Development of the vestibular disorders activities of daily living scale

Background: Existing scales of self-perceived disablement in patients with vestibular impairment either are too broad to detect the subtle deficits in this population or omit some important daily life tasks. Objectives: To develop a scale to assess self-perceived disablement in patients with vestibular impairment and to describe the development and initial testing of this new assessment tool. Design: A list of items was developed, sent to a panel of expert therapists for review and then revised to yield the preliminary 31-item, 10-point scale that was administered to subjects. The scale was revised again, yielding the final 28-item scale, which was administered to a new group of subjects. Setting: Data were collected from patients in an outpatient clinic of a tertiary care center. Participants: Patients diagnosed as having benign paroxysmal positional vertigo and patients diagnosed as having chronic vestibulopathy, excluding Meniere disease, postsurgical vertigo, and postconcussion vertigo. Results: The final scale has 3 subscales: functional, ambulation, and instrumental. It has good face validity, high internal consistency (alpha greater than or equal to.90), and high test-retest reliability (r(c)greater than or equal to 0.87). Scale ratings ranged from 1 (independent) to 10 (ceasing to participate in the activity), but median scores for most subjects were 4 or less. From 41% (39/94) to 44% (41/94) of subjects considered themselves to be independent on those tasks. Conclusions: This scale has good face validity, high internal consistency, and high test-retest reliability. It may be useful for evaluating functional limitation and perceived handicap or disability before and after intervention and for helping patients become more realistic in understanding their own capabilities.