Vestibular and ocular motor dysfunction occurs in an estimated 60%–90% of concussion patients. The Vestibular/Ocular Motor Screening (VOMS) tool is validated for use in concussion patients older than 9 years. The goal of the current study was to adapt the current VOMS tool for a pediatric sample of children aged 5–9 years and establish its clinical utility in this patient population.

In this case-control study, 80 symptomatic concussion patients (n = 33 [41%] female) aged 5–9 years (mean age 7.40 ± 1.09 years) and 40 (n = 18 [45%] female) age- and sex-matched uninjured controls (mean age 7.10 ± 1.26 years) completed the VOMS–Child (VOMS-C), a version of the VOMS adapted for younger patients. Differences in binary "yes" or "no" symptom provocation for headache, dizziness, and nausea/"tummy ache" across the 7 items of the VOMS-C, and near point of convergence (NPC) distance, were examined. Logistic regression (LR) models were built to classify concussion and controls. Predicted probabilities were generated from the LR model and entered into receiver operating characteristic (ROC) curve models to generate area under the curve (AUC) values.

VOMS-C item provocation ranged from 13% to 30% for concussed patients and 3% to 20% for controls. The LR model distinguished concussed participants from controls (R² = 0.39; p < 0.001), with significant predictors being smooth pursuits, family depression history, and NPC distance. The ROC analysis had an AUC of 0.81 (95% CI 0.73–0.89; p < 0.001) in the good range.

Accurate diagnosis of concussion in the clinic setting requires comprehensive evaluation in multiple domains, including detailed clinical interview, neurocognitive testing, and vestibular/ocular motor assessment, regardless of patient age. Our results provide preliminary support for the VOMS-C as a developmentally appropriate tool for concussion management.

估计 60%–90% 的脑震荡患者会出现前庭和眼球运动功能障碍。前庭/眼部运动筛查 (VOMS) 工具经验证可用于 9 岁以上的脑震荡患者。当前研究的目标是针对 5-9 岁儿童的儿科样本调整当前的 VOMS 工具，并确定其在该患者群体中的临床效用。

在这项病例对照研究中，80 名年龄在 5-9 岁（平均年龄 7.40 ± 1.09 岁）的有症状脑震荡患者（n = 33 [41%] 女性）和 40 名（n = 18 [45%] 女性）年龄和性别-匹配的未受伤对照（平均年龄 7.10 ± 1.26 岁）完成了 VOMS-Child (VOMS-C)，这是一种适用于年轻患者的 VOMS 版本。检查了 VOMS-C 的 7 个项目中头痛、头晕和恶心/“肚子痛”的二元“是”或“否”症状激发的差异，以及近会聚点 (NPC) 距离。建立逻辑回归 (LR) 模型来对脑震荡和控制进行分类。预测概率从 LR 模型生成，并输入接受者操作特征 (ROC) 曲线模型以生成曲线下面积 (AUC) 值。

脑震荡患者的 VOMS-C 项目激发范围为 13% 至 30%，对照组为 3% 至 20%。LR 模型将脑震荡参与者与对照组区分开来（R ² = 0.39；p < 0.001），重要的预测因素是平稳的追求、家族抑郁史和 NPC 距离。ROC 分析的 AUC 为 0.81（95% CI 0.73–0.89；p < 0.001），处于良好范围内。

在临床环境中准确诊断脑震荡需要在多个领域进行综合评估，包括详细的临床访谈、神经认知测试和前庭/眼部运动评估，无论患者年龄如何。我们的结果为 VOMS-C 作为脑震荡管理的发展适当工具提供了初步支持。