{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T01:46:29Z","timestamp":1782524789507,"version":"3.54.5"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The purpose of this study was to establish the psychometric properties of the 9-Item Vestibular Activities Avoidance Instrument (VAAI-9), a patient-reported outcome measure developed to identify fear avoidance beliefs in persons with vestibular disorders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective cohort study included 100 participants 18\u00a0years and older seeking care at a balance disorders clinic for dizziness. Participants completed the VAAI-9, the Dizziness Handicap Inventory (DHI), and other patient-reported outcomes at the initial visit and the 3-month follow-up. To measure test\u2013retest reliability, the VAAI-9 was completed again 5\u00a0days after the initial visit and was analyzed using a 2-way mixed ICC for absolute agreement. Internal consistency was determined using the Cronbach alpha. The Spearman correlation coefficient was used to assess convergent validity of the VAAI-9 with other outcomes. Receiver operating characteristic curves were used to identify baseline VAAI-9 cutoff scores for those who reported mild (DHI\u2009\u2264\u200930) or moderate or severe (DHI\u2009&amp;gt;\u200930) perceived disability at the 3-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean age of the study cohort was 49 (SD\u2009=\u200916) years; 73 (73%) were women. Seventy-one participants completed the 5-day follow-up, and 68 completed the 3-month follow-up. The VAAI-9 demonstrated excellent internal consistency (\u03b1\u2009=\u20090.91) and test\u2013retest reliability (ICC\u2009=\u20090.90). Baseline VAAI-9 scores had moderate to strong associations with other outcome measures at baseline and 3\u00a0months. A baseline VAAI-9 score of 26 or higher had a sensitivity of 80.6% and a specificity of 78.4% for identifying a DHI score of &amp;gt;30 at 3\u00a0months (area under the curve\u2009=\u20090.86).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results provide evidence of excellent reliability and validity for the 9-item VAAI in persons with vestibular disorders. A baseline VAAI-9 score of \u226526 identified individuals at risk of persistent moderate to severe disability due to dizziness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>Initial levels of fear avoidance beliefs measured using the VAAI-9 provided important prognostic information about outcomes for persons with vestibular symptoms.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzad094","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T16:40:03Z","timestamp":1689612003000},"source":"Crossref","is-referenced-by-count":7,"title":["The Psychometric Properties of the 9-Item Vestibular Activities Avoidance Instrument"],"prefix":"10.1093","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-4533","authenticated-orcid":false,"given":"Pamela M","family":"Dunlap","sequence":"first","affiliation":[{"name":"Department of 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