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RehabMeasures Instrument

Visual Vertigo Analogue Scale

Last Updated

Purpose

The VVAS is a visual analog scale that rates the intensity of visual vertigo in nine challenging situations of visual motions that typically provoke dizziness.

Link to Instrument

Acronym VVAS

Area of Assessment

Activities of Daily Living
Balance – Vestibular
Functional Mobility
Gait
Vestibular

Assessment Type

Patient Reported Outcomes

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Key Descriptions

  • 9 separate visual analogue scales to rate intensity of visual vertigo provoking situation.
  • 0-10 cm line
  • Individual marks a vertical line on a 10 cm line to indicate the amount of dizziness provoked by each of 9 situations.
  • Zero anchor representing no dizziness and 10 anchor representing extreme dizziness or activity avoided due to dizziness.

Number of Items

9

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Jennifer Fay, PT, DPT, NCS and Tracy Rice, PT, MPH, NCS and the Vestibular EDGE task force of the Neurology section of the APTA.

Body Part

Head

ICF Domain

Activity
Participation
Environment

Measurement Domain

Sensory

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

(Vestibular > 6 weeks post)

Vestibular EDGE

LS

LS

LS

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

Vesstibular EDGE

LS

LS

LS

LS

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

Vestibular EDGE

No

Yes

Yes

Yes

Considerations

The measure has good clinical utility. However, there is limited research into the psychometric properties of this tool.

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Vestibular Disorders

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Internal Consistency

102 individuals with vestibulopathy (BPPV without balance impairment, BVH and central origin dizziness excluded)

Excellent Internal Consistency (Cronbach alpha = 0.94)

Construct Validity

102 individuals with vestibulopathy (BPPV without balance impairment, BVH and central origin dizziness excluded)

Excellent predictive validity between VVAS and total DHI (r = 0.67, p < 0.0001) as well as VAS and functional (r = 0.71, p < 0.0001), emotional (r = 0.65, p < 0.0001) and Adequate predictive validity with physical DHI subscale score (r = 0.45, p < 0.0001).

Bibliography

Dannenbaum, E., Chilingaryan, G., et al. (2011). "Visual vertigo analogue scale: an assessment questionnaire for visual vertigo." J Vestib Res 21(3): 153-159. 

Eleftheriadou, A., Skalidi, N., et al. (2012). "Vestibular rehabilitation strategies and factors that affect the outcome." European Archives of Oto-Rhino-Laryngology 269(11): 2309-2316.