestibular hypofunction.Arch Otolaryngol Head Neck Surg. 2007; 133: 383-389
- Temporal and spatial characteristics of gait during performance of the Dynamic Gait Index in people with and people without balance or vestibular disorders.Phys Ther. 2008; 88: 640-651
Published online: March 29, 2012
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In-press corrected proof published online on May 11, 2012, at www.archives-pmr.org.
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