Dizziness-related disability following mild-moderate traumatic brain injury

Brain Inj. 2017;31(11):1436-1444. doi: 10.1080/02699052.2017.1377348. Epub 2017 Oct 3.

Abstract

Objective: To investigate the associations between dizziness-related disability after mild- moderate Traumatic Brain Injury (TBI) and personal factors, injury-related factors and post-injury functioning using the International Classification of Functioning, Disability and Health (ICF) as a framework.

Methods: Baseline assessments for a Randomised Controlled Trial (RCT) were obtained for 65 patients (mean age 39.2 years; SD 12.9 years; 70.8% women) who had dizziness and reduced balance 2-6 months after injury. The severity of the brain injury, physical and psychological self-reported symptoms and results from the performance based tests were used as independent variables. The main outcome measure (dependent variable) was the Dizziness Handicap Inventory (DHI).

Results: Multivariate analyses showed that, the dizziness-related disability was predicted by pre-injury comorbidities (p ≤ 0.05) and was associated with self-reported vertigo symptoms (p < 0.001), reduced performance-based balance (p ≤ 0.05) and psychological distress (p ≤ 0.05). These factors accounted for 62% of the variance in DHI.

Conclusion: Dizziness and balance problems after mild-moderate TBI appear to be complex biopsychosocial phenomena. Assessments linked to the ICF domains of functioning might contribute to a broader understanding of the needs of these patients. Further, prospective clinical studies with non-dizzy control groups are needed to investigate dizziness-related disability after TBI.

Keywords: ICF; Traumatic brain injury; balance; dizziness.

MeSH terms

  • Adult
  • Aged
  • Brain Injuries, Traumatic / complications*
  • Disabled Persons* / psychology
  • Dizziness / diagnosis
  • Dizziness / etiology*
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Postural Balance / physiology*
  • Retrospective Studies
  • Self Report
  • Sensation Disorders / diagnosis
  • Sensation Disorders / etiology*