Psychometric Properties of Vestibular and Ocular Measures Used for Concussion Assessments: A Scoping Review.
Keely Barnes, Heidi Sveistrup, Motahareh Karimijashni and 2 others
PMID 39330929WHAT IT FOUND
Vestibular and ocular tests for adult concussion show highly variable accuracy.
The Community Balance and Mobility Scale and Vestibular Ocular Motor Screening appear most promising, while the widely used Balance Error Scoring System has inconsistent results. Many tests lack reliability data, especially for monitoring long-term recovery.
Key findings
01The Community Balance and Mobility Scale and Vestibular Ocular Motor Screening are identified as having positive psychometric properties and clinical relevance, with the CB&M requiring minimal equipment and the VOMS being the superior combined measure.
02The Balance Error Scoring System, the most explored measure, shows wide variability in sensitivity and area under the curve, leading the authors to question its utility beyond the acute phase.
03There is a significant gap in reliability data for ocular measures, with no studies evaluating reliability for common eye tests other than the King-Devick test.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review did not assess the quality of the included studies, so the strength of the evidence for each measure varies. Only English-language studies were included, which may limit generalizability. Most data were derived from sport-related concussions in young men, so findings may not apply to other populations or settings. There is a significant gap in reliability and responsiveness data, meaning the review cannot confirm how well these measures track recovery over time.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not interpret the variability in psychometric properties as evidence that these measures are useless. Instead, understand that the review highlights a lack of standardized, high-quality evidence for many tests, particularly regarding their reliability and ability to monitor long-term recovery. The 'positive' or 'indeterminate' labels in the review reflect the state of the literature, not a definitive clinical verdict on each tool's utility in every patient.