Dizziness Handicap Inventory: self-perception of symptoms at the beginning of rehabilitation in subjects with vestibular deficits
A 10-year descriptive study
Abstract
Objective: To classify self-perceived symptoms as mild, moderate, or severe and to describe the most affected domain of the Dizziness Handicap Inventory (DHI) according to sex, type of vestibular disorder, and age at the beginning of the vestibular rehabilitation (VR) program.
Materials and methods: This is an observational, descriptive, cross-sectional, retrospective study. Subjects, aged over 18 years, with vestibular deficits who attended the initial interview of a VR program at a physical therapy office in the Autonomous City of Buenos Aires between 2011 and 2021 were included. Variables were grouped into primary (self-perception of disability) and secondary (sex, type of vestibular disorder, and age).
Results: A total of 527 subjects were included. Of them, 45% had mild symptoms; 38%, moderate; and 16%, severe. The youngest subjects reported moderate symptoms, whereas the rest of the group reported mild symptoms. Women showed higher self-perception of symptoms. Subjects with peripheral vestibular syndromes obtained lower DHI scores.
Conclusion: Self-perceived symptoms were moderate to severe in 54% of subjects, and the physical and functional domains were the most affected. This relevant information allows us to set clear objectives to reduce symptoms and resulting disabilities, thus improving the quality of life in subjects with vestibular deficits.
References
Cohen H. Defining disablement in otolaryngology. Ear Nose Throat J. 1995; 74(4):233-237. doi: 10.1177/014556139507400410
Crossref
| Google Scholar
Mira E. Improving the quality of life in patients with vestibular disorders: the role of medical treatments and physical rehabilitation. Int J Clin Pract. 2008; 62 (1): 109 - 114. doi: 10.1111/j.1742-1241.2006.01091.x doi: 10.1111/j.1742-1241.2006.01091.x
Crossref
| Google Scholar
Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol. 2016;137:67-82. doi: 10.1016/B978-0-444-63437-5.00005-4 doi: 10.1016/B978-0-444-63437-5.00005-4
Crossref
| Google Scholar
Jacob RG, Furman JM. Psychiatric consequences of vestibular dysfunction. Curr Opin Neurol. 2001;14(1):41–6. doi: 10.1097/00019052-200102000-00007 doi: 10.1097/00019052-200102000-00007
Crossref
| Google Scholar
Ulrich-Lai YM, Herman JP. Neural regulation of endocrine and autonomic stress responses. Nat Rev Neurosci. 2009; 10(6):397–409. doi:10.1038/nrn2647 doi: 10.1038/nrn2647
Crossref
| Google Scholar
Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1990;116:424-7. doi: 10.1001/archotol.1990.01870040046011 doi: 10.1001/archotol.1990.01870040046011
Crossref
| Google Scholar
Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline. J Neurol Phys Ther. 2016;40(2):124-55. doi: 10.1097/NPT.0000000000000120 doi: 10.1097/NPT.0000000000000120
Crossref
| Google Scholar
Cohen H. Vestibular rehabilitation improves daily life function. Am J Occup The. 1994;48(10): 919-25. doi: 10.5014/ajot.48.10.919 doi: 10.5014/ajot.48.10.919
Crossref
| Google Scholar
Meli A, Zimatore G, Badaracco C, De Angelis E, Tufarelli D. Vestibular rehabilitation and 6-month follow-up using objective and subjective measures. Acta Otolaryngol. 2006; 126(3):259-266. doi: 10.1080/00016480500388885 doi: 10.1080/00016480500388885
Crossref
| Google Scholar
Van De Wyngaerde KM, Lee MK, Jacobson GP, Pasupathy K, Romero-Brufau S, McCaslin DL. The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal. Otol Neurotol. 2019; 40(9):1217-1223. doi: 10.1097/MAO.0000000000002365 doi: 10.1097/MAO.0000000000002365
Crossref
| Google Scholar
Ten Voorde M, van der Zaag-Loonen HJ, van Leeuwen RB. Dizziness impairs health-related quality of life. Qual Life Res. 2012;21:961–966. doi: 10.1007/s11136-011-0001-x doi: 10.1007/s11136-011-0001-x
Crossref
| Google Scholar
Vanspauwen R, Knoop A, Camp S, van Dinther J, Erwin Offeciers F, Somers T, et al. Outcome evaluation of the dizziness handicap inventory in an outpatient vestibular clinic. J Vestib Res. 2016;26(5-6):479-486. doi: 10.3233/VES-160600 doi: 10.3233/VES-160600
Crossref
| Google Scholar
Novoa CI, Donoso TS, Martínez VY, Mercado ZA, Pino UC, Mercado MV. Efectividad de cinco sesiones de rehabilitación vestibular en mujeres mayores de 60 años con hipofunción vestibular. Rev. Otorrinolaringol. Cir. Cabeza Cuello. 2018; 78(3): 259-266. doi: 10.4067/s0717-75262018000300259 doi: 10.4067/s0717-75262018000300259
Crossref
| Google Scholar
Hansson EE, Månsson NO, Håkansson A. Balance performance and self-perceived handicap among dizzy patients in primary health care. Scand J Prim Health Care. 2005;23(4):215-20. doi: 10.1080/02813430500287299 doi: 10.1080/02813430500287299
Crossref
| Google Scholar
Ceballos LR, Vargas AAM. Aplicación y Utilidad del Dizziness Handicap Inventory en pacientes con vértigo del Servicio de Otorrinolaringología del Hospital de Especialidades del Centro Médico Nacional Siglo XXI. An Med Asoc Med Hosp ABC. 2004;49 (4): 176-183.
