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Dizziness Handicap Inventory (DHI)
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Supplemental-Highly Recommended: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months) and Persistent/Chronic (3 months and greater post concussion) as a symptom reports/inventories (if dizziness is described in the Post-Concussion Symptom Scale)
Supplemental: Acute Hospitalized, Concussion/Mild TBI, Moderate/Severe TBI: Rehabilitation, Traumatic Brain Injury (TBI)
Short Description of Instrument
The Dizziness Handicap Inventory (DHI), a 25-item self-report questionnaire was developed to evaluate the self-perceived handicapping effects imposed by vestibular system disease (Jacobson & Newman, 1990). The items in the DHI are subgrouped into functional, emotional and physical domains representing aspects of dizziness and unsteadiness.
Sport-Related Concussion Specific:
Advantages: The DHI is generally widely used and translated into 14 languages (Mutlu & Serbetcioglu 2013). It has been used in other medical disorders to measure self-perceived handicapping effects, in aspects of dizziness and unsteadiness in functional, emotional and physical domains (Mutlu & Serbetcioglu 2013). For example it was used in vestibular system disease (Jacob & Newman, 1990).
Limitations: Items of the DHI do not evaluate the otological or neurovegetative symptoms and does not assess the effects of dizziness on self-care activities.  In concussion/mtTBI management, it has been rarely used so far.
Scoring: Functional domain: 9 questions, 36 points; Emotional domain: 9 questions, 36 points, and Physical domain: 7 questions, 28 points
Answers to questions are graded: 0 (No); 2 (Sometimes); 4 (Yes)
Maximum score = 100 (28 points for physical, 36 points each for emotional and functional domains)
Scores: Scores greater than 10 points should be referred to balance specialists for further evaluation.
Mild Handicap: 16–34 points
Moderate Handicap: 36–52 points
Severe Handicap: 54+ points
Jacobson GP & Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424-427.
Gottshall K, Drake A, Gray N, McDonald E, Hoffer ME. Objective vestibular tests as outcome measures in head injury patients.Laryngoscope. 2003;113(10):1746-1750.
Mutlu B & Serbetcioglu B. Discussion of the dizziness handicap inventory. J Vestib Res. 2013;23(6):271-277.


Document last updated July 2019