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.

Reliability and validity of the Falls Efficacy Scale-International (FES-I) in individuals with dizziness and imbalance.

HYPOTHESIS: The purpose of this research is to establish the test-retest reliability and convergent validity of the Falls Efficacy Scale-International (FES-I) in people with vestibular disorders. BACKGROUND: Individuals with vestibular dysfunction have an increased risk of falling. The FES-I is a measure used to quantify an individual's concern of falling during different tasks. METHODS: A cross-sectional descriptive study was used to determine the test-retest reliability and convergent validity of the FES-I. Fifty-three individuals with vestibular or balance dysfunction completed the FES-I twice during an initial evaluation by a neurotologist. Test-retest reliability was assessed using the intraclass correlation coefficient. The convergent validity was measured by correlating the FES-I with the Activities-Specific Balance Confidence (ABC) scale, Dizziness Handicap Inventory (DHI), Vestibular Activities and Participation (VAP) scale, 4-item Dynamic Gait Index (DGI-4), and measuring gait speed. RESULTS: The FES-I demonstrated high test-retest reliability (intraclass correlation coefficient, model 3,1: 0.94; 95% confidence interval, 0.90-0.97) and had concurrent validity with other self-report and physical performance measures (correlation coefficients for the ABC, -0.84; DHI, 0.75; VAP, 0.78; gait speed, -0.55; and DGI-4, -0.55). CONCLUSION: The FES-I is a reliable and valid tool for measuring an individual's concern of falling in a sample of people with vestibular disorders.