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RehabMeasures Instrument

Vestibular Disorders Activities of Daily Living Scale

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Purpose

  • The Vestibular Disorders Activities of Daily Living Scale was developed to assess self-perceived disablement in individuals with vestibular impairment.
  • The scale evaluates the effects of vertigo and balance disorders on independence in everyday activities of daily living.  
  • The tool is designed to be useful for evaluating functional limitation and perceived handicap and disability before and after therapeutic intervention. The tool is also designed to assist individuals in becoming more realistic in the understanding of their own capabilities.
  • The tool was designed to be more directed to specific basic and instrumental activities of daily living. 

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instrument details

Acronym VADL

Area of Assessment

Activities of Daily Living
Functional Mobility
Gait
Life Participation
Self-efficacy
Social Relationships
Social Support
Vestibular

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Vestibular Disorders

Key Descriptions

  • The Vestibular Disorders Activities of Daily Living Scale (VADL) is a 28-item self-report questionnaire that is broken down into 3 subscales:
    1) Functional - evaluates the individual’s perception of basic self-maintenance tasks
    2) Ambulatory - evaluates perception of mobility related skills
    3) Instrumental - evaluates self-perception in higher-level, more socially complex tasks
  • The questionnaire requires individuals to rate their self-perceived disablement level on a scale that ranges from 1 (independent) to 10 (too difficult, no longer performed).

Number of Items

28

Equipment Required

  • The questionnaire

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Reviewed with references for individuals with vestibular disorders by Tracy Rice, PT, MPH, NCS and Jenny Fay, PT, DPT, NCS and the Vestibular EDGE task force of the Neurology Section of the APTA (2013).

ICF Domain

Body Function
Activity
Participation

Measurement Domain

Activities of Daily Living

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)

Vestibular EDGE

LS

 

LS

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

Vestibular 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 VADL Scale has limited psychometric properties research, so this should be considered before use.

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

Vestibular Disorders

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Test/Retest Reliability

Adults complaining of dizziness, vertigo and imbalance (peripheral vestibular disorders, BPPV)

High test-retest reliability after 2 hours utilizing for the concordance correlation coefficient: Total score (rc = 1); functional subscale score (rc = 0.87); ambulation subscale score (rc = 0.95); and instrumental subscale score (rc = 0.97).

Internal Consistency

Adults complaining of dizziness, vertigo and imbalance (peripheral vestibular disorders, BPPV)

High internal consistency for total score (ɑ = 0.97); functional subscale score (ɑ = 0.92); ambulation subscale (ɑ = 0.96); and instrumental subscale (ɑ = 0.91)

Construct Validity

Adults complaining of dizziness, vertigo and imbalance (peripheral vestibular disorders, BPPV)

 

There is moderate correlation between the VADL Scale score and the DHI total score (Spearman p = 0.66, p < 0.001)

Significant difference found between controls and patients (p < 0.0001)

No difference between individuals with BPPV and chronic vestibulopathy

No correlation between VADL scores and vertigo intensity (10-point scale)

Weak correlation between VADL total scores and vertigo frequency (10-point scale): (Spearman’s p p = 0.32, P = 0.04). Weak correlation between VADL instrumental scores to vertigo frequency: (Spearmans p p = 0.42, P = 0.004).

Weak statistically significant relationships found between SOT conditions 5 and 6 and VADL total scores and all subscores and between SOT composite score and total, functional and instrumental scores.

Face Validity

Good face validity as determined by a group of experts

Bibliography

Alghwiri, A. A., Marchetti, G. F., et al. (2011). "Content Comparison of Self-Report Measures Used in Vestibular Rehabilitation Based on the International Classification of Functioning, Disability and Health." Physical Therapy 91(3): 346-357. 

Aratani, M. C., Perracini, M. R., et al. (2010). "Disability rank in vestibular older adults." Geriatrics & gerontology international 11(1): 50-54. 

Cohen, H. S. and Kimball, K. T. "Measurement Tools Analysis: Vestibular Disorders Activities of Daily Living (VADL)." 

Cohen, H. S. and Kimball, K. T. (2000). "Development of the vestibular disorders activities of daily living scale." Arch Otolaryngol Head Neck Surg 126(7): 881-887. Find it on PubMed

Cohen, H. S. and Kimball, K. T. (2002). "Improvements in path integration after vestibular rehabilitation." J Vestib Res 12(1): 47-51. Find it on PubMed

Cohen, H. S. and Kimball, K. T. (2003). "Increased independence and decreased vertigo after vestibular rehabilitation." Otolaryngol Head Neck Surg 128(1): 60-70. Find it on PubMed

Cohen, H. S. and Kimball, K. T. (2004). "Decreased ataxia and improved balance after vestibular rehabilitation." Otolaryngol Head Neck Surg 130(4): 418-425. Find it on PubMed

Cohen, H. S., Kimball, K. T., et al. (2000). "Application of the vestibular disorders activities of daily living scale." Laryngoscope 110(7): 1204-1209. Find it on PubMed

Cohen, H. S., Wells, J., et al. (2003). "Driving disability and dizziness." J Safety Res 34(4): 361-369. Find it on PubMed

Duracinsky, M., Mosnier, I., et al. (2007). "Literature review of questionnaires assessing vertigo and dizziness, and their impact on patients' quality of life." Value in health 10(4): 273-284. 

Maskell, F., Chiarelli, P., et al. (2006). "Dizziness after traumatic brain injury: overview and measurement in the clinical setting." Brain Inj 20(3): 293-305. Find it on PubMed

Mira, E. (2008). "Improving the quality of life in patients with vestibular disorders: the role of medical treatments and physical rehabilitation." Int J Clin Pract 62(1): 109-114. Find it on PubMed

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