Background
Methods
Translation and cross cultural adaptation of the VSS
Participants
Measures
Internal validity determination
Factor analysis
Reliability determination
External validity determination
Discriminant validity
Convergent validity
Results
Participants with vestibular disorder (n=202) | Subgroup for reliability testing (n=40) | Healthy participants (n=52) | ||||
---|---|---|---|---|---|---|
Age in years: mean (SD)
| 50.0 | (13.47) | 50.7 | (13.63) | 46.7 | (13.12) |
Gender: n women/men (% women):
| 124/78 | (61.4) | 23/17 | (57.5) | 28/24 | (53.8) |
Independence or need of support for ADL/household: n (%)
| ||||||
independent | 162 | (80.2) | 33 | (82.5) | 52 | (100.0) |
need of occasional support | 27 | (13.4) | 6 | (15.0) | 0 | |
need of regular weekly or daily support | 13 | (6.4) | 1 | (2.5) | 0 | |
Duration of dizziness: n (%)
| ||||||
dizziness since ≥ 1 month, less than 6 mo | 58 | (28.7) | 8 | (20.0) | ||
dizziness since ≥ 6 mo up to 12 mo | 27 | (13.4) | 7 | (17.5) | ||
dizziness since > 12 mo | 117 | (57.9) | 25 | (62.5) | ||
Diagnosis: n (%)
| ||||||
Unilateral peripheral vestibular disorder:
|
73
|
(36.14)
|
10
| (25.00) | ||
unilat BPPV | 26 | (12.9) | 3 | (7.5) | ||
unilat. Morbus Meniere | 27 | (13.4) | 4 | (10.0) | ||
unilat. neuritis vestibularis | 4 | (2.0) | 2 | (5.0) | ||
others | 16 | (7.9) | 1 | (2.5) | ||
Bilateral peripheral vestibular disorder:
|
17
|
(8.4)
|
4
| (10.0) | ||
bilat. BPPV | 2 | (1.0) | 0 | |||
bilat. M. Meniere | 1 | (.5) | 0 | |||
bilat. neuritis vestibularis | 4 | (2.0) | 3 | (7.5) | ||
others | 10 | (5.0) | 1 | (2.5) | ||
Central vestibular disorder:
|
73
|
(36.1)
|
18
| (45.0) | ||
incomplete central compensation | 7 | (3.5) | 2 | (5.0) | ||
psycho-physical vertigo | 17 | (8.4) | 2 | (5.0) | ||
others (e.g. vest. Migraine) | 49 | (24.3) | 14 | (35.0) | ||
Multifactorial/multisensory vestibular disorder:
|
39
|
(19.3)
|
8
| (20.0) | ||
Self percieved level of disability: n (%)
| ||||||
little | 56 | (27.7) | 7 | (17.5) | ||
moderate | 100 | (49.5) | 23 | (57.5) | ||
severe | 46 | (22.8) | 10 | (25.0) | ||
UCLA 1: frequency of dizziness: n (%)
| ||||||
rarely | 23 | (11.4) | 4 | (10.0) | ||
sometimes | 91 | (45.0) | 19 | (47.5) | ||
approximately half of the time | 39 | (19.3) | 10 | (25.0) | ||
usually | 34 | (16.8) | 4 | (10.0) | ||
always | 15 | (7.4) | 3 | (7.5) | ||
UCLA 2: Intensity of dizziness: n (%)
| ||||||
very mild | 10 | (5.0) | 2 | (5.0) | ||
mild | 23 | (11.4) | 4 | (10.0) | ||
moderate | 78 | (38.6) | 17 | (42.5) | ||
moderately severe | 73 | (36.1) | 13 | (32.5) | ||
severe | 18 | (8.9) | 4 | (10.0) | ||
UCLA 3: dizziness induced limitations in activities or participation: n (%)
| ||||||
no effect at all | 15 | (7.4) | 3 | (7.5) | ||
continuing all activities but allowance for dizziness | 39 | (19.3) | 8 | (20.0) | ||
continuing most of the activities | 79 | (39.1) | 18 | (45.0) | ||
continuing some of the activities | 51 | (25.2) | 9 | (22.5) | ||
unable to continue any of the activities | 18 | (8.9) | 2 | (5.0) |
Translation and pilot testing of the prefinal translation of the VSS-G
Internal validity determination
Principal component analysis
Item | Factor 1 | Factor 2 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
CH
|
Germany
|
Mexic hosp
|
UK hosp.
