{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:24:36Z","timestamp":1785767076511,"version":"3.56.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional vestibular disorder exacerbated by posture, movement, or visual stimuli. Widely used dizziness questionnaires lack specificity for PPPD symptoms. The Niigata PPPD Questionnaire (NPQ) and its German-translated and revised version (NPQ-R), including two additional subscales, were developed to address this gap. Its internal consistency, convergent validity, and test\u2013retest reliability were found to be satisfactory. The aim of the present study was to examine the NPQ-R\u2019s structure using confirmatory factor analysis (CFA) and Rasch item analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We analysed data from 265 (135 female) patients (50.2\u202f\u00b1\u202f16.8\u202fyears, dizziness duration 46.3\u202f\u00b1\u202f76.6\u202fmonths) who completed the NPQ-R. CFA was conducted using the robust maximum likelihood estimator in R (lavaan), and Rasch item analysis was performed for each subscale separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CFA revealed moderate-to-high covariances between the five latent variables (range: 0.59\u20130.97), with all items except one demonstrating significant standardised loadings. Rasch analysis indicated acceptable item fit for most items. Person separation reliability ranged from 0.63 to 0.75 across subscales. Item 2 (Visual Stimulation) exhibited misfit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The NPQ-R demonstrates promising psychometric properties. While the Rasch analyses support reliability and internal coherence, the CFA results suggest that the overall five-factor model may require refinement. Conceptual clarity and wording of specific items should be re-examined. However, the NPQ-R remains suitable for PPPD assessment and severity determination in clinical and research contexts, while theoretical and empirical refinement of its factor structure is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1797481","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T04:14:28Z","timestamp":1775621668000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Confirmatory factor analysis and Rasch analysis of the German revised version of the Niigata PPPD questionnaire: NPQ-R"],"prefix":"10.3389","volume":"17","author":[{"given":"Eve-Ya\u00ebl","family":"Gerber","sequence":"first","affiliation":[{"name":"Department of Research, Reha Rheinfelden","place":["Rheinfelden, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Hilfiker","sequence":"additional","affiliation":[{"name":"Private Physiotherapy Practice Tschopp & Hilfiker","place":["Brig, Switzerland"]},{"name":"Institute of Higher Education and Research in Healthcare, Lausanne University Hospital","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Wandel","sequence":"additional","affiliation":[{"name":"Institute for Optimisation and Data Analysis, Bern University of Applied Sciences","place":["Burgdorf, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Behrendt","sequence":"additional","affiliation":[{"name":"Department of Research, Reha Rheinfelden","place":["Rheinfelden, Switzerland"]},{"name":"School of Engineering and Computer Science, Bern University of Applied Sciences","place":["Biel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ch\u00e9telat","sequence":"additional","affiliation":[{"name":"Department of Research, Reha Rheinfelden","place":["Rheinfelden, Switzerland"]},{"name":"School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences","place":["Winterthur, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"El Khadlaoui","sequence":"additional","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sch\u00e4dler","sequence":"additional","affiliation":[{"name":"Private Physiotherapy Practice","place":["Sumiswald, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Maywald","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, LMU University Hospital","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zwergal","sequence":"additional","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital","place":["Munich, Germany"]},{"name":"Department of Neurology, LMU University Hospital","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Bonati","sequence":"additional","affiliation":[{"name":"Department of Research, Reha Rheinfelden","place":["Rheinfelden, Switzerland"]},{"name":"Department of Clinical Research, University of Basel","place":["Basel, Switzerland"]},{"name":"Department of Neurology, Stroke Center, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Becker-Bense","sequence":"additional","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital","place":["Munich, Germany"]},{"name":"Department of Neurology, LMU University Hospital","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Schuster-Amft","sequence":"additional","affiliation":[{"name":"Department of Research, Reha Rheinfelden","place":["Rheinfelden, Switzerland"]},{"name":"School of Engineering and Computer Science, Bern University of Applied Sciences","place":["Biel, Switzerland"]},{"name":"Department of Sport, Exercise, and Health, University of Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0142468","DOI":"10.1371\/journal.pone.0142468","article-title":"Persistent postural-perceptual dizziness: a matter of higher, central dysfunction?","volume":"10","author":"Holle","year":"2015","journal-title":"PLoS 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