Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion

Objective To understand the relationship between initial vestibular and ocular motor screening (VOMS) and recovery time, and the utility of VOMS to screen for protracted recovery in youth/adolescent patients with sport-related concussion (SRC).Methods Participants (8–18 years) who were diagnosed wit...

Full description

Saved in:
Bibliographic Details
Main Authors: Gregory Knell, Todd Caze, Scott O Burkhart
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Sport & Exercise Medicine
Online Access:https://bmjopensem.bmj.com/content/7/1/e000970.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850181217441284096
author Gregory Knell
Todd Caze
Scott O Burkhart
author_facet Gregory Knell
Todd Caze
Scott O Burkhart
author_sort Gregory Knell
collection DOAJ
description Objective To understand the relationship between initial vestibular and ocular motor screening (VOMS) and recovery time, and the utility of VOMS to screen for protracted recovery in youth/adolescent patients with sport-related concussion (SRC).Methods Participants (8–18 years) who were diagnosed with an SRC within 7 days of the injury were administered the VOMS test by certified medical personnel. Recovery time (days) and protracted recovery (>30 days) were the primary outcomes. Multivariable regression models were used to evaluate the association between VOMS symptom provocation and (1) recovery time (days) and (2) protracted recovery. Measures of VOMS validity, predictive ability and receiver operator curves were used to assess VOMS as a prognostic tool to accurately classify a normal/protracted recovery.Results After adjustment, any symptom provocation across all VOMS domains was associated (p<0.05) with greater recovery time, except the convergence test (p=0.08) in females. All VOMS test thresholds (≥1 to ≥10) in males and (≥1 to ≥5) in females were associated (p<0.05) with recovery time. However, the VOMS test performed poorly among males (receiver operating characteristic (ROC) area=0.66) and failed among females (ROC area=0.56) as a prognostic tool to identify those that will have a normal/protracted recovery.Conclusion In this sample, overall, the VOMS test was associated with recovery time (days); however, the VOMS was not a valid stand-alone prognostic tool to identify a delayed recovery, but may be useful in combination with other concussion symptomology assessments. Future studies should confirm these findings in larger samples while taking into consideration other comorbid factors that may influence recovery time.
format Article
id doaj-art-5842f6465fa0491a8924d401f416bdbd
institution OA Journals
issn 2055-7647
language English
publishDate 2021-03-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open Sport & Exercise Medicine
spelling doaj-art-5842f6465fa0491a8924d401f416bdbd2025-08-20T02:17:57ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472021-03-017110.1136/bmjsem-2020-000970Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussionGregory Knell0Todd Caze1Scott O Burkhart2Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USAAndrews Institute for Orthopaedics and Sports Medicine, Children`s Health System of Texas, Plano, TX, USAAndrews Institute for Orthopaedics and Sports Medicine, Children`s Health System of Texas, Plano, TX, USAObjective To understand the relationship between initial vestibular and ocular motor screening (VOMS) and recovery time, and the utility of VOMS to screen for protracted recovery in youth/adolescent patients with sport-related concussion (SRC).Methods Participants (8–18 years) who were diagnosed with an SRC within 7 days of the injury were administered the VOMS test by certified medical personnel. Recovery time (days) and protracted recovery (>30 days) were the primary outcomes. Multivariable regression models were used to evaluate the association between VOMS symptom provocation and (1) recovery time (days) and (2) protracted recovery. Measures of VOMS validity, predictive ability and receiver operator curves were used to assess VOMS as a prognostic tool to accurately classify a normal/protracted recovery.Results After adjustment, any symptom provocation across all VOMS domains was associated (p<0.05) with greater recovery time, except the convergence test (p=0.08) in females. All VOMS test thresholds (≥1 to ≥10) in males and (≥1 to ≥5) in females were associated (p<0.05) with recovery time. However, the VOMS test performed poorly among males (receiver operating characteristic (ROC) area=0.66) and failed among females (ROC area=0.56) as a prognostic tool to identify those that will have a normal/protracted recovery.Conclusion In this sample, overall, the VOMS test was associated with recovery time (days); however, the VOMS was not a valid stand-alone prognostic tool to identify a delayed recovery, but may be useful in combination with other concussion symptomology assessments. Future studies should confirm these findings in larger samples while taking into consideration other comorbid factors that may influence recovery time.https://bmjopensem.bmj.com/content/7/1/e000970.full
spellingShingle Gregory Knell
Todd Caze
Scott O Burkhart
Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
BMJ Open Sport & Exercise Medicine
title Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
title_full Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
title_fullStr Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
title_full_unstemmed Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
title_short Evaluation of the vestibular and ocular motor screening (VOMS) as a prognostic tool for protracted recovery following paediatric sports-related concussion
title_sort evaluation of the vestibular and ocular motor screening voms as a prognostic tool for protracted recovery following paediatric sports related concussion
url https://bmjopensem.bmj.com/content/7/1/e000970.full
work_keys_str_mv AT gregoryknell evaluationofthevestibularandocularmotorscreeningvomsasaprognostictoolforprotractedrecoveryfollowingpaediatricsportsrelatedconcussion
AT toddcaze evaluationofthevestibularandocularmotorscreeningvomsasaprognostictoolforprotractedrecoveryfollowingpaediatricsportsrelatedconcussion
AT scottoburkhart evaluationofthevestibularandocularmotorscreeningvomsasaprognostictoolforprotractedrecoveryfollowingpaediatricsportsrelatedconcussion