Dizziness Handicap Inventory and Visual Vertigo Analog Scale in Vestibular Dysfunction

(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory (DHI) is widely used in the assessment of dizziness-related disability, but its clinical efficacy needs further expansion. The aim of this study was to identify the subscales of DHI that may correlate with some vestibular or nonvestibular dysfunctions. (2) Material and methods: This observational study included 343 dizzy patients with one of the following clinical conditions: Vestibular impairment noncompensated or compensated, central or bilateral, benign paroxysmal positional vertigo (BPPV), migraine and psychogenic dizziness. Principal component analysis was used to examine the factorial structure of the questionnaire. (3) Results: The DHI questionnaire total scoring and its vestibular subscale distinguished between patients with compensated and uncompensated vestibular dysfunction with positive predictive values of 76% and 79%, respectively. The DHI items composing the F3 (positional) subscale revealed the highest scoring in the BPPV group with 75% sensitivity and 92% negative predictive value (NPV) in reference to Dix–Hallpike tests. The DHI total score and the subscales scores correlated with anxiety-depression, and the highest correlation coefficients were calculated for vestibular (F2 0.56) and anxiety (F5 0.51) subscales. (4) Conclusions: Our analysis revealed that the DHI vestibular subscale distinguishes between patients with compensated and uncompensated vestibular dysfunction. The positional subscale showed the highest scoring in the BPPV group with high sensitivity and low specificity of the test. The DHI is highly correlated with patients’ psychological status.

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Differences in Symptoms among Adults with Canal versus Otolith Vestibular Dysfunction: A Preliminary Report

ISRN Rehabilitation ◽

10.1155/2014/629049 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Lisa Farrell ◽

Rose Marie Rine

Keyword(s):

Functional Status ◽

Semicircular Canal ◽

Preliminary Report ◽

Vestibular Function ◽

Vestibular Dysfunction ◽

Dizziness Handicap Inventory ◽

Symptom Index ◽

Qualitative Nature ◽

Vestibular Function Testing ◽

Function Testing

Despite the importance of symptomatology in the diagnosis of vestibular dysfunction, the qualitative nature of the symptoms related to semicircular canal (canal) versus otolith dysfunction is not fully understood. The purpose of this study was to compare symptoms, and their severity, in individuals with canal versus otolith peripheral vestibular dysfunction. A subjective tool, the Descriptive Symptom Index (DSI), was developed to enable categorization of symptoms as rotary, linear, imbalance or falls, and nondistinct. Fourteen adults were recruited and grouped based on vestibular function testing: canal only dysfunction, otolith only dysfunction, or canal and otolith dysfunction. Also, the Dizziness Handicap Inventory (DHI) was used to grade the severity of perceived limitations due to symptoms. The DSI was reliable and differentiated those with canal (rotary symptoms) versus otolith (linear symptoms) dysfunction. Most individuals with otolith only dysfunction did not report rotary symptoms. DHI scores were significantly higher in those with otolith dysfunction, regardless of canal functional status. All who experienced falls had otolith dysfunction and none had canal only dysfunction. Results support the importance of using linear and rotary descriptors of perceived disorientation as part of diagnosing vestibular dysfunction.

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Effect of Intermittent Hypoxia Training for Dizziness: A Randomized Controlled Trial

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0341 ◽

2019 ◽

Vol 28 (6) ◽

pp. 540-543

Author(s):

Xiao Bao ◽

Jie-Wen Tan ◽

Ying Long ◽

Howe Liu ◽

Hui-Yu Liu

Keyword(s):

Visual Analog Scale ◽

Intermittent Hypoxia ◽

Controlled Trial ◽

Control Group ◽

Analog Scale ◽

Dizziness Handicap Inventory ◽

Balance Confidence ◽

Randomized Controlled ◽

Scale Scores ◽

Confidence Scale

Objective: To study the effect of intermittent hypoxia training (IHT) for dizziness. Design: A single-blind, randomized controlled trial. All participants were recruited from a rehabilitation department in an acute university-affiliated hospital. Intervention: Participants with dizziness were randomly assigned to 2 groups (IHT group and control group). The Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, and Vertigo Visual Analog Scale were conducted at baseline, end of the fourth week. Results: Among 52 subjects, there were18 males and 34 females, ages 35 to 62 years old (mean [SD] = 46.9 [7.93]). Time length since onset ranged from 12 to 34 months (20.2 [7.15] mo). Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness were improved after IHT intervention in the end of the fourth week. There were significant differences between the IHT group and the control group in the Dizziness Handicap Inventory, Activities-specific Balance Confidence Scale, Vertigo Visual Analog Scale scores, and attack frequencies of dizziness at the end of the fourth week (P < .05). No adverse events occurred during the study. Conclusion: IHT could improve dizziness after intervention at the end of the fourth week. IHT could be the effective method for treating dizziness.

