Kristiansen Lene, Magnussen Liv H, Wilhelmsen Kjersti T, Maeland Silje, Nordahl Stein Helge G, Hovland Anders, Clendaniel Richard, Boyle Eleanor, Juul-Kristensen Birgit
Department of Health and Function, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngol and Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
Front Neurol. 2022 Jul 15;13:850986. doi: 10.3389/fneur.2022.850986. eCollection 2022.
Associations between dizziness-related handicap and a variety of self-reported measures have been reported. However, research regarding associations between dizziness-related handicap and aspects of functioning that includes both physical tests and self-reported measures is scarce.
The purpose of the study was to describe the variations in signs and symptoms in people with persistent dizziness using physical tests and self-reported outcomes across three severity levels of the Dizziness Handicap Inventory (DHI) and investigate their associations with the DHI.
Participants with persistent dizziness ( = 107) were included in this cross-sectional study. The participants underwent (1) physical tests (gait tests, grip strength, body flexibility, and movement-induced dizziness) and completed questionnaires regarding (2) psychological measures (Mobility Inventory of Agoraphobia, Body Sensation Questionnaire, Agoraphobic Cognitions Questionnaire, and Hospital Depression and Anxiety Questionnaire), and (3) fatigue, dizziness severity, and quality of life (Chalders Fatigue Scale, Vertigo Symptom Scale-Short Form, and EQ visual analog scale), in addition to the DHI. Data were presented by descriptive statistics for three DHI severity levels (mild, moderate, and severe). A multiple linear backward regression analysis was conducted for each group of measures in relation to the DHI total score, with additional analyses adjusting for age and sex. Based on these results, significant associations were tested in a final regression model.
With increasing severity levels of DHI, the participants demonstrated worse performance on most of the physical tests (preferred and fast gait velocity, dizziness intensity after head movements), presented with worse scores on the self-reported measures (avoidance behavior, fear of bodily sensation, fear of fear itself, psychological distress, fatigue, dizziness severity, quality of life). After adjusting for age and sex, significant associations were found between total DHI and avoidance behavior, psychological distress, dizziness severity, and quality of life, but not with any of the physical tests, explaining almost 56% of the variance of the DHI total score.
There was a trend toward worse scores on physical tests and self-reported measurements with increasing DHI severity level. The DHI seems to be a valuable tool in relation to several self-reported outcomes; however, several signs and symptoms may not be detected by the DHI, and thus, a combination of outcomes should be utilized when examining patients with persistent dizziness.
已有报道称头晕相关障碍与多种自我报告的测量指标之间存在关联。然而，关于头晕相关障碍与包括身体测试和自我报告测量指标在内的功能方面之间关联的研究却很匮乏。
本研究的目的是使用身体测试和自我报告结果来描述持续性头晕患者在头晕残障量表（DHI）三个严重程度级别上的体征和症状变化，并调查它们与DHI的关联。
本横断面研究纳入了107例持续性头晕患者。参与者接受了（1）身体测试（步态测试、握力、身体柔韧性和运动诱发头晕），并完成了关于（2）心理测量指标（广场恐惧症移动性量表、身体感觉问卷、广场恐惧症认知问卷以及医院抑郁焦虑问卷），以及（3）疲劳、头晕严重程度和生活质量（查尔德斯疲劳量表、眩晕症状量表简表和EQ视觉模拟量表）的问卷调查，此外还进行了DHI评估。数据通过描述性统计呈现DHI的三个严重程度级别（轻度、中度和重度）。针对每组测量指标与DHI总分进行多元线性向后回归分析，并进行额外分析以调整年龄和性别。基于这些结果，在最终回归模型中检验显著关联。
随着DHI严重程度级别的增加，参与者在大多数身体测试（偏好和快速步态速度、头部运动后的头晕强度）中表现更差，在自我报告测量指标（回避行为、对身体感觉的恐惧、对恐惧本身的恐惧、心理困扰、疲劳、头晕严重程度、生活质量）上得分更低。调整年龄和性别后，发现DHI总分与回避行为、心理困扰、头晕严重程度和生活质量之间存在显著关联，但与任何身体测试均无关联，这解释了DHI总分方差的近56%。
随着DHI严重程度级别的增加，身体测试和自我报告测量指标得分有变差的趋势。DHI似乎是一个与多种自我报告结果相关的有价值工具；然而，DHI可能无法检测到一些体征和症状，因此，在检查持续性头晕患者时应综合使用多种结果。
