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RehabMeasures Instrument

Vestibular Rehabilitation Benefits Questionnaire

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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). T
  • 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.   

Link to Instrument

Acronym VRBQ

Area of Assessment

Activities of Daily Living
Life Participation
Quality of Life
Social Relationships
Vestibular

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Key Descriptions

  • 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:
    1) Dizziness and anxiety (six items)
    2) Motion-provoked dizziness (five items)
    3) Quality of life (11 items)
  • The score for the entire tool ranges from 0 to 100%:
    1) 0 indicates no deficit
    2) 100% indicates 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://www.isvr.soton.ac.uk/audiology/vrbq.htm.

Number of Items

22

Equipment Required

  • Questionnaire / Scoring template

Time to Administer

20 minutes

Required Training

Reading an Article/Manual

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).

Body Part

Head

ICF Domain

Body Function
Activity
Participation

Measurement Domain

Activities of Daily Living
Emotion
General Health
Motor
Sensory

Considerations

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

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Vestibular Disorders

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Minimally Clinically Important Difference (MCID)

Adults undergoing vestibular rehabilitation

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

Adults undergoing vestibular rehabilitation

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

Test/Retest Reliability

Adults undergoing vestibular rehabilitation

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).

Internal Consistency

Adults undergoing vestibular rehabilitation

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

Construct Validity

Adults undergoing vestibular rehabilitation

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.

Responsiveness

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

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. 

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. 

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. 

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.