Self-reported Dizziness Handicap Impacts Walking Capacity In People With Vestibular Dysfunction

After 40 years of age, it’s estimated that 35% of the population have vestibular dysfunction requiring medical assistance. Dizziness is the most common symptom and believed to be associated with a decreased functional capacity and participation in activities of daily living. PURPOSE: To determine if walking capacity and physical activity are related to self-reported dizziness and function of the vestibulo-ocular reflex (VOR) in participants with vestibular dysfunction. METHODS: 25 adults (17 females and 8 males; mean age 70.1 ± 13.6) with self-reported dizziness and vestibular dysfunction, diagnosed by a licensed physical therapist, were recruited. Predictor variables included: 1) Dizziness Handicap Inventory (DHI) and velocity-gain of the VOR in 2) horizontal, 3) anterior, and 4) posterior canals captured using video head impulse (vHIT) testing. The outcomes of interest included: 1) walking capacity, assessed with the two-minute walk test (2MWT), and 2) minutes of moderate to vigorous activity (MVPA), captured using an activity tracker worn on the wrist for 7-days. Multiple linear regression models were built for each of the 4 predictor variables, controlling for age, to examine the effect on 2MWT distance and MVPA. Significance was set at alpha = 0.05. RESULTS: Models examining walking capacity, were all found to be significant (p < 0.01), with age significantly contributing to each (p < 0.05). However, only DHI was found to significantly contribute to 2MWT distance (p = 0.002), showing that with each point increase in DHI (i.e., worse dizziness handicap) a 1.2-meter decrease in walking distance was predicted. VOR gain did not significantly contribute to 2MWT distance in any of the canals (p > 0.05). Similarly, models examining MVPA were all found to be significant (p < 0.05), with age significantly contributing to each (p < 0.05). However, DHI and VOR gain did not significantly contribute to MVPA. CONCLUSION: Increases in self-reported dizziness handicap are related to decreases in walking capacity in people with vestibular dysfunction. This relationship was significant even when controlling for age, a known predictor of walking capacity. Interestingly, this same relationship was not observed when examining physical activity, while VOR gain was not related to walking capacity or physical activity. Supported by: AI was used to translate to English from Spanish