Abstract:
Objective: This study aimed to determine the test-retest reliability of the computerized
rotational head impulse test (crHIT) as an additional clinical tool to assess horizontal
semi-circular canal (HSCC) function in the pediatric population.
Methods: To determine the test-retest reliability of the crHIT, the study included 29
normally developing children with a mean age of 12.2 years ± 2.7 (range: 8-17 years)
with no history of vestibular symptoms and disorders. Participants underwent two
crHITs within one session and one crHIT within 4 weeks in the following session. Each
crHIT included two protocols: one using an earth-bound target and the other using a
head-fixed target. The test-retest reliability was determined using a quantitative
research approach with a repeated measures design.
Results: The mean aVOR gains for both stationary and suppression crHIT ranged
from 0.93 – 1.01, with gains being lower for suppression compared to stationary crHIT.
For stationary crHIT the ANOVA regression was not statistically significant for both
leftward (within-session p=0.021 & between-session p=0.015) and rightward (within session p=0.052 & between-session p=0.038) rotations, indicating no linear
relationship between the differences and the averages, revealing a good test-retest
reliability. For the suppression crHIT the regression of the differences was statistically
significant for both leftward (within-session p=0.608 & between-session p=0.318) and
rightward (within-session p=0.631 & between-session p=0.523) rotations. A positive
relationship was observed for within-session and a negative relationship for between session measurements. The suppression crHIT did not yield a good test-retest
reliability, but the differences measured were smaller for between-session compared
to within-session.
Conclusions: The stationary crHIT is a reliable clinical tool in assessing HSCC
functioning in the pediatric population as it demonstrates good test-retest repeatability.
Therefore, extending the pediatric vestibular test battery with crHIT can be a valuable
diagnostic tool without adding to the overall test time. The suppression crHIT does not
present with a good test-retest reliability due to the VOR inhibition reducing the gain
with each impulse. Further research is needed to determine whether the statistically
significant regression is clinically significant.
