Functional assessment of patients with vertigo and dizziness in occupational medicine

Abstract

Background Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations. Material and Methods A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients’ symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography. Results The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall’s W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08–0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI – 46% and 57%, respectively. Conclusions The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179–189

Keywords

• vertigo
• dynamic gait index
• videonystagmography
• posturography
• Berg Balance Scale
• unbalance