The development of the ICF vestibular environmental scale.
UNLABELLED
People with vestibular disorders report changes in symptoms based on their environment with many situations increasing their symptoms. The purpose of this paper was to utilize the International Classification of Functioning Disability and Health (ICF) from the World Health Organization (WHO) to describe common environmental triggers for dizziness in persons living with balance and vestibular disorders. A multi-centre cross-sectional study was conducted with four different centres on three different continents, including patients from the United States (Pittsburgh), Germany (Munich), Jordan (Amman) and Saudi Arabia (Riyadh).


SUBJECTS
Three hundred eighty one persons with vestibular disorders participated.


METHODS
A 9-item questionnaire (the Vestibular Environmental Scale) was developed from existing ICF items, which were compared to Dizziness Handicap Inventory (DHI) scores. Sixty-five percent of participants reported that "quick movements in the vicinity" increased symptoms, "crowds" at 45%, and "design of buildings, e.g. narrow hallways, stairs, elevators" at 42%. The "crowds" item was a good positive predictor of psychogenic vertigo (OR 1.8, 95% Confidence Interval 1.03-3.16), while "food" (OR 0.47, 95% Confidence Interval 0.17-1.29) and "light" (OR 0.41 95% Confidence Interval 0.23-0.75) were negative predictors of psychogenic vertigo. There also was a positive correlation between the number of triggers and DHI score (Spearman correlation coefficient 0.47, p < 0.0001). Sixty-eight percent of the subjects reported an increase in symptoms with between 1 and 4 environmental triggers. In our cross cultural sample, environmental triggers affect dizziness in persons living with balance and vestibular disorders. The use of items from the ICF of the WHO may help to promote cross cultural sharing of information in persons with dizziness.
['Whitney|Susan L|SL|', 'Alghadir|Ahmad|A|', 'Alghwiri|Alia|A|', 'Alshebber|Kefah M|KM|', 'Alshehri|Mohammed|M|', 'Furman|Joseph M|JM|', 'Mueller|Martin|M|', 'Grill|Eva|E|']
D000203:Activities of Daily Living D000328:Adult D003431:Cross-Cultural Comparison D003430:Cross-Sectional Studies D004185:Disability Evaluation D004244:Dizziness D004777:Environment D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012931:Social Environment D011795:Surveys and Questionnaires D014717:Vertigo D015837:Vestibular Diseases
ICF Vestibular environment dizziness rehabilitation vestibular rehabilitation