A New Addition to the Concussion Toolkit?: Examining the Incremental Validity of the Vestibular/Ocular Motor Screening

The Vestibular/Ocular Motor Screening (VOMS) offers a simple, low-cost measure of vestibular and ocular motor functions following a concussion but little is known about its incremental validity above and beyond traditional neurocognitive screening measures in predicting concussion symptom severity. Method: 159 concussed youth participants completed the VOMS, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), and the post-concussion symptom scale (PCSS). Results: Patients with higher symptom rating scores on the VOMS vestibular ocular reflex (VOR) and visual motor sensitivity (VMST) domains, respectively, reported higher concussion symptom severity, both at medium effect sizes (rs range .30-.33). In a multiple hierarchical regression, the VOMS primary scores uniquely contributed to the prediction of concussion symptom severity when controlling for neurocognitive performance (R2 = .09, F [4, 150] = 4.30, p = .003.) The VOR domain was the only VOMS primary measure that significantly contributed to concussion symptom severity in this multivariable model ( = .22, p = .047). Secondary analyses of VOMS provocation change scores showed a comparable pattern of univariate correlations, but a parallel multiple hierarchical regression showed that the provocation change scores were not associated with concussion symptom severity above and beyond neurocognitive functioning. Conclusions: Findings from this study support the incremental validity of the VOMS primary scores (but not provocation change scores) in relation to concussion symptom severity in concussed youth. The VOMS VOR domain may be a particularly valuable indicator of concussion symptom severity.