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Mutlu, Basak ; Serbetcioglu, Bulent
doi: 10.3233/VES-130488pmid: 24447966
PURPOSE: A review of the Dizziness Handicap Inventory (DHI). NUMBER OF STUDIES: Seventy-four studies. MATERIALS/METHODS: Articles published between January 1990 and May 2012 were identified by searches in PubMed electronic database. Of the 227 articles meeting the inclusion criteria 74 were reviewed. These articles are discussed under nine topics; Reliability, validity and internal consistency of the original version of DHI, relationship between vestibular/balance tests and DHI, association between DHI and the other scales related to balance impairments, exploratory factor analysis of the DHI, screening version of DHI, translations of DHI into other languages, the role of DHI to assess the success of the treatment of balance disorder, DHI results in various vestibular disorders, general characteristics of DHI in patients with balance impairment. CONCLUSIONS: Self reported measures represent unique pieces of the information important for the management of dizzy patients. DHI is the most widely used self reported measurement of patients with dizziness. It has been translated into fourteen languages, so it is widely accepted.
Mutlu, Basak; Serbetcioglu, Bulent
doi: 10.3233/ves-130488pmid: 24447966
Purpose:A review of the Dizziness Handicap Inventory (DHI).Number of studies:Seventy-four studies. Materials/methods:Articles published between January 1990 and May 2012 were identified by searches in PubMed electronic database. Of the 227 articles meeting the inclusion criteria 74 were reviewed. These articles are discussed under nine topics; Reliability, validity and internal consistency of the original version of DHI, relationship between vestibular/balance tests and DHI, association between DHI and the other scales related to balance impairments, exploratory factor analysis of the DHI, screening version of DHI, translations of DHI into other languages, the role of DHI to assess the success of the treatment of balance disorder, DHI results in various vestibular disorders, general characteristics of DHI in patients with balance impairment. Conclusions:Self reported measures represent unique pieces of the information important for the management of dizzy patients. DHI is the most widely used self reported measurement of patients with dizziness. It has been translated into fourteen languages, so it is widely accepted.
doi: 10.3233/ves-130480pmid: 24447967
Dizziness is one of the most troublesome symptoms of vestibular disorders, although its description remains somewhat imprecise, encompassing vertigo, lightheadedness, disequilibrium and giddiness. Symptoms include sensitivity to motion stimuli and discomfort with open spaces, such as empty streets and bridges. It is accompanied by varying degrees of anxiety and phobic behaviors. Several tools have been developed in an attempt to quantify the degree of disability, self-perceived health status and quality of life in patients with dizziness. This review focuses on the University of California, Los Angeles Dizziness Questionnaire (UCLA-DQ), which is used to assess the effect of dizziness on quality of life. This paper also includes a summary of the advantages and disadvantages of the UCLA-DQ and compares it to other instruments used to assess dizziness. In spite of a few disadvantages, we believe that this multidimensional questionnaire is an appropriate tool for evaluating patients with vestibular impairment. It should be used during the acute phase of symptoms, as well as during and after rehabilitative therapy, to assess patient improvement.
doi: 10.3233/VES-130480pmid: 24447967
Dizziness is one of the most troublesome symptoms of vestibular disorders, although its description remains somewhat imprecise, encompassing vertigo, lightheadedness, disequilibrium and giddiness. Symptoms include sensitivity to motion stimuli and discomfort with open spaces, such as empty streets and bridges. It is accompanied by varying degrees of anxiety and phobic behaviors. Several tools have been developed in an attempt to quantify the degree of disability, self-perceived health status and quality of life in patients with dizziness. This review focuses on the University of California, Los Angeles Dizziness Questionnaire (UCLA-DQ), which is used to assess the effect of dizziness on quality of life. This paper also includes a summary of the advantages and disadvantages of the UCLA-DQ and compares it to other instruments used to assess dizziness. In spite of a few disadvantages, we believe that this multidimensional questionnaire is an appropriate tool for evaluating patients with vestibular impairment. It should be used during the acute phase of symptoms, as well as during and after rehabilitative therapy, to assess patient improvement.
