Authors

  1. Buttner, Fionn BSc
  2. Howell, David R. PhD
  3. Doherty, Cailbhe PhD
  4. Blake, Catherine PhD
  5. Ryan, John MBBS, FRCEM, FRCSEd, FFSEM, DCH
  6. Delahunt, Eamonn PhD

Abstract

Objective: To (1) quantify the diagnostic accuracy of the vestibular/oculomotor screening (VOMS), and (2) determine the recovery of vestibular and oculomotor impairments exhibited by concussed athletes compared with nonconcussed athletes using the VOMS.

 

Setting: Clinical assessment laboratory.

 

Participants: Amateur athletes who were diagnosed with sport-related concussion by emergency department physicians, and non-concussed, control athletes.

 

Design: Prospective, longitudinal study.

 

Main Measures: Participants were assessed 1 week following sport-related concussion, upon clearance to return-to-sporting activity, and 2 weeks following return-to-sporting activity by a study investigator who administered the VOMS. We calculated test sensitivity, specificity, and positive and negative predictive values to estimate the diagnostic accuracy of the VOMS. We performed a mixed-design analysis of variance to assess differences in VOMS symptom scores reported by concussed athletes compared with control athletes.

 

Results: Fifty concussion participants and 50 control participants completed the study. The VOMS demonstrated sensitivity and specificity of 96% and 46%, respectively, and produced positive and negative predictive values of 64% and 92%, respectively. The concussion group exhibited a significantly greater symptom provocation change score from baseline than the control group for all test domains of the VOMS only in the first week following concussion.

 

Conclusion: The VOMS may be most useful as a clinical screening tool to rule out, rather than confirm, the presence of sport-related concussion. The VOMS may be appropriate to inform the recovery of vestibular and oculomotor impairments exhibited by concussed individuals over time.