title: A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings.
abstract: BACKGROUND
  Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues.
  
  
  OBJECTIVE
  To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 2.
  
  
  METHODS
  Sixty-four patients, aged 13.9 ± 2.5 years and seen approximately 5.5 ± 4.0 days after a sport-related concussion, and 78 controls were administered the Vestibular/Ocular Motor Screening (VOMS) assessment, which included 5 domains: (1) smooth pursuit, (2) horizontal and vertical saccades, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS). Participants were also administered the Post-Concussion Symptom Scale (PCSS).
  
  
  RESULTS
  Sixty-one percent of patients reported symptom provocation after at least 1 VOMS item. All VOMS items were positively correlated to the PCSS total symptom score. The VOR (odds ratio [OR], 3.89; P < .001) and VMS (OR, 3.37; P < .01) components of the VOMS were most predictive of being in the concussed group. An NPC distance ≥5 cm and any VOMS item symptom score ≥2 resulted in an increase in the probability of correctly identifying concussed patients of 38% and 50%, respectively. Receiver operating characteristic curves supported a model including the VOR, VMS, NPC distance, and ln(age) that resulted in a high predicted probability (area under the curve = 0.89) for identifying concussed patients.
  
  
  CONCLUSIONS
  The VOMS demonstrated internal consistency as well as sensitivity in identifying patients with concussions. The current findings provide preliminary support for the utility of the VOMS as a brief vestibular/ocular motor screen after sport-related concussions. The VOMS may augment current assessment tools and may serve as a single component of a comprehensive approach to the assessment of concussions.
authors.affiliation: Centers for Rehabilitation Services, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Mucha
authors.affiliation: Department of Orthopaedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Collins
authors.affiliation: Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.affiliation: Eye and Ear Institute, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Furman
authors.affiliation: Centers for Rehabilitation Services, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Cara
authors.initials: C
authors.lastname: Troutman-Enseki
authors.affiliation: Department of Orthopaedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: DeWolf
authors.affiliation: Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Marchetti
authors.affiliation: Department of Orthopaedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA akontos@pitt.edu.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009460:Neurologic Examination / Q000379:methods*; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000209:etiology*; D038223:Post-Concussion Syndrome; D012372:ROC Curve; D015837:Vestibular Diseases / Q000175:diagnosis / Q000209:etiology*
keywords: concussion; ocular motor; symptoms; vestibular
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