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Minimal Important Change and Symptom Trajectory of the Japanese Version of Vertigo Symptom Scale-Short Form in
Shogo Fukumoto1, Shota Yoshikawa2, Akiyoshi Matsugi3
1Department of Rehabilitation, Japan Community Healthcare Organization (JCHO) Hoshigaoka Medical Center, Hirakata.
Objectives:
To investigate changes in the Japanese version of the Vertigo Symptom Scale-short form (VSS-sf) scores and to determine the minimal important change (MIC) in participants with subacute infratentorial stroke.
Design:
Multicenter prospective longitudinal study.
Setting:
Inpatient rehabilitation units across 5 neurosurgical hospitals.
Participants:
A total of 74 inpatients with first-ever subacute infratentorial stroke.
Interventions:
Not applicable.
Main Outcome Measures:
The VSS-sf, gaze nystagmus, and nausea were assessed at baseline (within 7d to 3mo after stroke onset), 2 weeks, and 4 weeks. At follow-up assessments, the Global Rating of Change (GRC) scale was used by both the participant and the therapist to rate dizziness improvement at rest and during movement. MIC was estimated using receiver operating characteristic curve analysis based on GRC thresholds.
Results:
VSS-sf scores significantly decreased over time, indicating symptom improvement. The correlation between VSS-sf change scores and GRC met the acceptable threshold at 4 weeks. The MIC was 4.00 points at rest (95% confidence interval, 4.00-6.00; sensitivity=0.56, specificity=0.93, area under the curve=0.73) and 6.00 points during movement (95% confidence interval, 4.00-9.07; sensitivity=0.68, specificity=0.83, area under the curve=0.76).
Conclusions:
To our knowledge, this is the first study to establish the clinical course and MIC of the VSS-sf in patients with subacute infratentorial stroke. The findings demonstrate that vertigo and dizziness improve over 4 weeks. A change of ≥4 points at rest or ≥6 points during movement represents meaningful improvement, providing useful benchmarks for clinical evaluation.
