Vestibular outcome measures: the published values

The DHI, DGI, FGA and ABC — what each measures, the published thresholds and the population each was measured in, and the smallest change that exceeds measurement error. You score the instrument. This page is the reference you would otherwise look up.

NeuroDash publishes this as its own summary. It is not reviewed by an outside board-certified specialist and carries no CEU. It reproduces no instrument’s items — each remains the copyright holder’s — and it applies no threshold to any patient. It is general reference, not a diagnosis and not a recommendation for any individual.

DHI

Dizziness Handicap Inventory

Measures

Self-reported handicap from dizziness.

Score frame

25 items, scored 0 to 100. Higher is worse.

Published thresholds

0–30 mild · 31–60 moderate · 61–100 severe (Whitney 2004).

Meaningful change

A change of about 18 points or more is generally regarded as exceeding measurement error (Jacobson & Newman 1990).

Read with care

A self-report of handicap, not a diagnostic test. It measures what the patient reports about their life, not what the labyrinth is doing.

Source

Shirley Ryan AbilityLab; Jacobson & Newman 1990; Whitney 2004

DGI

Dynamic Gait Index

Measures

Gait and balance across changing tasks.

Score frame

8 items, scored 0 to 24. Higher is better.

Published thresholds

19 or below out of 24 was associated with increased fall risk in older adults and in vestibular disorders.

Meaningful change

MDC about 3.2 points in vestibular disorders — a smaller change may be measurement noise.

Read with care

Has a ceiling effect in higher-functioning patients, which is the reason the FGA exists.

Source

Shirley Ryan AbilityLab; Hall & Herdman

FGA

Functional Gait Assessment

Measures

Gait assessment with less ceiling effect than the DGI.

Score frame

10 items, scored 0 to 30. Higher is better.

Published thresholds

22 or below out of 30 in community-dwelling older adults (Wrisley & Kumar 2010). The threshold is population-specific — about 15 out of 30 has been reported in Parkinson disease.

Meaningful change

MDC about 6 points in vestibular disorders (Marchetti 2014).

Read with care

The cut-score depends on the population it was derived in. Read the reference for your patient's population before using any threshold.

Source

Shirley Ryan AbilityLab; Wrisley & Kumar 2010; Marchetti 2014

ABC

Activities-specific Balance Confidence scale

Measures

Self-reported balance confidence across everyday activities.

Score frame

16 items, scored 0 to 100 percent. Higher is better.

Published thresholds

Below 67 percent was associated with increased fall risk (Lajoie & Gallagher). Reported bands: below 50 low function, 50 to 66 fall risk, 67 to 80 moderate, above 80 high.

Meaningful change

MCID about 18.1 percent in vestibular disorders (Wellons 2022).

Read with care

A self-report of confidence. Context matters, and confidence and capacity are not the same measurement.

Source

Shirley Ryan AbilityLab; Lajoie & Gallagher; Wellons 2022

Thresholds are reported with the population they were derived in because they do not transfer between populations. A value from one cohort applied to a different one is a different claim than the paper made.

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