Responsiveness of self-report measures in individuals with vertigo, dizziness, and unsteadiness.
OBJECTIVE
The responsiveness (sensitivity to change) of many self-report measures commonly used with individuals who have balance and vestibular dysfunction has not been assessed. The purpose of this study was to determine the responsiveness of 4 self-report measures including the Activities-Specific Balance Confidence (ABC) scale, Dizziness Handicap Inventory (DHI), Falls Efficacy Scale-International (FES-I), and Vestibular Activities and Participation (VAP) scale in people seeking treatment for vertigo, dizziness, and unsteadiness.


METHODS
A prospective descriptive study.


METHODS
Forty-five patients (mean age, 56 yr; range, 18-79 yr) with vertigo, dizziness, and unsteadiness were included.


METHODS
Participants completed the measures at their initial physician examination and 4 to 6 weeks later. The follow-up visit included a Global Rating of Change Scale (GROC). The change in total scores for each self-report measure from initial visit to follow-up visit were recorded and compared against the GROC. A Spearman correlation was performed to determine the relationship between all 4 self-report measures and the GROC. A receiver operating characteristic (ROC) curve was also used to evaluate responsiveness.


RESULTS
Significant correlations were found between the GROC and ABC (ρ = 0.50), DHI (ρ = 0.61), and FES-I (ρ = 0.36) but not the VAP (ρ = 0.27). The ROC curve analysis showed that the area under the curve was significantly greater than 0.5 for the ABC, DHI, and FES-I.


CONCLUSIONS
The DHI demonstrated the greatest responsiveness, with an optimal cutoff of a change in 3 points related to significant change.
*Department of Physical Therapy, †Department of Physical Therapy and Otolaryngology, ‡Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A, and Department of Rehabilitation Sciences, King Saud University, Ridayh, Saudi Arabia.
Lauren A
LA
Friscia
Michael T
MT
Morgan
Patrick J
PJ
Sparto
Joseph M
JM
Furman
Susan L
SL
Whitney
D000293:Adolescent; D000328:Adult; D000368:Aged; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D004244:Dizziness / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014717:Vertigo / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult