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. Study Design A prospective descriptive study. Patients Forty-five patients (mean age, 56 yr; range, 18–79 yr) with vertigo, dizziness, and unsteadiness were included. Main Outcome Measures 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. Conclusion The DHI demonstrated the greatest responsiveness, with an optimal cutoff of a change in 3 points related to significant change.