Save 60% of time with the shortened Dizziness Handicap Inventory

• Our findings indicate that the DHI-S questionnaire is a valid, reliable and responsive tool to measure vestibular symptoms in general practice and could prove to be a valuable tool.

Therefore, it is applicable to utilize the DHI-S in clinical practice.  Awesome!

So how does this relate to Cervicogenic Dizziness?

As noted in the title, 60% of the questions are omitted in the shortened version of the DHI.  Unfortunately, the DHI-S is missing 2 out of 3 key questions that Susan Reid & colleagues found in 2017 to screen patients with Cervicogenic Dizziness.

The key questions on the DHI for screening for Cervicogenic Dizziness are:

1. Does looking up increase your problem? (P1)
2. Because of your problem, are you afraid to leave your home without having someone accompany you? (E9)
3. Do quick movements of your head increase your problem? (P11)

The DHI-S does include #2 above, which would usually be answered, “No”, if someone has Cervicogenic Dizziness.  However, #1 and #3 above, which would usually be answered, “Yes”, if someone has Cervicogenic Dizziness, are missing.

Therefore, if you are using the DHI to screen patients and assist in ruling out Cervicogenic Dizziness (such as prior to your physical examination), you will be missing too many data points, at least based on Reid’s 2007 work, from the DHI-S to make an appropriate call.  Also, the items missing in the DHI-S do not show the potential of head on neck awareness as #1 and #3 above ask, again, confirming not a good measure for Cervicogenic Dizziness.

You can learn more about the screening and treatment process of Cervicogenic Dizzinesss through Integrative Clinical Concepts, where the author and his wife, a Vestibular Specialist, teach a 2-day course.  Pertinent to this blog post, the first day provides the most up-to-date evidence review from multiple disciplines to diagnose through the “Optimal Sequence Algorithm” to assist in ruling out disorders and ruling in cervical spine, including determining if single or double entity exists.  

If you would like to host a course for your staff (either a vestibular, neuro, sports or ortho clinic), please do not hesitate to contact me at harrisonvaughanpt@gmail.com for prices and discounts.

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Authors

Harrison N. Vaughan, PT, DPT, OCS, Dip. Osteopracic, FAAOMPT    

Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts

Danielle N. Vaughan, PT, DPT, Vestibular Specialist  

Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts