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Otol Neurotol. 2007 Jan;28(1):87-93.

The dizziness handicap inventory and its relationship with functional balance performance.

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Division of Neuro- and Psychomotor Physical Therapy, Department of Health Care Sciences, University College of Antwerp, Merksem, Belgium.



The purpose of this study was to describe the relation between the Dizziness Handicap Inventory (DHI) and balance performance measures.


Retrospective case series.


Outpatient balance clinic in a tertiary referral center.


Patients referred with dizziness or imbalance of vestibular and nonvestibular origin.


DHI, Romberg with Jendrassik maneuver, standing on foam, tandem Romberg, single-leg stance, the timed up and go test, the Dynamic Gait Index (DGI), tandem gait, and the 10-m walking test.


The mean age of participants (n = 214) was 53.9 years. The mean DHI total score was 35.1, ranging from 0 to 96. Spearman rank correlation coefficients (rS) between DHI and the static balance tests were fair and ranged between -0.42 (p < 0.01) for single-leg stance with eyes closed and -0.51 (p < 0.01) for single-leg stance with eyes open. Only the Romberg test with Jendrassik maneuver correlated weakly (rS = -0.25; p < 0.01) with the DHI. Correlations with the walking tests were moderate, the connection with the DGI being the strongest one (rS = -0.69; p < 0.01). Forty-two percent of the variance in DHI scores in our patients was accounted for by the DGI score (r = 0.417).


Functional balance tests involving locomotion correlate better with DHI scores when compared with static balance measures. The DGI explains a large component of handicap in dizzy and unsteady patients, which advocates its use in these patients.

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