Translation, cross-cultural adaptation and reliability of the german version of the dizziness handicap inventory

Otol Neurotol. 2009 Apr;30(3):359-67. doi: 10.1097/MAO.0b013e3181977e09.


Objective: To translate the Dizziness Handicap Inventory into German (DHI-G) and investigate reliability, assess the association between selected items of the University of California Los Angeles Dizziness Questionnaire and the DHI-G, and compare the scores of patients and healthy participants.

Study design: Cross-sectional design.

Setting: Tertiary center for vertigo, dizziness, or balance disorders.

Patients: One hundred forty-one patients with vertigo, dizziness, and unsteadiness associated with a vestibular disorder, with a mean age (standard deviation) of 51.5 (13.2) years, and 52 healthy individuals participated.

Interventions: Fourteen patients participated in the cognitive debriefing; 127 patients completed the questionnaires once or twice within 1 week.

Main outcome measures: The DHI-G assesses disability caused by dizziness and unsteadiness; the items of the University of California Los Angeles Dizziness Questionnaire assess dizziness and impact on everyday activities. Internal consistency was estimated using Cronbach alpha, reproducibility by calculating Bland-Altman limits of agreement and intraclass correlation coefficients. Associations were estimated by Spearman correlation coefficients.

Results: Patients filled out the DHI-G without problem and found that their self-perceived disabilities were mostly included. Cronbach alpha values for the DHI-G and the functional, physical, and emotional subscales were 0.90, 0.80, 0.71, and 0.82, respectively. The limits of agreement were +/-12.4 points for the total scale (maximum, 100 points). Intraclass correlation coefficients ranged from 0.90 to 0.95. The DHI-G correlated moderately with the question assessing functional disability (0.56) and fairly with the questions quantifying dizziness (0.43, 0.35). The DHI-G discriminated significantly between healthy participants and patients.

Conclusion: The DHI-G demonstrated good reliability and is recommended as a measure of disability in patients with dizziness and unsteadiness.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Data Interpretation, Statistical
  • Disability Evaluation
  • Dizziness / diagnosis*
  • Dizziness / psychology
  • Emotions
  • Female
  • Germany
  • Humans
  • Language
  • Male
  • Middle Aged
  • Quality of Life
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vertigo / diagnosis
  • Vertigo / psychology
  • Vestibular Diseases / diagnosis
  • Vestibular Diseases / psychology
  • Young Adult