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

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.