Perception of unsteadiness in patients with dizziness: association with handicap and imbalance

Dizziness is a common problem in patients seeking medical help and is often associated with imbalance and handicap. This study aimed to reveal whether the perception of unsteadiness could be an indication of greater imbalance and handicap in these patients. Patients with dizziness were categorized into two groups, steady patients (n = 15) and unsteady patients (n = 23), based on the presence or absence of self-perceived unsteadiness. The level of self-perceived handicap was evaluated by the Dizziness Handicap Inventory. Static balance ability was evaluated using a force platform and the center of pressure motion was calculated during various quiet standing conditions. Dynamic balance ability was evaluated by the functional forward reach test and Dynamic Gait Index. All the patients also went through isometric strength tests of the lower extremities. It was found that all patients reported themselves to be handicapped by dizziness. Patients who perceived themselves to be unsteady had greater handicap and poorer static standing, but did not differ from the steady patients in regard to muscle strength or functional balance tests. Thus, self- perceived unsteadiness was associated with greater handicap and poorer static balance in dizzy patients. In clinical management of these patients, special attention should be paid to balance and handicap.