RehabMeasures Instrument
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  2. Vestibular Activities and Participation Measure

Vestibular Activities and Participation Measure

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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.   

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instrument details

Acronym VAP

Area of Assessment

Activities of Daily Living
Balance – Vestibular
Functional Mobility
Gait
Life Participation
Occupational Performance
Self-efficacy
Social Relationships
Social Support
Vestibular

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Populations

Vestibular Disorders

Key Descriptions

  • 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.

Number of Items

34

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Reviewed for individuals with vestibular disorders by Tracy Rice, PT, MPH, NCS and Jenny Fay, PT, DPT, NCS and the Vestibular EDGE task force of the Neurology Section of the APTA (2013).

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Cognition
Emotion
Motor

Considerations

The VAP Measure is a newly developed tool with limited research at this point, but there is a very comprehensive initial study.

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Vestibular Disorders

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Standard Error of Measurement (SEM)

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

(Algwhiri A A, et al, 2011) 

  • The standard error of measurement for the VAP = 0.21

Minimal Detectable Change (MDC)

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

(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.

Test/Retest Reliability

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

(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).

Internal Consistency

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

(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)

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

(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).

Content Validity

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

(Algwhiri A A, et al, 2011) 

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

Face Validity

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

(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.  

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

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