Vestibular Rehabilitation Benefits Questionnaire

Acronym:

VRBQ

Purpose:

Designed by A. Morris, M. Lutman, and L. Yardley (2009), the Vestibular Rehabilitation Benefit Questionnaire (VBRQ) was designed to assess the outcome of individuals undergoing vestibular rehabilitation.  The prototype questionnaire was developed based on the literature, patient interview and items from other subjective measures of dizziness (DHI, VHQ, DFI, UCLA-DQ, VADL, VSS, and the DBS).  The prototype questionnaire was designed to measure the effect of dizziness on quality of life and included 36 items.  The tool was validated against a set of established questionnaires; the DHI, VSS-sf, and the SF-36.  The tool then was refined down to what is currently known and recognized as the 22- item VRBQ. The VBRQ measures the difference between the individual's current state of symptoms and quality of life as compared to a state that is normal for the individual.  The VBRQ is a concise and psychometrically robust tool that subjectively addresses the primary aspects of dizziness impact on quality of life.   

Description:

The Vestibular Rehabilitation Benefit Questionnaire is a 22-item paper/pencil design subjective questionnaire utilized clinically to assess the outcome of individual's undergoing vestibular rehabilitation programs.  The tool is designed to be a pre and post test measure to determine the effectiveness of physical therapy intervention on an individual's symptoms and the impact of those symptoms on quality of life.  The 22-item questionnaire consists of items falling into three subscale categories: dizziness and anxiety (six items), motion-provoked dizziness (five items), and quality of life (11 items). The score for the entire tool ranges from 0 to 100%; zero percent indicating no deficit and 100% indicating significant deficit as compared to normal state.  Any score above zero percent indicates a presence of symptoms, loss of function or decreased quality of life.  Scoring of the VRBQ requires scoring each item using the scoring template, adding the relevant item scores together to find the subscale scores and then multiplying the raw subscale scores by the value in the % deficit box for each subscale score (see scoring sheet attached to tool).  If however, the quality of life subscale score is less than zero (a negative score), then the score must be raised to zero.  The scoring of the VRBQ requires the use of the scoring template attached to the actual tool itself.  The questionnaire and method of scoring and interpretation can be found at http://ift.tt/1VgEL7L. 

Area of Assessment: Activities of Daily Living, Life Participation, Quality of Life, Social Relationships, Vestibular

Body Part: Head

ICF Domain: Body Function, Activity, Participation

Domain: ADL, Emotion, General Health, Motor, Sensory

Assessment Type: Patient Reported Outcomes

Length of Test: 06 to 30 Minutes

Time to Administer:

20 minutes

Number of Items: 22-item self report questionnaire

Equipment Required:

The questionnaire and scoring template

Training Required:

None

Type of training required: No Training, Reading an Article/Manual

Cost: Free

Actual Cost:

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

Administration Mode: Paper/Pencil

Diagnosis: Vestibular Disorders

Populations Tested:

Adults undergoing vestibular rehabilitation

Standard Error of Measurement (SEM):

Not Established

Minimal Detectable Change (MDC):

Not Established

Minimally Clinically Important Difference (MCID):

Clinically meaningful change Summary scores:

Total = 7%

Quality of life = 9%

Symptoms =  6%

Symptom subscales:

Dizziness = 9%

Anxiety= 5%

Motion-provoked dizziness = 13%

Minimum clinically meaningful change is based on 2SD of the mean score change on repetition over 24 hours (95% confidence)

Cut-Off Scores:

Scores range from 0-100% (zero indicating no impact from dizziness and 100% indicating maximal impact from dizziness)

Normative Data:

Not Established

Test-retest Reliability:

Strong interclass correlations for the VRBQ total (ICC = 0.92); dizziness (ICC = 0.99); anxiety (ICC = 0.99); motion-provoked dizziness (ICC = 0.98); quality of life (ICC = 0.94). 

Interrater/Intrarater Reliability:

Not Established

Internal Consistency:

VRBQ Total Cronbach's α = 0.73; dizziness α = 0.89; anxiety α = 0.74; motion- provoked dizziness α = 0.91 and quality of life α = 0.92

Criterion Validity (Predictive/Concurrent):

Not Established

Construct Validity (Convergent/Discriminant):

The VRBQ total is moderately correlated to the DHI total score (r = 0.44) and to the VSS total score (r = 0.45). Weak correlation to the SF-36 mental and physical subscale scores (r = -0.27) and (r = -0.33) respectively.

Content Validity:

Not Established

Face Validity:

Not Established

Floor/Ceiling Effects:

Not Established

Responsiveness:

The VRBQ shows effect sizes in the range of 0.35-0.67 indicating a moderate effect.

Considerations:

Familiarization with the tool and scoring template prior to use would be beneficial.

Bibliography:

Alghwiri, A. A., Marchetti, G. F., et al. (2011). "Content Comparison of Self-Report Measures Used in Vestibular Rehabilitation Based on the International Classification of Functioning, Disability and Health." Physical Therapy 91(3): 346-357.

Cohen, H. S. (2011). "Assessment of functional outcomes in patients with vestibular disorders after rehabilitation." NeuroRehabilitation 29(2): 173-178. Find it on PubMed

Meldrum, D., Herdman, S., et al. (2012). "Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial." BMC Ear Nose Throat Disord 12(1): 3. Find it on PubMed

Morris, A. E., Lutman, M. E., et al. (2008). "Measuring outcome from Vestibular Rehabilitation, Part I: Qualitative development of a new self-report measure." Int J Audiol 47(4): 169-177. Find it on PubMed

Morris, A. E., Lutman, M. E., et al. (2009). "Measuring outcome from vestibular rehabilitation, part II: refinement and validation of a new self-report measure." Int J Audiol 48(1): 24-37. Find it on PubMed

Year published: 2009

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