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 pati ents 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 sca le 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 ter tiary care center. Participants: Patients diagnosed as having benign paroxysmal positional ver tigo and patients diagnosed as having chronic vestibulopathy, excluding Men iere disease, postsurgical vertigo, and postconcussion vertigo. Results: The final scale has 3 subscales: functional, ambulation, and instr umental. It has good face validity, high internal consistency (alpha greate r 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 themselve s 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 functiona l limitation and perceived handicap or disability before and after interven tion and for helping patients become more realistic in understanding their own capabilities.