Exploring Group Differences Invirtual Reality Voms Assessment In Student-athletes With Sport-related Concussion

The Vestibular/Ocular Motor Screening (VOMS) exam is a crucial tool for assessing sport-related concussion (SRC). Previous studies have established that implementing the VOMS in a virtual reality (VR) setting is a plausible method of administration; however, there is limited research examining sex differences, attention deficit hyperactivity disorder (ADHD), and previous concussion history impacts on VOMS performance in VR. There are known variations in traditional administration methods in these populations, such as higher symptom provocation. PURPOSE: This study examined VOMS change scores in collegiate student-athletes with SRC, analyzing differences across sex, ADHD status, and concussion history. METHODS: 18 NCAA Division I athletes (9 male, 5 ADHD, 10 with SRC history, average age = 19.4 years) with diagnosed SRC were assessed using the VOMS in VR. Student-athletes rated four symptoms (headache, dizziness, nausea, and fogginess) on a Likert scale of 0-10, with 10 indicating maximum severity. The change score (CS) was calculated and represented the total symptom increase after each subtest compared to baseline measurements. The subtests included smooth pursuits, saccades, near-point convergence, vestibular ocular reflex, and visual motion sensitivity. Three Mann-Whitney U tests analyzed group differences across sex, ADHD diagnosis, and concussion history. RESULTS: Total CS during SRC ranged from 0 to 46 across all participants. No significant differences were observed between groups: sex (p = 0.340; males: mean CS = 12.0 ± 13.4, females: mean CS = 16.78 ± 12.9), ADHD status (p = 0.599; ADHD: mean CS = 14.62 ± 9.6, non-ADHD: mean CS = 13.8 ± 14.5), or concussion history (p = 0.961; previous SRC: mean CS = 14.5 ± 10.4, no previous SRC: mean CS = 14.3 ± 16.5). CONCLUSION: This pilot study provides initial evidence that VOMS administration in VR yields consistent results across sex, ADHD status, and concussion history. The VOMS in VR is an acceptable method of administration and can be used in a diverse population. Due to high standard variations, further research is needed with a larger sample size.