VOMS Baseline Versus Postinjury: A Comparison of a Standardized Novel Prototype and a Virtual Reality Application in Sport-Related Concussion.

Abstract

Background: The novel prototype (PRO) or virtual reality (VR) are viable methods of standardization to reduce administration variability during the Vestibular Ocular Motor Screening (VOMS) test. Little is known regarding how sport-related concussion (SRC) responds to VOMS in VR.

Hypothesis: There will be no difference between PRO and VR total symptom provocation change score (TSPCS), individual subtest symptoms, and near point convergence (NPC) distance within the first 72 hours after SRC.

Study design: Cohort study.

Level of evidence: Level 3.

Methods: At baseline, 394 Division I student-athletes (female, 154; average age, 20.8 ± 1.4 years) completed VOMS using PRO, and 511 (female, 223; average age, 20.9 ± 6.6 years) using VR. Within 72 hours of an SRC, 29 participants (female, 18; 20.6 ± 1.4 years) completed VOMS using PRO and 22 (female, 10; 21.1 ± 1.3 years) using VR. Participants reported subjective symptoms of headache, dizziness, nausea, and fogginess before the test began and after each VOMS subtest in VR. Mann-Whitney U tests assessed differences in TSPCS, NPC distance, and subtest symptoms between PRO and VR at baseline and postinjury (PI). Baseline to PI for each modality was also examined.

Results: No significant difference was observed for TSPCS (PRO PI, 10.2 ± 11.3; VR PI, 10.5 ± 12.9; P = 0.51) and NPC distance (PRO PI, 5.30 ± 6.1 cm; VR PI, 2.80 ± 0.51 cm; P = 0.75) for PRO versus VR at PI. This trend continued with all subtests.

Conclusion: In this Division I collegiate population, symptom provocation during the VOMS in VR is not different than with PRO at PI; however, this comparison was underpowered as no a priori sample size calculation was conducted.

Clinical relevance: VR does not provoke additional symptoms PI. VR may be used as a viable method for VOMS test standardization and delivery.