|
Prim care (UK)
|
Swiss
|
Germany
|
Mexic hosp
|
UK hosp
|
Prim care (UK)
| |
01. Things spinning/moving (V**): | ||||||||||
a. less than 2 min |
0.55
| 0.35 | 0.46*
| 0.34 | 0.24 | 0.02 | 0.13 | −0.07 | 0.21 | −0.06 |
b. 2 to 20 min | 0.27 | 0.08 | 0.12 | 0.13 | 0.14 | 0.47*
|
0.64
|
0.53
|
0.71
| 0.44*
|
c. 20 min to 1 h | 0.17 | 0.08 | −0.03 | −0.02 | 0.13 |
0.60
|
0.65
|
0.54
|
0.83
|
0.74
|
d. several hours | −0.08 | −0.01 | −0.09 | −0.08 | −0.08 |
0.63
|
0.52
|
0.59
|
0.71
|
0.68
|
e. more than 12 h | −0.02 | 0.25 | −0.02 | 0.06 | −0.03 | 0.43*
| 0.06 |
0.51
|
0.52
| 0.36 |
02. Heart/chest pain (A***) |
0.52
|
0.52
|
0.67
|
0.52
|
0.52
| −0.06 | 0.04 | 0.09 | −0.14 | −0.19 |
03. Hot or cold spells (A) |
0.66
|
0.61
|
0.67
|
0.59
|
0.65
| 0.16 | 0.07 | 0.25 | 0.16 | 0.12 |
04. Falling over (V) | 0.40*
| 0.42*
| 0.28 | 0.27 | 0.40*
| 0.24 | 0.20 | 0.44*
| 0.36 | 0.23 |
05. Nausea, feeling sick (V) | 0.47*
|
0.50
|
0.58
| 0.40*
|
0.56
| 0.32 | 0.14 | 0.35 | 0.36 | 0.23 |
06. Muscle tension/sore (A) |
0.63
|
0.68
|
0.81
|
0.67
|
0.57
| 0.08 | 0.14 | 0.01 | 0.01 | 0.18 |
07. Light-headed/giddy (V): | ||||||||||
a. less than 2 min |
0.54
| 0.28 |
0.50
| 0.43*
| 0.28 | 0.05 | 0.17 | −0.07 | 0.11 | −0.06 |
b. 2 to 20 min | 0.40 | 0.18 | 0.30 | 0.17 | 0.11 |
0.60
|
0.65
| 0.46*
|
0.70
|
0.53
|
c. 20 min to 1 h | 0.21 | 0.08 | 0.13 | 0.18 | 0.08 |
0.73
|
0.77
|
0.65
|
0.70
|
0.74
|
d. several hours | 0.11 | 0.10 | 0.08 | 0.04 | 0.12 |
0.70
|
0.56
|
0.71
|
0.73
|
0.69
|
e. more than 12 h | 0.05 | 0.24 | 0.17 | 0.02 | −0.09 | 0.45*
| 0.16 |
0.50
| 0.46*
|
0.55
|
08. Trembling, shivering (A) |
0.56
|
0.63
|
0.67
|
0.56
|
0.53
| 0.15 | 0.08 | 0.27 | 0.02 | 0.16 |
09. Pressure in the ear (A) | 0.41*
|
0.57
|
0.60
| 0.27 | 0.46*
| 0.06 | 0.12 | 0.16 | 0.24 | 0.09 |
10. Heart pounding (A) |
0.54
|
0.59
|
0.58
|
0.66
|
0.64
| 0.10 | −0.12 | 0.23 | 0.02 | 0.09 |
11. Vomiting (V) | 0.22 | 0.15 | 0.30 | 0.01 | 0.26 | 0.12 | 0.22 | 0.28 | 0.32 | 0.38 |
12. Heavy feeling arms/legs (A) |
0.58
|
0.74
|
0.72
|
0.59
|
0.70
| 0.24 | 0.04 | 0.04 | 0.04 | 0.02 |
13. Visual disturbances (A) | 0.42*
|
0.71
|
0.72
|
0.58
|
0.61
| 0.11 | 0.14 | 0.16 | 0.10 | 0.18 |
14. Headache/pressure (A) |
0.57
| 0.48*
|
0.71
|
0.52
|
0.58
| 0.11 | 0.18 | 0.23 | 0.06 | 0.11 |
15. Unable to stand/walk (V) | 0.16 | 0.40*
| 0.38 | 0.27 |
0.54
| 0.42*
| 0.18 | 0.40*
| 0.35 | 0.35 |
16. Breathing difficulties (A) |
0.63
|
0.69
|
0.62
|
0.53
|
0.72
| 0.05 | −0.07 | 0.08 | 0.06 | −0.02 |