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Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo

Research in Vestibular Science ◽

10.21790/rvs.2021.20.3.93 ◽

2021 ◽

Vol 20 (3) ◽

pp. 93-100

Author(s):

Jung-Yup Lee ◽

In-Buhm Lee ◽

Min-Beom Kim

Keyword(s):

Sensory Integration ◽

Benign Paroxysmal Positional Vertigo ◽

Semicircular Canals ◽

Clinical Test ◽

Analog Scale ◽

Dizziness Handicap Inventory ◽

Positional Vertigo ◽

Postural Imbalance ◽

Canalith Repositioning Procedure ◽

Paroxysmal Positional Vertigo

Objectives: This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB). Methods: A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS＞0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results. Results: There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (p＜0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation. Conclusions: We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.

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Latent vestibular dysfunction and its effect on quality of life in elderly individuals, the need of active screening and intervention

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20183697 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1258

Author(s):

Himanshu Swami ◽

Aravind B. M.

Keyword(s):

Quality Of Life ◽

Tertiary Care ◽

The Elderly ◽

Vestibular Dysfunction ◽

Care Hospital ◽

Dizziness Handicap Inventory ◽

Post Intervention ◽

Before And After ◽

The Impact

Background: Dizziness is a commonly reported complaint among elderly.. Among the elderly in particular, factors such as Ageing, presbycusis, diabetes, chronic kidney disease, osteopenia, and osteoporosis increase the risk. Dizziness handicap inventory is used to assess the quality of life among the individuals with vestibular dysfunction. This is also used to assess the impact of interventions for vestibular dysfunction. This study aims to estimate the prevalence of latent vestibular dysfunction among the Indian population, and the impact of interventions among the same.Methods: A prospective observational study was conducted at a tertiary care hospital. As per sample size estimates, 200 participants aged >60 years without previous diagnosis of vestibular dysfunction were screened using appropriate tests. The quality of life of the affected individuals were assessed using Dizziness Handicap Inventory Score (DHIS) before and after intervention. Results: The prevalence of latent vestibular dysfunction was found to be 23.5%. Most of them reported having moderate handicap due to the condition. Following intervention, those with moderate handicap either became normal (47.8%) or had residual mild handicap (52.2%). The mean DHIS score significantly decreased from 40.91 points during pre-intervention to 16.12 points post-intervention.Conclusions: Around one-fourth of the Indian elderly is found to have latent vestibular dysfunction. It has a major impact on the individual’s quality of life. Yet, screening and intervention is found to make a considerable improvement among the affected individuals.

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Effect of vestibular exercise and optokinetic stimulation using virtual reality in persistent postural-perceptual dizziness

Scientific Reports ◽

10.1038/s41598-021-93940-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seo-Young Choi ◽

Jae-Hwan Choi ◽

Eun Hye Oh ◽

Se-Joon Oh ◽

Kwang-Dong Choi

Keyword(s):

Virtual Reality ◽

Daily Living ◽

Analogue Scale ◽

Optokinetic Stimulation ◽

Virtual Reality System ◽

Head Mount Display ◽

Dizziness Handicap Inventory ◽

Gait Function ◽

Visual Vertigo

AbstractTo determine the effect of customized vestibular exercise (VE) and optokinetic stimulation (OS) using a virtual reality system in patients with persistent postural-perceptual dizziness (PPPD). Patients diagnosed with PPPD were randomly assigned to the VE group or VE with OS group. All participants received VE for 20 min using a virtual reality system with a head mount display once a week for 4 weeks. The patients in the VE with OS group additionally received OS for 9 min. We analysed the questionnaires, timed up-to-go (TUG) test, and posturography scores at baseline and after 4 weeks. A total of 28 patients (median age = 74.5, IQR 66–78, men = 12) completed the intervention. From baseline to 4 weeks, the dizziness handicap inventory, activities of daily living (ADL), visual vertigo analogue scale, and TUG improved in the VE group, but only ADL and TUG improved in the VE with OS group. Patients with severe visual vertigo improved more on their symptoms than patients with lesser visual vertigo (Pearson’s p = 0.716, p < 0.001). Our VE program can improve dizziness, quality of life, and gait function in PPPD; however, additional optokinetic stimuli should be applied for individuals with visual vertigo symptoms.

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The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽

10.1027/0227-5910/a000062 ◽

2011 ◽

Vol 32 (2) ◽

pp. 99-105 ◽

Cited By ~ 23

Author(s):

Friedrich Martin Wurst ◽

Isabella Kunz ◽

Gregory Skipper ◽

Manfred Wolfersdorf ◽

Karl H. Beine ◽

...

Keyword(s):

Emotional Responses ◽

Well Being ◽

Emotional Reaction ◽

Emotional Reactions ◽

Analog Scale ◽

General Hospitals ◽

Item Questionnaire ◽

Retrospective Nature ◽

The Impact ◽

Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

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Coloured Analog Scale

PsycTESTS Dataset ◽

10.1037/t12430-000 ◽

1996 ◽

Author(s):

Patricia A. McGrath ◽

Cheryl E. Seifert ◽

Kathy N. Speechley ◽

John C. Booth ◽

Larry Stitt ◽

...

Keyword(s):

Analog Scale

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