Valdez MCG, Candoni GJ, Coronel MD, Coronel Tugnoli EY, Fernández CP, Sanchez Correa CM, et al. Tiempo de evolución y riesgo de caídas en sujetos que ingresan a rehabilitación vestibular en un hospital de la Ciudad Autónoma de Buenos Aires. Estudio descriptivo. AJRPT. 2021;3(1):4-12. doi: 10.58172/ajrpt.v3i1.139 doi: 10.58172/ajrpt.v3i1.139
Crossref
| Google Scholar
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Declaración de la Iniciativa STROBE (Strengthening the Reporting of Observational studies in Epidemiology): directrices para la comunicación de estudios observacionales. Gac Sanit. 2008;22(2):144-150. doi: 10.1157/13119325
Crossref
| Google Scholar
Caldara B, Asenzo AI, Brusotti Paglia G, Ferreri E, Gomez RS, Laiz MM, et al. Adaptación cultural y validación del Dizziness Handicap Inventory: versión Argentina. Acta Otorrinolaringol Esp. 2012;63(2):106-114. doi: 10.1016/j.otorri.2011.09.006 doi: 10.1016/j.otorri.2011.09.006
Crossref
| Google Scholar
Whitney SL, Wrisley DM, Brown KE, Furman JM. Is perception of handicap related to functional performance in persons with vestibular dysfunction? Otol Neurotol. 2004;25 (2):139-43. doi: 10.1097/00129492-200403000-00010 doi: 10.1097/00129492-200403000-00010
Crossref
| Google Scholar
Strupp M, Dlugaiczyk J, Ertl-Wagner BB, Rujescu D, Westhofen M, Dieterich M. Vestibular Disorders. Dtsch Arztebl Int. 2020;117(17):300-310. doi: 10.3238/arztebl.2020.0300 doi: 10.3238/arztebl.2020.0300
Crossref
| Google Scholar
Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (MPPP): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208. doi: 10.3233/VES-170622 doi: 10.3233/VES-170622
Crossref
| Google Scholar
Silva AL, De Brito Marcedo Ferreira LM, De Medeiro Freitas RV, Costa de Lima K, Oliveira Guerra R, Oliveira Bezerra de Figueiredo Ribeiro KM. Quality of life in the institutionalized elderly with dizziness complaint: a cross-sectional study. Rev. CEFAC. 2018;20(2):228-237. doi: 10.1590/1982-021620182023017 doi: 10.1590/1982-021620182023017
Crossref
| Google Scholar
Verdecchia DH, Monzón AM, Urbina Jaimes V, da Silva Paiva L, Oliveira FR, de Carvalho TD. Correlation between timed up and go, usual gait speed and dizziness handicap inventory in elderly with vestibular disorders: a retrospective and analytical study. Arch Physiother. 2020;10:12. doi: 10.1186/s40945-020-00083-x doi: 10.1186/s40945-020-00083-x
Crossref
| Google Scholar
Morales-Ayala LL, Cárdenas-Velásquez MI. Evaluación de los pacientes con vértigo mediante el Cuestionario de Discapacidad del Vértigo (DHI). Ar Orl Mex. 2014;59:59-65.
