Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework

AimTo explore the full spectrum of symptoms and impacts associated with chronic unilateral vestibular hypofunction (UVH), and to assess whether these symptoms and impacts are fully covered by patient-reported outcome measures (PROMs) within the International Classification of Functioning, Disability...

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Main Authors: Mustafa Karabulut, Hamide Avci, Eda Yalçınkaya, Merel Kimman, Wolfgang Viechtbauer, Alfarghal Mohamad, Vincent Van Rompaey, Nils Guinand, Angélica Perez Fornos, Levent Özlüoğlu, Osman Nuri Özgirgin, Raymond van de Berg
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1589404/full
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author Mustafa Karabulut
Hamide Avci
Eda Yalçınkaya
Merel Kimman
Wolfgang Viechtbauer
Alfarghal Mohamad
Vincent Van Rompaey
Nils Guinand
Angélica Perez Fornos
Levent Özlüoğlu
Osman Nuri Özgirgin
Raymond van de Berg
author_facet Mustafa Karabulut
Hamide Avci
Eda Yalçınkaya
Merel Kimman
Wolfgang Viechtbauer
Alfarghal Mohamad
Vincent Van Rompaey
Nils Guinand
Angélica Perez Fornos
Levent Özlüoğlu
Osman Nuri Özgirgin
Raymond van de Berg
author_sort Mustafa Karabulut
collection DOAJ
description AimTo explore the full spectrum of symptoms and impacts associated with chronic unilateral vestibular hypofunction (UVH), and to assess whether these symptoms and impacts are fully covered by patient-reported outcome measures (PROMs) within the International Classification of Functioning, Disability and Health (ICF) framework.MethodsA qualitative study was conducted using semi-structured interviews, which were recorded, transcribed, and analyzed by two independent reviewers through a consensus approach. Data collection continued until thematic saturation was reached. Domains were then identified from interviews and PROMs (Dizziness Handicap Inventory, Hospital Anxiety and Depression Scale, EQ-5D-5L) using the ICF linking process. The analysis comprised three stages: (1), documenting the full spectrum of UVH symptoms and impacts from interviews, (2) reporting domains and constructs based on interviews, (3) comparing domains identified from interviews with those from PROMs (DHI, HADS, EQ-5D-5L, analyzed separately).ResultsFifteen patients with chronic UVH were interviewed. Reported symptoms revealed 16 physical symptoms, four cognitive symptoms, and five emotions. Key challenges included driving difficulties, darkness, sleep problems, fear of falling, and discomfort in crowded environments. Patients adapted certain behaviors, such as moving slowly, using supports, and avoiding sudden movements. Regarding the ICF framework, the most frequently reported construct was Body functions, with key domains including emotional, vestibular, and hearing-related functions. Activities and participation focused on maintaining body position and family relationships, while environmental factors highlighted the impact of light and sound. Interviews identified key domains related to vision, memory, multitasking, and activities impacting quality of life that were often overlooked by the PROMs.ConclusionPatients with chronic UVH experience a wide spectrum of physical, cognitive, and emotional symptoms, resulting in significant limitations in daily life. The frequently used PROMs (DHI, HADS, and EQ-5D-5L) do not fully cover these symptoms and their impacts, which leave many aspects underrepresented. A tailored PROM for UVH may be needed, to better reflect the specific symptoms, behaviors and functional limitations related to chronic UVH.
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spelling doaj-art-51f6d880a89d4da0aeea85885a4eeeae2025-08-20T02:01:33ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15894041589404Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF frameworkMustafa Karabulut0Hamide Avci1Eda Yalçınkaya2Merel Kimman3Wolfgang Viechtbauer4Alfarghal Mohamad5Vincent Van Rompaey6Nils Guinand7Angélica Perez Fornos8Levent Özlüoğlu9Osman Nuri Özgirgin10Raymond van de Berg11Division of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsFaculty of Behavioural and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, NetherlandsDepartment of Otolaryngology-Head and Neck Surgery, Bayındır Hospital, Ankara, TürkiyeDepartment of Clinical Epidemiology and Medical Technology (KEMTA), Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Maastricht University, Maastricht, NetherlandsDepartment of Ear Nose Throat, King Abdul Aziz Medical City, Jeddah, Saudi ArabiaDepartment of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BelgiumService of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, SwitzerlandService of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Otorhinolaryngology and Head and Neck Surgery, Ankara Baskent University Hospital, Ankara, TürkiyeDepartment of Otolaryngology-Head and Neck Surgery, Bayındır Hospital, Ankara, TürkiyeDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsAimTo explore the full spectrum of symptoms and impacts associated with chronic unilateral vestibular hypofunction (UVH), and to assess whether these symptoms and impacts are fully covered by patient-reported outcome measures (PROMs) within the International Classification of Functioning, Disability and Health (ICF) framework.MethodsA qualitative study was conducted using semi-structured interviews, which were recorded, transcribed, and analyzed by two independent reviewers through a consensus approach. Data collection continued until thematic saturation was reached. Domains were then identified from interviews and PROMs (Dizziness Handicap Inventory, Hospital Anxiety and Depression Scale, EQ-5D-5L) using the ICF linking process. The analysis comprised three stages: (1), documenting the full spectrum of UVH symptoms and impacts from interviews, (2) reporting domains and constructs based on interviews, (3) comparing domains identified from interviews with those from PROMs (DHI, HADS, EQ-5D-5L, analyzed separately).ResultsFifteen patients with chronic UVH were interviewed. Reported symptoms revealed 16 physical symptoms, four cognitive symptoms, and five emotions. Key challenges included driving difficulties, darkness, sleep problems, fear of falling, and discomfort in crowded environments. Patients adapted certain behaviors, such as moving slowly, using supports, and avoiding sudden movements. Regarding the ICF framework, the most frequently reported construct was Body functions, with key domains including emotional, vestibular, and hearing-related functions. Activities and participation focused on maintaining body position and family relationships, while environmental factors highlighted the impact of light and sound. Interviews identified key domains related to vision, memory, multitasking, and activities impacting quality of life that were often overlooked by the PROMs.ConclusionPatients with chronic UVH experience a wide spectrum of physical, cognitive, and emotional symptoms, resulting in significant limitations in daily life. The frequently used PROMs (DHI, HADS, and EQ-5D-5L) do not fully cover these symptoms and their impacts, which leave many aspects underrepresented. A tailored PROM for UVH may be needed, to better reflect the specific symptoms, behaviors and functional limitations related to chronic UVH.https://www.frontiersin.org/articles/10.3389/fneur.2025.1589404/fullunilateral vestibular hypofunctionunilateral vestibular lossunilateral vestibulopathysymptomsinternational classification of functioningdisability and health (ICF)
spellingShingle Mustafa Karabulut
Hamide Avci
Eda Yalçınkaya
Merel Kimman
Wolfgang Viechtbauer
Alfarghal Mohamad
Vincent Van Rompaey
Nils Guinand
Angélica Perez Fornos
Levent Özlüoğlu
Osman Nuri Özgirgin
Raymond van de Berg
Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
Frontiers in Neurology
unilateral vestibular hypofunction
unilateral vestibular loss
unilateral vestibulopathy
symptoms
international classification of functioning
disability and health (ICF)
title Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
title_full Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
title_fullStr Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
title_full_unstemmed Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
title_short Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework
title_sort chronic unilateral vestibular hypofunction a qualitative study exploring the full spectrum of symptoms and impacts through the icf framework
topic unilateral vestibular hypofunction
unilateral vestibular loss
unilateral vestibulopathy
symptoms
international classification of functioning
disability and health (ICF)
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1589404/full
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