B - 28 Overcoming Access Challenges: Exploring Affordable Options for Pediatric Concussion and Vestibular Dysfunction Diagnosis

Abstract Objective Sport and recreation-related head injuries, numbering 1.3 to 2.2 million annually in the US, lead to vestibular dysfunction in up to 80% of pediatric concussions. While the Gaze Stabilization Test (GST) is widely used for identifying such dysfunction, its cost and requirement for specialized equipment limit its accessibility. This study explored the effectiveness of utilizing the Vestibular/Ocular Motor Screening (VOMS) and the Dizziness Handicap Inventory (DHI) in clinical concussion testing among student athletes as more accessible options. Methods Patients receiving care at a concussion clinic were screened for study inclusion. Patients were included if they received a confirmed diagnosis of concussion, were injured playing a sport, and were seen by the vestibular-trained physical therapist within seven days of their injury. Patients completed the GST, VOMS, and DHI as part of an initial clinical assessment. Sensitivity, specificity, and AUC were analyzed for the VOMS and DHI compared to the GST. Results Thirty-one student-athletes (15.3 ± 1.5 years; 19 male, 12 female) were included. Participants who reported a symptom increase of two or more after completing the VOMS (+2 VOMS) exhibited a sensitivity of 0.879, a specificity of 0.261, and an AUC of 0.586. Specificity increased as symptoms increased (+3 VOMS and + 4 VOMS). In comparison, DHI scores at or above the clinical cut-off yielded a sensitivity of 0.500, a specificity of 0.696, and an AUC of 0.598. Conclusion In the absence of robust assessments such as the GST, utilizing the combination of the VOMS and the DHI may provide important diagnostic insights regarding vestibular dysfunction.