Dizziness handicap inventory score is highly correlated with markers of gait disturbance

Damiano Zanotto, Erin M. Mamuyac, Adam R. Chambers, John S. Nemer, John A. Stafford, Sunil K. Agrawal, Anil K. Lalwani

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objective: To evaluate the association between Dizziness Handicap Inventory-Screening version (DHI-S) score and spatiotemporal gait parameters using SoleSound, a newly developed, inexpensive, portable footwear-based gait analysis system. Study Design: Cross-sectional. Patients: One hundred eighteen patients recruited from otology clinic. Intervention(s): Subjects completed the DHI-S survey and four uninterrupted walking laps wearing SoleSound instrumented footwear on a hard, flat surface for 100 m. Main Outcome Measure(s): For each subject, mean and coefficient of variation (CV) of stride length, cadence, walking speed, foot-ground clearance, double-support time, swing period, and stance-to-swing were computed by considering 40 strides of steady-state walking within each lap. Linear regression models were employed to study correlations between these variables and DHI-S scores after adjusting for age, sex, and race/ethnicity. Results: Patients with higher DHI-S score took shorter steps and less steps per minute (-0.017m and -1.1 steps/min per every four-point increase in DHI-S score, p<0.05) than patients with a lower DHI-S score, with slower walking speed (-0.025 m/s per every four-point increase in DHI-S score, p<0.01). Additionally, patients with higher DHI-S scores showed larger variability in all analyzed temporal parameters (+0.1% for CV of cadence, +0.5% for CV of double support period, +0.2% for CV of swing period, and +0.4% for CV of stance-to-swing, per every four-point increase in DHI-S score, p<0.01). Conclusion: SoleSound was effective in measuring a wide range of gait parameters. Patients' self-perception of vestibular handicap, as assessed with DHI-S, is associated with deterioration in measurable gait parameters independent of age.

Original languageEnglish (US)
Pages (from-to)1490-1499
Number of pages10
JournalOtology and Neurotology
Issue number10
StatePublished - Dec 1 2017
Externally publishedYes


  • Dizziness handicap inventory
  • Gait disturbance
  • Portable gait analysis
  • SoleSound

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology


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