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RehabMeasures Instrument

Motion Sensitivity Quotient/Test

Last Updated

Purpose

Clinical test designed to measure motion-provoked dizziness during a series of 16 quick changes to head or body positions. May also be used as a guide for developing an exercise program for patients with motion provoked dizziness.

Acronym MSQ / MST

Area of Assessment

Balance – Vestibular
Functional Mobility
Vestibular

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Brain Injury
  • Vestibular Disorders

Key Descriptions

  • Each subject performs 16 different head and/or body movements and instructed to indicate the onset and offset of any dizziness that occurred in each position.
  • The duration of dizziness, which was recorded with a stopwatch, is assigned the following values:
    1 point for 5s to 10s of dizziness
    2 points for 11s to 30s of dizziness
    3 points for > 30s of dizziness.
  • Subject is also asked to rate the intensity of the dizziness on a scale of 0 to 5 (0 = no symptoms, 5 = severe dizziness).
  • A raw score for each position is calculated by adding duration score to the intensity score.
  • MST quotient equals number of positions that provoked symptoms times the intensity and duration total for all positions divided by 20.48
  • MST quotient of 0 indicates no symptoms; MST quotient of 100 indicates severe unrelenting symptoms in all positions.
  • Improvement is indicated by:
    1) Decreased number of provoking positions
    2) Increased number of reps before symptom occurrence
    3) Decreased intensity of symptoms
    4) Shorter duration of symptoms

Number of Items

16

Equipment Required

  • Score Sheet
  • Pencil
  • Stop Watch
  • Couch

Time to Administer

20-30 minutes

Required Training

Reading an Article/Manual

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Adwaita Subhedar in 10/2012;Updated 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 in 2013.  

Body Part

Head

ICF Domain

Body Structure
Body Function

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:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

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)

VEDGE

LS

 

LS

 

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

VEDGE

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)

VEDGE

No

Yes

Yes

Yes

 

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 (VEDGE) 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:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

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

NR

Not Recommended

 

 

Recommendations based on level of care in which the assessment is taken:

 

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

UR

UR

UR

UR

UR

 

 

Recommendations based on EDSS Classification:

 

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

MS EDGE

UR

UR

UR

NR

 

 

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)

MS EDGE

No

No

No

Yes

 

Considerations

  • This test has good clinical utility for determining positions for motion provoked dizziness however there is limited psychometric data on this measure.  
  • Motion sensitivity quotient though is a valid and reliable scale, is not used widely in assessing motion induced dizziness. 
  • The construct validity, SEM, MDC value, face validity, has not been established. More research has to be done for this scale. 
  • Also, the research conducted on this scale has small sample sizes. Larger sample sizes and more data have to be collected about this scale. 

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Older Adults and Geriatric Care

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Cut-Off Scores

 

Test/Retest Reliability

Community dwelling individuals:

 (Akin et al, 2003; n = 15 participants with motion provoked dizziness; mean age = 65 years; = 10 control group participants)

  • Excellent: (ICC= 0.98 within 90 minutes of each other and ICC = 0.96 within 24 hours of each other )

Interrater/Intrarater Reliability

Community dwelling individuals

(Akin et al, 2003) 

  • Excellent interrater validity (ICC = 0.99)

Criterion Validity (Predictive/Concurrent)

Community dwelling individuals

(Akin et al, 2003)

  • Specificity: 80% 
  • Sensitivity: 100%

Content Validity

Community dwelling individuals

(Akin et al, 2003) 

  • All patients with self reported motion provoked dizziness were symptomatic on the MSQ

Floor/Ceiling Effects

Community dwelling individuals

(Akin et al, 2003) 

  • According to the author, there was greater variability at higher scores (> 10), and a floor effect seen at lower scores of MSQ (< 10)

Vestibular Disorders

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Cut-Off Scores

Raw score: 0-128

Mild = 0-10; Moderate = 11-30; Severe = 31-100

(Sharon and Hullar, 2013)

  • Individuals with vestibular migraine and meniere’s disease scored significantly higher on the MSQ than controls (p < 0.0001) 

 

Individuals with Motion Provoked Dizziness: 

(Shepard et al, 1993)

  • 0-10% = mild motion sensitivity
  • 11-30% = moderate motion sensitivity
  • 31-100% = severe motion sensitivity

Bibliography

Akin, F. W. and Davenport, M. J. (2003). "Validity and reliability of the Motion Sensitivity Test." J Rehabil Res Dev 40(5): 415-421. Find it on PubMed

Clendaniel, R. A. (2010). "The effects of habituation and gaze stability exercises in the treatment of unilateral vestibular hypofunction: a preliminary results." J Neurol Phys Ther 34(2): 111-116. Find it on PubMed

Mruzek, M., Barin, K., et al. (1995). "Effects of vestibular rehabilitation and social reinforcement on recovery following ablative vestibular surgery." Laryngoscope 105(7 Pt 1): 686-692. Find it on PubMed

Norre, M. E. and Beckers, A. M. (1988). "Vestibular habituation training. Specificity of adequate exercise." Arch Otolaryngol Head Neck Surg 114(8): 883-886. Find it on PubMed

Sharon, J. D. and Hullar, T. E. (2013). "Motion sensitivity and caloric responsiveness in vestibular migraine and Meniere's disease." Laryngoscope. Find it on PubMed

Shepard, N. T. and Telian, S. A. (1995). "Programmatic vestibular rehabilitation." Otolaryngol Head Neck Surg 112(1): 173-182. Find it on PubMed

Shepard, N. T., Telian, S. A., et al. (1993). "Vestibular and balance rehabilitation therapy." Ann Otol Rhinol Laryngol 102(3 Pt 1): 198-205. Find it on PubMed

Smith-Wheelock, M., Shepard, N. T., et al. (1991). "Physical therapy program for vestibular rehabilitation." Am J Otol 12(3): 218-225. Find it on PubMed

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