Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R
BackgroundPersistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, or non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic dis...
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2025-01-01
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| author | Sarah Chételat Sarah Chételat Eve-Yaël Gerber Eve-Yaël Gerber Sarah El Khadlaoui Frank Behrendt Frank Behrendt Michaela Stark Michaela Stark Stefan Schädler Stefan Schädler Maximilian Maywald Lena Fabritius Johannes Gerb Johannes Gerb Denis Grabova Wiebke Trost Andreas Zwergal Andreas Zwergal Ralf Strobl Ralf Strobl Katrin Parmar Katrin Parmar Hans Ulrich Gerth Hans Ulrich Gerth Leo H. Bonati Leo H. Bonati Leo H. Bonati Sandra Becker-Bense Corina Schuster-Amft Corina Schuster-Amft Corina Schuster-Amft |
| author_facet | Sarah Chételat Sarah Chételat Eve-Yaël Gerber Eve-Yaël Gerber Sarah El Khadlaoui Frank Behrendt Frank Behrendt Michaela Stark Michaela Stark Stefan Schädler Stefan Schädler Maximilian Maywald Lena Fabritius Johannes Gerb Johannes Gerb Denis Grabova Wiebke Trost Andreas Zwergal Andreas Zwergal Ralf Strobl Ralf Strobl Katrin Parmar Katrin Parmar Hans Ulrich Gerth Hans Ulrich Gerth Leo H. Bonati Leo H. Bonati Leo H. Bonati Sandra Becker-Bense Corina Schuster-Amft Corina Schuster-Amft Corina Schuster-Amft |
| author_sort | Sarah Chételat |
| collection | DOAJ |
| description | BackgroundPersistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, or non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic diseases. To assess the severity and impact of PPPD, Japanese researchers developed the Niigata PPPD Questionnaire (NPQ). The study's aim was to evaluate the concurrent construct validity and reliability [including test-retest reliability, internal consistency, standard error of measurement (SEM), and minimal detectable change (MDC)] of the German version of the NPQ (12 items) and its revised version, NPQ-R, which contains 19 items addressing additional symptoms and symptom behavior.MethodsThe Swiss Reha Rheinfelden and the German Center for Vertigo and Balance Disorders included 265 PPPD patients (mean age 50.2 ± 16.8 years, disease duration 46.3 ± 76.6 months). Patients completed the NPQ and the NPQ-R (twice), the DHI and potentially related constructs: anxiety (ABC-Scale, VSS), depression (HADS), and general health (SF-36) once. To assess the questionnaires' reliability and validity, several statistical measures were calculated, including Spearman's rank correlation coefficients, Intraclass Correlation Coefficients (ICC2, 1), Cronbach's alpha, SEM, and MDC.ResultsOn average, patients scored 29.9 ± 13.2 for NPQ and 52.3 ± 19.6 for NPQ-R. Correlations between NPQ/NPQ-R and (1) disease-specific questionnaires were rs= 0.712 and rs= 0.752 (DHI), rs=0.426 and rs= 0.0.462 (VSS-V), rs= -0.500 and rs= -0.545 (ABC-Scale), (2) anxiety-specific subscales rs = 0.394 and rs = 0.430 (VSS-A) and rs= 0.354 and rs= 0.430 (HADS-A), (3) depression-related subscales rs=0.438 and rs= 0.487 (HADS-D), and (4) general health rs ranged between rs= -0.216 and −0.578 (all SF-36 subscales). Internal consistency, test-retest reliability, SEM and MDC calculated for NPQ/NPQ-R were α = 0.88/α = 0.91, ICC=0.83 (CI 0.77 to 0.0.87), SEM 5.55/8.37, and MDC 15/23 points.ConclusionThe German versions of NPQ and NPQ-R are valid and reliable patient-reported outcome measures for assessing PPPD, demonstrating satisfactory psychometric measurement properties including convergent construct validity and reliability parameters: internal consistency, test-retest reliability, SEM, and MDC as an evaluative measure. The NPQ-R, with its additional subscales addressing associated symptoms and symptom behavior, represents both the patient and clinician perspective on PPPD-specific problems. Therefore, we recommend utilizing the NPQ-R for a comprehensive assessment of PPPD. |
| format | Article |
| id | doaj-art-685df324e1974e6cade17fe1b506171b |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Neurology |
| spelling | doaj-art-685df324e1974e6cade17fe1b506171b2025-01-27T05:14:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011610.3389/fneur.2025.15175661517566Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-RSarah Chételat0Sarah Chételat1Eve-Yaël Gerber2Eve-Yaël Gerber3Sarah El Khadlaoui4Frank Behrendt5Frank Behrendt6Michaela Stark7Michaela Stark8Stefan Schädler9Stefan Schädler10Maximilian Maywald11Lena Fabritius12Johannes Gerb13Johannes Gerb14Denis Grabova15Wiebke Trost16Andreas Zwergal17Andreas Zwergal18Ralf Strobl19Ralf Strobl20Katrin Parmar21Katrin Parmar22Hans Ulrich Gerth23Hans Ulrich Gerth24Leo H. Bonati25Leo H. Bonati26Leo H. Bonati27Sandra Becker-Bense28Corina Schuster-Amft29Corina Schuster-Amft30Corina Schuster-Amft31School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, SwitzerlandDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandDepartment of Psychology, University of Basel, Basel, SwitzerlandGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandSchool of Engineering and Computer Science, Bern University of Applied Sciences, Biel, SwitzerlandSchool of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, SwitzerlandDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandPhysiotherapie Stefan Schädler, Sumiswald, SwitzerlandDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyDepartment of Neurology, University