Vestibular Activities and Participation Measure

Acronym:

VAP

Purpose:

The Vestibular Activities and Participation Measure (VAP) was developed to assess the extent of activity limitations and participation restrictions created by vestibular disorders.  The tool specifically targets areas of activity and participation as outlined by the ICF.  The tool was designed as a disease-specific, self-report measure of activity limitations and participation restrictions for individuals with vestibular impairment that corresponds directly to the ICF.  It was designed to provide clinicians and researchers with an instrument that can be easily used for specific purposes and clearly compared to other instruments.  It can also be used to reflect patients' status.  The VAP can be used for assessment, intervention planning and outcome evaluation in individuals with vestibular disorders.   

Description:

The Vestibular Activities and Participation Measure (VAP) is a 34-item self-report questionnaire that asks the individual to evaluate the effect of dizziness and/or balance problems on their ability to perform activity and participation tasks.  The responses range from none (0 points), moderate (2 points), severe (3 points), unable to do (4 points) to not applicable.  The total score for the VAP is obtained by calculating the average of the item scale values after excluding the "not applicable" items. 

Area of Assessment: Activities of Daily Living, Balance Vestibular, Functional Mobility, Gait, Life Participation, Occupational Performance, Self-Efficacy, Social Relationships, Social Support, Vestibular

Body Part: Not Applicable

ICF Domain: Activity, Participation

Domain: ADL, Cognition, Emotion, Motor

Assessment Type: Patient Reported Outcomes

Length of Test: 06 to 30 Minutes

Time to Administer:

5-10 min

Number of Items: 34-item self report questionnaire

Equipment Required: The questionnaire

Training Required:

None

Type of training required: No Training

Cost: Free

Actual Cost: Difficulty accessing the tool and scoresheet; must access through the original article.  

Age Range: Adult: 18-64 years, Elderly adult: 65+

Administration Mode: Paper/Pencil

Diagnosis: Vestibular Disorders

Populations Tested: Adults complaining of dizziness and imbalance (peripheral vestibular disorders, central vestibular disorders and unspecified dizziness)

Standard Error of Measurement (SEM):

(Algwhiri A A, et al, 2011)

• The standard error of measurement for the VAP = 0.21

Minimal Detectable Change (MDC):

(Algwhiri A A, et al, 2011)

• The MDC₉₅ for the VAP = 0.58, which describes the amount of change in patient status required to exceed chance variation. 

Minimally Clinically Important Difference (MCID):

Not Established

Cut-Off Scores:

Not Established

Normative Data:

Not Established

Test-retest Reliability:

(Algwhiri A A, et al, 2011)

• High test-retest reliability after 2 hours utilizing for the concordance correlation coefficient: Total score (rc = 1); functional subscale score (rc = 0.87); ambulatrion subscale score (rc = 0.95); and instrumental subscale score (rc = 0.97).

Interrater/Intrarater Reliability:

Not Established

Internal Consistency:

(Algwhiri A A, et al, 2011)

• High internal consistency for total score (ɑ = 0.97); functional subscale score (ɑ = 0.92); ambulation subscale (ɑ = 0.96); and instrumental subscale (ɑ = 0.91)

Criterion Validity (Predictive/Concurrent):

(Algwhiri A A, et al, 2011)

• A significant strong correlation (p = 0.70; p < 0.05) between VAP and the World Health Organization Disability Assessment Schedule II (WHODAS II).
• Moderate to strong correlations (p = 0.54-0.74) between VAP total score and the DHI dimensions and total scores. Strong correlation between VAP and DHI total score (p = 0.74).

Construct Validity (Convergent/Discriminant):

Not Established

Content Validity:

(Algwhiri A A, et al, 2011)

• Use of Delphi technique in the development of the VAP contributed to good content validity. 

Face Validity:

(Algwhiri A A, et al, 2011)

• Good face validity as determined by a group of experts and by 39 of the 55 candidate items retrieved from current instruments that have been previously validated in individuals with vestibular disorders.   

Floor/Ceiling Effects:

Not Established

Responsiveness:

Not Established

Considerations:

Newly developed tool with limited research backing to this point, but a very comprehensive initial study.   

Bibliography:

Alghwiri, A. A., Whitney, S. L., et al. (2012). "The development and validation of the vestibular activities and participation measure." Arch Phys Med Rehabil 93(10): 1822-1831. Find it on PubMed

Year published: 2012

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