Two independent medical experts with very good knowledge in English translated the original version in Persian, and then reached a consensus on the final translated version. The Persian version of the DHI was prepared using the back-translation method. The range of DHI score is from 0 (no disability) to 100 (severe disability) ( 3). Each item has three responses of yes (4 points), sometimes (2 points), or no (0 point). The original DHIis a 25-item questionnaire evaluating patient's physical, functional, and emotional limitations. Laboratory tests consisted of audiometry, tympanometry, acoustic reflex, and video nystagmography. In addition to comprehensive history taking, a neuro-otological examination and laboratory tests were performed. Out of the included patients, 50, 37, and 26 subjects had a peripheral vestibular disorder, a central vestibular pathology, and signs/symptoms of both sites classified as a mixed syndrome, respectively. In addition, 30 healthy subjects (i.e., 16 males and 14 females mean age: 43.8☙.9 years) underwent only the first examination. A total of 113 patients (i.e., 48 males and 65 females mean age: 44.5☑1.3 years) met the inclusion criteria and participated in the investigation at the first and second examinations (after 2 weeks). All procedures were also performed in accordance with the principles of the Helsinki Declaration. In addition, the study protocol was approved by the Ethical Committee of Guilan University of Medical Sciences. In line with research ethics principle, informed consent was obtained from all included subjects. Healthy participants were selected from family members and health care staff. On the other hand, the patients with dizziness due to cardiopulmonary, musculoskeletal, or psychiatric disorders were excluded from the study. The inclusion criteria were: 1) age of 18-75 years, 2) ability to walk, 3) ability to perform at least 50% of daily activities, and 4) fluency in speaking Persian. Patients who had dizziness for at least one month were recruited from the Otorhinolaryngology Clinic of Amiralmomenin Hospital and Neurology Clinic of Poursina Hospital, affiliated to Guilan University of Medical Sciences, Rasht, Iran, between May 2016 and August 2018. The secondary aim was to compare the P-DHI scores between subjects with and without vertigo. To assess the disability and feelings of anxiety and depression, we evaluated the association of DHI, original subscale, and retained factors in our factor analysis with functional disability and several generic questionnaires. The primary aim of the present study was to evaluate the validity and reliability of the P-DHI and examine its dimensions using an exploratory factor analysis. The total scale, along with its subscales, had the Cronbach's alpha coefficient range of 0.79-0.90. It was shown that the Persian version of DHI (P-DHI) had good face and content validities. ( 4), performing a study on patients with dizziness aged 18-70 years. In Iran, this questionnaire was translated by Jafarzadeh et al. So far, the DHI has been translated into different languages, and its psychometric properties have been evaluated in different populations. Jacobson and Newman developed the Dizziness Handicap Inventory (DHI) to assess the impact of vestibular vertigo/dizziness on the quality of life and measure the results of vestibular rehabilitation therapy ( 3). However, none of these tests reflect the real impact of dizziness on patients’ activities. Researchers used several outcome measures (e.g., vestibular-ocular reflex, balance performance, and performance on computerized dynamic posturography or functional ability) to evaluate the handicapping effects of dizziness on the quality of life. Hansson proposed vestibular rehabilitation as a valuable treatment for these patients ( 2). Vertigo can be severe enough to affect patients’ occupational performance or daily activities ( 1). Vestibular disorders account for about one-fourth of cases suffering from this condition. Vertigo is a frequent and highly uncomfortable complaint.
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