The six-item visual vertigo analogue scale: A modified questionnaire for assessment of visual vertigo

Abstract

Background

Individuals with vestibular disorders often describe symptoms of dizziness, disorientation, and impaired balance induced by visual stimuli, commonly referred to as visual vertigo.

Objective

The purpose of this study was to improve assessment of visually induced symptoms by modifying the original, nine-item Visual Vertigo Analogue Scale (VVAS) to produce a more robust, interpretable, and clinically useful measure of visual vertigo. We also aimed to establish a cut-off score for identifying patients with vestibular disorders and low- versus high-severity visual vertigo.

Methods

Patients with vestibular disorders (n = 199) and controls (n = 107) completed the modified VVAS (mVVAS). Exploratory factor analysis was conducted to develop a shorter scale and internal consistency analyses were performed. A K-means cluster analysis was used to determine a cut-off score for identifying low- and high-severity groups.

Results

A reduced six-item scale (VVAS-6), which included three items from the VVAS and three items from the mVVAS, had excellent internal consistency (Cronbach’s α = 0.93). We identified four concepts within the VVAS-6 (walking with visual stimulation, visual stimulation only, escalator, car). A cut-off score of 37 was able to identify patients with vestibular disorders and high severity of visual vertigo.

Conclusions

The use of a cut-off score of 37 for the VVAS-6 scale resulted in an improvement in correctly identifying patients with vestibular disorders and high severity of visual vertigo from controls.