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

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 +/- 12.3 yrs; 48 women) with dizziness or imbalance symptoms of peripheral vestibular origin were used for analysis. Intervention(s): / Main Outcome Measure(s): 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, chi(2) 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 +/- 25; DHI: 33 +/- 26; 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.