Peters, Brian T.; Cohen, Helen S.; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J.
doi: 10.3233/ves-130502pmid: 24447968
Background:Dynamic visual acuity (DVA) testing may be a useful, indirect indicator of vestibulo-ocular reflex function. Previous evidence shows that acuity for 2 m targets differs little between patients and normals using a 75 ms display duration and that healthy subjects do not differ in acuity when standing and walking while viewing a far target but they do differ when viewing a near target. Objective:Improve the protocol of a screening tool by testing the hypothesis that healthy control subjects and patients and with unilateral peripheral vestibular weakness differ on DVA when viewing far targets while seated. Methods:Controls and patients were tested while they were seated in a chair that oscillated vertically at 2 Hz. They viewed a computer screen 4 m away, while stationary and while moving, with viewing times of either 75 ms or 500 ms. Results:The amount of change between static and dynamic conditions did not differ significantly between patients and controls for the 75 ms condition but controls had lower difference scores than patients when using the 500 ms duration. The ROC value was low, 0.68. Compared to historical data using the 75 ms duration at a distance of 2 m, subjects in both diagnostic groups had better visual acuity at the 75 ms/4 m distance. Conclusions:These results suggest that using the longer duration is better for differentiating patients from healthy controls and they support previous evidence showing that near target viewing is more challenging.
Peters, Brian T. ; Cohen, Helen S. ; Sangi-Haghpeykar, Haleh ; Bloomberg, Jacob J.
doi: 10.3233/VES-130502pmid: 24447968
BACKGROUND: Dynamic visual acuity (DVA) testing may be a useful, indirect indicator of vestibulo-ocular reflex function. Previous evidence shows that acuity for 2 m targets differs little between patients and normals using a 75 ms display duration and that healthy subjects do not differ in acuity when standing and walking while viewing a far target but they do differ when viewing a near target. OBJECTIVE: Improve the protocol of a screening tool by testing the hypothesis that healthy control subjects and patients and with unilateral peripheral vestibular weakness differ on DVA when viewing far targets while seated. METHODS: Controls and patients were tested while they were seated in a chair that oscillated vertically at 2 Hz. They viewed a computer screen 4 m away, while stationary and while moving, with viewing times of either 75 ms or 500 ms. RESULTS: The amount of change between static and dynamic conditions did not differ significantly between patients and controls for the 75 ms condition but controls had lower difference scores than patients when using the 500 ms duration. The ROC value was low, 0.68. Compared to historical data using the 75 ms duration at a distance of 2 m, subjects in both diagnostic groups had better visual acuity at the 75 ms/4 m distance. CONCLUSIONS: These results suggest that using the longer duration is better for differentiating patients from healthy controls and they support previous evidence showing that near target viewing is more challenging.
doi: 10.3233/VES-130486pmid: 24447969
Vestibular rehabilitation focuses at decreasing the impact of symptoms, such as vertigo dizziness and imbalance have on people's daily life and their role in society. The international Classification of Functioning Disability and Health – ICF offers a unified and standard language and framework for describing health and health related states. The ICF aims at facilitating communication information about health, like functioning and disability. For this purpose the ICF has a systematic coding scheme for health data with more than 1400 categories. The big number of categories is impractical to apply in a specific area like vestibular disorders. Therefore a narrowing down to the relevant categories in a comprehensive core set for vertigo (100 categories) and a brief core set (29 categories) were developed. The purpose of this article is to reflect on the potential use of ICF in vestibular rehabilitation.
doi: 10.3233/ves-130486pmid: 24447969
Vestibular rehabilitation focuses at decreasing the impact of symptoms, such as vertigo dizziness and imbalance have on people's daily life and their role in society. The international Classification of Functioning Disability and Health – ICF offers a unified and standard language and framework for describing health and health related states. The ICF aims at facilitating communication information about health, like functioning and disability. For this purpose the ICF has a systematic coding scheme for health data with more than 1400 categories. The big number of categories is impractical to apply in a specific area like vestibular disorders. Therefore a narrowing down to the relevant categories in a comprehensive core set for vertigo (100 categories) and a brief core set (29 categories) were developed. The purpose of this article is to reflect on the potential use of ICF in vestibular rehabilitation.
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