Test-retest reliability of the computerized rotational head impulse test in the pediatric population

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.