ORIGINAL ARTICLE
CORRELATING TWO QUESTIONNAIRES: VESTIBULAR ACTIVITIES AND PARTICIPATION (VAP) AND DIZZINESS HANDICAP INVENTORY (DHI)
 
More details
Hide details
1
Department of Audiology and Speech Language Pathology, Bharati Vidyapeeth Deemed University’s Medical Hospital, Pune, India
CORRESPONDING AUTHOR
Sharda A. Sarda   

Sharda Sarda, Department of Audiology and Speech Language Pathology, Bharati Vidyapeeth Deemed University’s Medical Hospital, 16/2 Bharirathi Building, near Amba Mata Mandir, Sukhsagarnagar, Katraj, Pune-411046, India, e-mail: sharada.sarda@gmail.com. Tel. +0011-9764310600
Publication date: 2015-12-31
 
J Hear Sci 2015;5(4):33–40
 
KEYWORDS
ABSTRACT
Background:
Dizziness is known to affect the quality of life, irrespective of its underlying pathology. The Dizziness Handicap Inventory (DHI) is a commonly used questionnaire to assess self-perceived handicap among individuals with dizziness. However, the International Classification of Functioning, Disability and Health (ICF), emphasises the assessment of activity limitations and participation restrictions. A recently developed questionnaire, the Vestibular Activities and Participation (VAP), is based on the ICF model and has been found to be a valid and reliable tool. The present study was undertaken to explore which items of DHI relate to vestibular activity limitations and participation restrictions by investigating the correlations between items of DHI and VAP.

Material and Methods:
This was a prospective study involving 56 individuals whose primary complaint was dizziness due to vestibular pathology. All had undergone detailed audio-vestibular tests prior to administration of a Marathi translation of the DHI and VAP questionnaires.

Results:
12 of the 25 questions on the DHI showed strong and moderate correlations with the total VAP score (r=0.48–0.68, p<0.05), while 8 questions showed significant but weak correlation (r=0.34–0.44, p<0.05), and 5 questions showed no correlation (r=0.27–0.29, p>0.05). The results indicate that less than half the 25 questions covering the physical, functional, or emotional domains of DHI reflect activity limitations or participation restriction in day-to-day life.

Conclusions:
The results indicate that responses to only some of the items of DHI are important when studying activity limitations and participation restrictions of people with dizziness. These particular items may be a better indicator of the effect of dizziness on the quality of life, and hence could be most relevant when reporting post-therapeutic improvement in quality of life.

 
REFERENCES (24)
1.
Boult C, Murphy J, Sloane P, Mor V, Drone C. The relation of dizziness to functional decline. J Am Geriatr Soc, 1991; 39: 838–61.
 
2.
Cohen H, Kane-Wineland M, Miller L, Hatfield C. Occupation and visual/vestibular interaction in vestibular rehabilitation. Otolaryngol Head Neck Surg, 1995;112: 526–32.
 
3.
Ganança FF, Castro ASO, Branco FC, Natour J. Impact of dizziness on the quality of life in patients with peripheral vestibular dysfunction. Rev Bras Otorrinolaringol, 2004; 70(1): 94–101.
 
4.
Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory (DHI). Arch Otolaryngol Head Neck Surg, 1990;116: 424–7.
 
5.
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.
 
6.
Andersson G, Asmundson GJG, Denev J, Nilsson J, Larsen HC. A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness. Behaviour Research and Therapy, 2006;44: 1265–73.
 
7.
Johansson M, Akerlund D, Larsen HC, Andersson G. Randomized controlled trial of vestibular rehabilitation combined with cognitive-behavioral therapy for dizziness in older people. Otolaryngol Head Neck Surg, 2001; 125: 151–6.
 
8.
Perez N, Garmendia I, Garcia-Granero M, Martin E, GarciaTapia R. Factor analysis and correlation between Dizziness Handicap Inventory and dizziness characteristics and impact on quality of life scales. Acta Otolaryngol Suppl, 2001; 545: 145–54.
 
9.
Kurre A, Bastiaenen CH, van Gool CJ, Gloor-Juzi T, de Bruin ED, Straumann D. Exploratory factor analysis of the Dizziness Handicap Inventory (German version). BMC Ear Nose Throat Disord, 2010; 10: 3.
 
10.
International Classification of Functioning, Disability and Health. [http://www.who.int/classificat...], 30.01.2010.
 
11.
Alghwiri AA, Whitney SL, Baker CE, Sparto PJ, Marchetti GF, Rogers JC. The development and validation of the vestibular activities and participation measure. Arch Phys Med Rehabil, 2012; 93: 1822–31.
 
12.
Castro AS, Gazzola JM, Natour J, Ganança FF. Brazilian version of the dizziness handicap inventory. Pro Fono, 2007;19: 97–104.
 
13.
Enloe LJ, Shields RK. Evaluation of health-related quality of life in individuals with vestibular disease using disease-specific and general outcome measures. Phys Ther, 1997: 890–903.
 
14.
Asmundson GJ, Stein MB, Ireland D. A factor analytic study of the dizziness handicap inventory: does it assess phobic avoidance in vestibular referrals? J Vestib Res, 1999; 9: 63–8.
 
15.
Gámiz MJ, Lopez-Escamez JA. Health-related quality of life in patients over sixty years old with benign paroxysmal positional vertigo. Gerontology, 2004; 50(2): 82–6.
 
16.
Ten Voorde M, van der Zaag-Loonen HJ, van Leeuwen RB. Dizziness impairs health-related quality of life. Quality of Life Research, 2012; 21: 961–6.
 
17.
Duracinsky M, Mosnier I, Bouccara D, Sterkers O, Chassany O. Working Group of the Société Française d’Oto-Rhino-Laryngologie (ORL). Literature review of questionnaires assessing vertigo and dizziness and their impact on patients’ quality of life. Value Health, 2007;10: 273–84.
 
18.
León VV, Gutiérrez V, Hurtado CE, Ramirez-Velez R. Relationship between health-related quality of life and disability in women with peripheral vertigo. Acta Otorrinolaringol, 2010; 61: 255–61.
 
19.
Grimby A, Rosenhall U. Health-related quality of life and dizziness in old age. Gerontology, 1995; 41(5): 286–98.
 
20.
Handa RR, Kuhn AM, Cunha F, Schaffleln R, Ganança FF. Quality of life in patients with benign paroxysmal positional vertigo and/or Ménière’s disease. Braz J Otorhinolaryngol, 2005; 71: 776–82.
 
21.
Yardley L, Putman J. Quantitative analysis of factors contributing to handicap and distress in vertiginous patients: A questionnaire study. Clin Otolaryngol Allied Sci, 1992; 17(3): 231–6.
 
22.
Grill E, Furman JM, Alghwiri AA, Müller M, Whitney SL. Using core sets of the international classification of functioning, disability and health (ICF) to measure disability in vestibular disorders: study protocol. J Vestib Res, 2013;23(6): 297–303.
 
23.
Alghwiri AA, Marchetti GF, Whitney SL. Content comparison of self-report measures used in vestibular rehabilitation based on the international classification of functioning, disability and health. Phys Ther, 2011; 91(3): 346–57.
 
24.
Alghwiri A, Alghadir A, Whitney SL. The vestibular activities and participation measure and vestibular disorders. J Vestib Res, 2013; 23(6): 305–12.