Hospital, LMU Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyDepartment of Neurology, University Hospital, LMU Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, Munich, GermanyDepartment of Research, Reha Rheinfelden, Rheinfelden, Switzerland0Departments of Head, Spine and Neuromedicine and Biomedical Engineering, Translational Imaging in Neurology (ThINk) Basel, University Hospital Basel and University of Basel, Basel, SwitzerlandDepartment of Research, Reha Rheinfelden, Rheinfelden, Switzerland1Department of Medicine, University Hospital Münster, Münster, GermanyDepartment of Research, Reha Rheinfelden, Rheinfelden, Switzerland2Department of Neurology, Stroke Center, University Hospital Basel, Basel, Switzerland3Department of Clinical Research, University of Basel, Basel, SwitzerlandGerman Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, GermanyDepartment of Research, Reha Rheinfelden, Rheinfelden, SwitzerlandSchool of Engineering and Computer Science, Bern University of Applied Sciences, Biel, Switzerland4Department of Sport, Exercise and Health, University of Basel, Basel, SwitzerlandBackgroundPersistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, or non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic diseases. To assess the severity and impact of PPPD, Japanese researchers developed the Niigata PPPD Questionnaire (NPQ). The study's aim was to evaluate the concurrent construct validity and reliability [including test-retest reliability, internal consistency, standard error of measurement (SEM), and minimal detectable change (MDC)] of the German version of the NPQ (12 items) and its revised version, NPQ-R, which contains 19 items addressing additional symptoms and symptom behavior.MethodsThe Swiss Reha Rheinfelden and the German Center for Vertigo and Balance Disorders included 265 PPPD patients (mean age 50.2 ± 16.8 years, disease duration 46.3 ± 76.6 months). Patients completed the NPQ and the NPQ-R (twice), the DHI and potentially related constructs: anxiety (ABC-Scale, VSS), depression (HADS), and general health (SF-36) once. To assess the questionnaires' reliability and validity, several statistical measures were calculated, including Spearman's rank correlation coefficients, Intraclass Correlation Coefficients (ICC2, 1), Cronbach's alpha, SEM, and MDC.ResultsOn average, patients scored 29.9 ± 13.2 for NPQ and 52.3 ± 19.6 for NPQ-R. Correlations between NPQ/NPQ-R and (1) disease-specific questionnaires were rs= 0.712 and rs= 0.752 (DHI), rs=0.426 and rs= 0.0.462 (VSS-V), rs= -0.500 and rs= -0.545 (ABC-Scale), (2) anxiety-specific subscales rs = 0.394 and rs = 0.430 (VSS-A) and rs= 0.354 and rs= 0.430 (HADS-A), (3) depression-related subscales rs=0.438 and rs= 0.487 (HADS-D), and (4) general health rs ranged between rs= -0.216 and −0.578 (all SF-36 subscales). Internal consistency, test-retest reliability, SEM and MDC calculated for NPQ/NPQ-R were α = 0.88/α = 0.91, ICC=0.83 (CI 0.77 to 0.0.87), SEM 5.55/8.37, and MDC 15/23 points.ConclusionThe German versions of NPQ and NPQ-R are valid and reliable patient-reported outcome measures for assessing PPPD, demonstrating satisfactory psychometric measurement properties including convergent construct validity and reliability parameters: internal consistency, test-retest reliability, SEM, and MDC as an evaluative measure. The NPQ-R, with its additional subscales addressing associated symptoms and symptom behavior, represents both the patient and clinician perspective on PPPD-specific problems. Therefore, we recommend utilizing the NPQ-R for a comprehensive assessment of PPPD.https://www.frontiersin.org/articles/10.3389/fneur.2025.1517566/fullPersistent Postural-Perceptual Dizzinessfunctional dizzinesspatient-reported outcome measureconcurrent construct validitytest-retest reliabilityinternal consistency |
| spellingShingle | Sarah Chételat Sarah Chételat Eve-Yaël Gerber Eve-Yaël Gerber Sarah El Khadlaoui Frank Behrendt Frank Behrendt Michaela Stark Michaela Stark Stefan Schädler Stefan Schädler Maximilian Maywald Lena Fabritius Johannes Gerb Johannes Gerb Denis Grabova Wiebke Trost Andreas Zwergal Andreas Zwergal Ralf Strobl Ralf Strobl Katrin Parmar Katrin Parmar Hans Ulrich Gerth Hans Ulrich Gerth Leo H. Bonati Leo H. Bonati Leo H. Bonati Sandra Becker-Bense Corina Schuster-Amft Corina Schuster-Amft Corina Schuster-Amft Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R Frontiers in Neurology Persistent Postural-Perceptual Dizziness functional dizziness patient-reported outcome measure concurrent construct validity test-retest reliability internal consistency |
| title | Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R |
| title_full | Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R |
| title_fullStr | Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R |
| title_full_unstemmed | Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R |
| title_short | Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R |
| title_sort | convergent construct validity and test retest reliability of both german versions of the original and the revised niigata pppd questionnaire npq and npq r |
| topic | Persistent Postural-Perceptual Dizziness functional dizziness patient-reported outcome measure concurrent construct validity test-retest reliability internal consistency |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1517566/full |
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