Published Date2019-12-12
JournalClinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 2019-12-12 Find other publications in this journal
Author Info
  • Department of Health, Human Performance and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville, AR.
  • Department of Orthopedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Department of Psychology, Saint Joseph's University, Philadelphia, PA.


To compare VOMS item scores between a fixed and randomized administration order in a sample of nonconcussed high school athletes.Post-test only, quasi-experimental design.Local high schools in a mid-west region of the United States.Fifty nonconcussed high school athletes (M = 15.64; SD = 1.12 years) completed the VOMS in a randomized testing order (RANDOM), and 49 (M = 15.64; SD = 1.12 years) completed the VOMS in the fixed testing order (FIXED). The groups were matched on age, sex, learning disorder, attention-deficit/hyperactivity disorder, concussion history, and baseline concussion symptoms.The Vestibular/Ocular Motor Screening (VOMS) tool comprises pretest symptoms, smooth pursuit (SP), horizontal/vertical saccade (HSAC/VSAC), average near-point of convergence (NPC) distance, convergence symptoms, horizontal/vertical vestibular ocular reflex (HVOR/VVOR), and visual motion sensitivity (VMS).Mann-Whitney U tests were performed to examine differences between FIXED and RANDOM groups on VOMS items. RANDOM scores were rearranged in order of administration and combined with the FIXED group scores, and a Freidman test was performed for repeated measures.There were no significant differences between FIXED and RANDOM groups on VOMS pretest symptoms (U = 1171, P = 0.57), SP (U = 1122.5, P = 0.35), HSAC (U = 1128.5, P = 0.44), VSAC (U = 1055.5, P = 0.16), convergence symptoms (U = 1129.0, P = 0.41), average NPC distance (U = 979.0, P = 0.06), HVOR (U = 1085.0, P = 0.25), VVOR (U = 1126.0, P = 0.41), and VMS scores (U = 1101.0, P = 0.32). When VOMS items were rearranged and the sample was combined, there were no differences for repeated measures [χ (6) = 9.92, P = 0.13].There were no significant differences on VOMS items between FIXED and RANDOM groups for repeated measures. The testing order of VOMS items does not affect VOMS scores in nonconcussed high school athletes.