The Relationship Between the Activities-Specific Balance Confidence Scale and Balance Performance, Self-perceived Handicap, and Fall Status in Patients With Peripheral Dizziness or Imbalance.

ABSTRACT

OBJECTIVE: Describe the relationship between the Activities-Specific Balance Confidence (ABC) scale and Dizziness Handicap Inventory (DHI) with balance performance, as well as fall status in patients with peripheral vestibular disorders. STUDY DESIGN: Retrospective. SETTING: Outpatient balance clinic, tertiary referral center. PATIENTS Data from 97 patients (age 54.8 ±â€Š12.3 yrs; 48 women) with dizziness or imbalance symptoms of peripheral vestibular origin were used for analysis. INTERVENTIONS: /. MAIN OUTCOME MEASURES: ABC-scores, DHI-scores, static and dynamic balance tests, and fall status of the past 4 weeks, 2 months, and 6 months before the time of measurement were collected. Spearman's rho correlations, χ2 with post-hoc testing, and Kruskal-Wallis with post-hoc Mann-Whitney U test results were interpreted. RESULTS: The ABC- and DHI-scores show moderate correlations with static balance (ABC r = 0.44; DHI r = -0.34) and dynamic balance tests (ABC r = [-0.47;0.56]; DHI r = [-0.48;0.39]) and a strong inverse correlation with each other (ABC 70 ±â€Š25; DHI 33 ±â€Š26; r = -0.84). Related to fall status, weak correlations were found (ABC r = [-0.29;-0.21]; DHI r = [0.29;0.33]). Additional results show that subjects in the low-level functioning (ABC) or severe self-perceived disability (DHI) categories have a poorer balance assessed by standing balance, Timed-Up-and-Go and Functional Gait Assessment and are more likely to have experienced multiple falls. CONCLUSIONS: The ABC-scale and DHI showed a strong convergent validity, additionally the ABC-scale showed a better concurrent validity with balance performances and the DHI with fall history. In general, patients with peripheral vestibular impairments reporting a lower self-confidence or a more severe self-perceived disability show worse balance performances and a higher fall incidence.