17. Loss of concentration (A) |
0.56
|
0.59
|
0.64
|
0.61
|
0.72
| 0.28 | 0.05 | −0.03 | 0.05 | 0.15 |
18. Feeling unsteady (V): | ||||||||||
a. less than 2 min |
0.60
| 0.27 |
0.54
| 0.42 | 0.24 | 0.22 | 0.22 | 0.13 | 0.13 | −0.04 |
b. 2 to 20 min | 0.39 | 0.12 | 0.28 | 0.13 | 0.10 |
0.64
|
0.64
|
0.62
|
0.71
|
0.58
|
c. 20 min to 1 h | 0.28 | 0.02 | 0.17 | 0.06 | 0.13 |
0.75
|
0.76
|
0.66
|
0.74
|
0.77
|
d. several hours | −0.00 | −0.06 | −0.12 | −0.03 | 0.08 |
0.70
|
0.60
|
0.69
|
0.77
|
0.68
|
e. more than 12 h | 0.03 | 0.25 | −0.04 | 0.00 | −0.06 |
0.51
| 0.29 |
0.60
|
0.61
| 0.49*
|
19. Tingling, prickling (A) |
0.55
|
0.60
|
0.75
|
0.59
|
0.63
| −0.00 | 0.05 | 0.00 | −0.02 | 0.06 |
20. Pain in the lower back (A) |
0.59
|
0.56
|
0.71
|
0.56
|
0.66
| −0.04 | −0.07 | −0.08 | −0.20 | −0.09 |
21. Excessive sweating (A) |
0.57
|
0.60
| 0.19 | 0.47 |
0.60
| 0.21 | 0.05 | 0.19 | 0.12 | 0.18 |
22. Feeling faint, black out (A) |
0.51
|
0.61
| 0.02 | 0.45 |
0.60
| 0.19 | 0.12 | 0.26 | 0.30 | 0.06 |
Reliability determination
VSS-G | VSS-VER | VSS-AA | ||
---|---|---|---|---|
Cronbach's α [n = 202]
| .904 | .859 | .864 | |
ICC (CI) [n = 40]
| .926 (.826/.965) | .920 (.854/.957) | .913 (.737/.963) | |
Medians Healthy [n = 52] vs. peripheral vest disorder [n = 90]
|
U
| 326.50 | 43.00 | 1046.50 |
Z
| −8.529* | −9.782* | −5.486 8* | |
Medians Healthy [n = 52] vs. central vest. disorder [n = 73]
|
U
| 153.500 | 22.000 | 467.500 |
Z
| −8.742* | −9.467* | −7.171* | |
Medians Healthy [n = 52] vs. multifactorial disorder [n = 39]
|
U
| 89.50 | 62.00 | 210.00 |
Z
| −7.421* | −7.797* | −6.456* | |
No anxiety [n=166] vs. abnormal anxiety [n = 36]
|
U
| 1776.50 | 2446.00 | 1427.00 |
Z
| −3.811* | −1.706 | −4.912* |
External validity determination
Discriminant validity
Convergent validity
Spearman's Rho n = 202 | VSS-G | VSS-VER | VSS-AA | HADS-A |
---|---|---|---|---|
VSS-VER | .875**
| |||
VSS-AA | .865**
| .549**
| ||
HADS-A | .369**
|
.186
**
|
.452
**
| |
DHI |
.554
**
| .496**
| .464**
| .448**
|
Kendall-Tau n = 202 | VSS-G | VSS-VER | VSS-AA | frequency | intensity | disability |
---|---|---|---|---|---|---|
VSS-VER | .711**
| |||||
VSS-AA | .703**
| .397**
| ||||
frequency (UCLA-DQ1) | .317**
| .262**
| .299**
| |||
intensity (UCLA-DQ2) | .227**
| .275**
| .108*
| .101 | ||
disability | .400**
| .385**
| .321**
| .369**
| .469**
| |
impact on daily activities (UCLA-DQ3) | .281**
| .309**
| .172**
| .133*
| .590**
| .508**
|