Imbalance: Objective measures versus subjective self-report in clinical practice

Area of Science:

• Neurology
• Gerontology
• Rehabilitation Medicine

Background:

• Dizziness and imbalance are common clinical complaints, posing challenges in fall risk assessment.
• Current assessment relies on subjective patient reports and objective balance measures.
• The relationship between subjective handicap and objective balance performance needs further investigation.

Purpose of the Study:

• To evaluate the relationship between subjective dizziness handicap and objective balance measures.
• To investigate the utility of Virtual Reality (VR) in perturbing visual input during balance testing.
• To identify patient subgroups based on their response to VR-induced visual perturbations.

Main Methods:

• 90 patients completed the Dizziness Handicap Inventory (DHI) questionnaire.
• Balance was assessed via postural sway under various visual conditions (eyes open, eyes closed).
• Unpredictable VR visual perturbations were applied at different amplitudes during balance testing.

Main Results:

• No significant correlation was found between DHI scores and overall balance measurements.
• VR perturbations identified three distinct patient groups based on DHI scores and balance performance.
• A significant correlation emerged between DHI and balance performance within the largest patient subgroup.

Conclusions:

• Subjective self-report (DHI) and objective balance measures are both crucial for patient characterization.
• VR visual perturbations effectively categorized patients, providing insights into fall risk.
• VR perturbations help explain the initial lack of correlation between DHI scores and objective balance tests.