Category: Measurement; Brain Injury; Pediatric Rehabilitation
Objective : To examine and report the psychometric properties of the Dizziness Handicap Inventory – children and adolescents (DHI-CA) in post-concussion children and adolescents.
The specific objectives were 1) to examine the construct validity (convergent and discriminant), 2) to examine the structure of items within the DHI-CA and report the nature of their inter-relationships 3) to examine responsiveness of the DHI-CA and 4) to describe the internal consistency of the DHI-CA in post-concussion children and adolescents.
Setting : Specialized tertiary clinic
Participants (or Animals, Specimens, Cadavers) : A retrospective chart review was conducted for 132 consecutive children and adolescents who received vestibular physical therapy post-concussion.
Interventions : Not Applicable
Main Outcome Measure(s) : Data was extracted on various outcome measures including DHI-CA, sports concussion assessment tool -III (SCAT-III), vestibulo-ocular motor screen (VOMS) and patient-reported percent of recovery. The DHI-CA was examined for validity, factor structure, responsiveness and internal consistency.
The DHI-CA demonstrated convergent validity by demonstrating statistically significant relationship with the SCAT-III symptoms related to dizziness (rs = 0.30-0.40). The DHI-CA failed to demonstrate discriminant validity and showed limited diagnostic ability to discriminate between individuals who did or did not show clinically meaningful improvements. On factor analysis, structural inconsistencies were noted as the items demonstrated cross loading and an overall poor model fit was indicated (RMSEA = 0.105).
Despite demonstrating convergent validity, DHI-CA demonstrated limited discriminant validity and responsiveness along with significant structural limitations in the factor structure. Hence, caution is recommended while making clinical decisions based on the DHI-CA results.
Devashish Tiwari– Assistant Professor, MCPHS University, Cambridge, Massachusetts
Allon Goldberg– Associate Dean and Professor, University of Michigan-Flint, Flint, Michigan
Amy Yorke– Associate Professor, University of Michigan-Flint, Flint, Michigan
Gregory Marchetti– Associate Professor, Duquesne University, Pittsburgh, Pennsylvania
Bara Alsalaheen– Associate Professor, University of Michigan-Flint, Flint, Michigan