Page 48 - Portuguese Journal - SPORL - Vol 61. Nº1
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dizziness and vertigo are due to benign Materials and Methods
paroxysmal vertigo of childhood (BPVC), This study was conducted in a tertiary hospital
vestibular migraine (VM), viral infection, head in Lisbon between January and October 2021.
trauma, and otitis media 1,3,4 . Migraine, BPVC, The study was registered and approved by
and VM are the most common causes of these the ethics committee of the institution. The
symptoms 1,2,5 . BPVC, which is considered a team that developed the original version
precursor of migraine, is the most common of the instrument was asked, via e-mail, for
cause of vertigo in children aged up to six formal consent for the translation and use of
years, whereas VM manifests in older children the instrument. The procedures followed were
6 . Recently, the term BPVC has been replaced according to the regulations established by the
by the term “recurrent vertigo in childhood” Clinical Research and Ethics Committee and
by the Bárány Society . The vestibular system in accordance with the Helsinki Declaration of
7
appears to be important for normal cognitive the World Medical Association.
and emotional development of children . The adaptation was based on the steps
8
Vestibular disorders may lead to avoidance recommended by Beaton et al. , which
9
behaviors, with adverse effects on academic have been previously used to translate and
performance and quality of life . Therefore, culturally adapt another questionnaire . The
10
4
prompt diagnosis is important to resolve the methodological sequence was as follows:
condition or control the symptoms. Unlike translation into Portuguese, discussion
adults, younger children have often not yet among focus groups, back-translation into
developed the language required to express English, and validation by the team that
the specific nature of their symptoms, duration developed the original instrument. Three
of episodes, and what causes or accompanies focus groups were created to evaluate the
them . Moreover, vestibular tests (both clinical preservation of the construct and correct
2
and neurophysiological) are not uniformly understanding of sentences and expressions.
reliable in younger patients . These difficulties Written informed consent was obtained
6
hinder the determination of the origin and before creating the focus groups. The focus
severity of the imbalance problem and may groups were as follows: a group of caretakers
delay intervention . who accompanied the children to the vertigo
1,6
There are several instruments to assess the clinic, a group of children visiting the vertigo
presence, severity, and impact of vestibular clinic aged 8–17 years, and a group of teachers
symptoms in adults. However, few are currently from the institution’s school. The focus groups
available for use in the pediatric population. comprised eight children, sixteen caretakers,
In 2015, McCaslin et al. adapted the dizziness and four teachers from the institution’s
handicap inventory (DHI) to be answered school. The children were aged 8–15 years
by the caretakers of children aged 5–12 years (mean age of 12 years), and half of them were
(DHI-PC) because, in the case of younger girls. Parents/caretakers of the children who
patients, caretakers provide the clinical history did not understand the Portuguese language
and help determine the balance deficit . and children with developmental delays,
1
To our knowledge, the cultural adaptation neurological morbidities, or orthopedic
of the DHI-PC for Portugal has never been limitations were excluded from the study.
performed. This study aimed to translate The original version of the instrument contains
the Vanderbilt Pediatric Dizziness Handicap 21 questions to be answered by the child’s
Inventory for Patient Caregivers (DHI-PC) into caretaker. A total score in the DHI-PC between
European Portuguese and culturally adapt it 0 and 16 indicates that there is no limitation to
for use in Portuguese children with vestibular the child’s daily activities due to a vestibular
symptoms. problem. A score from 16 to 26 indicates a mild
limitation, while a score between 26 and 43
48 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery
