Development of ICF Core Set-based Instruments – the Vestibular Activities and Participation-extended Questionnaire (VAP-e)

Vertigo and dizziness count among the most frequent complaints in clinical practice. Although the disabling effects of vestibular disorders on participation and quality of life are obvious, the full extent of the burden is still hardly known; in part this is due to a lack of consensus about which assessment instrument to use. Recognising this research gap, an international multidisciplinary working group began a set of projects designed to develop standards for the assessment of functioning for vestibular disease. These projects were carried out under the auspices of the German Center of Vertigo and Balance Disorders at the Ludwig-Maximilians Universität (LMU) München and funded by the German Federal Ministry of Education and Research.

The first project, guided by the ICF Research Branch, was the development of the ICF Core Set for vestibular disease. Since the ICF Core Set itself is not considered an assessment instrument, the research group at LMU set out to harmonise the ICF Core Set categories with items from existing measures to develop an ICF-based instrument. This resulted in the Vestibular Activities and Participation-extended Questionnaire (VAP-e), a three-scale measure which satisfies the requirements of an internationally valid interval scale, namely specific objectivity and thus cross-cultural validity. Employing the ICF Core Set for vestibular disease as a starting point was extremely helpful due to its emphasis on environmental factors in vestibular disease. These environmental factors facilitates the identification of barriers and can be used for diagnostic purposes. Currently, the VAP-e is being used in a number of studies and in clinical routine data collection.

Subsequently, the Bárány Society, an international interdisciplinary society that facilitates contacts between basic scientists and clinicians engaged in vestibular research and facilitates international evidence-based consensus and standardisation based on existing work and in discussion with stakeholders, established a sub-committee to address topics related to “measuring functioning, participation, and quality of life” in vestibular research. The sub-committee work is still ongoing. For more information about the Bárány Society sub-committees see:


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