physioscience 2025; 21(S 03): S7-S8
DOI: 10.1055/s-0045-1812361
Abstracts
Präsentationen/Presentations
PS 3

Persistent Postural-Perceptual Dizziness (PPPD)

Authors

  • S Chételat

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    2   Zurich University of Applied Sciences, Institute of Physiotherapy, Winterthur, Switzerland

  • E Y Gerber

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland

  • S El Khadlaoui

    3   University Hospital LMU Munich, German Center for Vertigo and Balance Disorders, Munich, Germany

  • F Behrendt

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    4   Bern University of Applied Sciences, School of Engineering and Computer Science, Biel, Switzerland

  • M Stark

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    2   Zurich University of Applied Sciences, Institute of Physiotherapy, Winterthur, Switzerland

  • S Schädler

    5   Physiotherapy, Stefan Schädler, Suniswald, Switzerland

  • M Maywald

    6   University Hospital LMU Munich, Department of Psychiatry and Psychotherapy, Munich, Germany

  • L Fabritius

    3   University Hospital LMU Munich, German Center for Vertigo and Balance Disorders, Munich, Germany

  • J Gerb

    3   University Hospital LMU Munich, German Center for Vertigo and Balance Disorders, Munich, Germany
    7   University Hospital LMU Munich, Department of Neurology, Munich, Germany

  • D Grabova

    3   University Hospital LMU Munich, German Center for Vertigo and Balance Disorders, Munich, Germany

  • W Trost

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland

  • A Zwergal

    3   University Hospital LMU Munich, German Center for Vertigo and Balance Disorders, Munich, Germany
    7   University Hospital LMU Munich, Department of Neurology, Munich, Germany

  • R Strobl

    8   LMU Munich, Institute for Medical Information Processing, Biometry, and Epidemiology, Munich, Germany

  • K Parmar

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    9   University Hospital Basel and University of Basel, Departments of Head, Spine and Neuromedicine and Biomedical Engineering, Translational Imaging in Neurology (ThINk) Basel, Basel, Switzerland

  • H U Gerth

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    10   University Hospital Münster, Department of Medicine, Münster, Germany

  • L H Bonati

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    11   University Hospital Basel, Department of Neurology, Stroke Center, Basel, Switzerland
    12   University of Basel, Department of Clinical Research, Basel, Switzerland

  • C Schuster-Amft

    1   Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
    4   Bern University of Applied Sciences, School of Engineering and Computer Science, Biel, Switzerland
    13   University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
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Background Persistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic diseases. The study's aim was to evaluate the concurrent construct validity and reliability [including test-retest reliability, internal consistency, standard error of measurement (SEM), and minimal detectable change (MDC)] of the German version of the NPQ (12 items) and its revised version, NPQ-R, containing 19 items addressing additional symptoms and symptom behavior.

Methods The Swiss Reha Rheinfelden and the German Center for Vertigo and Balance Disorders included 265 PPPD patients (mean age 50.2±16.8 years, disease duration 46.3±76.6 months). Patients completed the NPQ and the NPQ-R (twice), the DHI and potentially related constructs: anxiety (ABC-Scale, VSS), depression (HADS), and general health (SF-36) once. To assess the questionnaires' reliability and validity, statistical analyses included: the Spearman's rank correlation coefficients, Intraclass Correlation Coefficients (ICC2, 1), Cronbach's alpha, SEM, and MDC.

Results On average, patients scored 29.9±13.2 for NPQ and 52.3±19.6 for NPQ-R. Correlations between NPQ/NPQ-R and (1) disease-specific questionnaires were rs = 0.712 and rs = 0.752 (DHI), rs = 0.426 and rs = 0.462 (VSS-V), rs = –0.500 and rs = –0.545 (ABC-Scale), (2) anxiety-specific subscales rs = 0.394 and rs = 0.430 (VSS-A) and rs = 0.354 and rs = 0.430 (HADS-A), (3) depression-related subscales rs = 0.438 and rs = 0.487 (HADS-D), and (4) general health rs ranged between rs = –0.216 and –0.578 (all SF-36 subscales). Internal consistency, test-retest reliability, SEM and MDC calculated for NPQ/NPQ-R were α = 0.88/α = 0.91, ICC = 0.83 (CI 0.77 to 0.87), SEM 5.55/8.37, and MDC 15/23 points.

Conclusions The German versions of NPQ and NPQ-R are valid and reliable patient-reported outcome measures for assessing PPPD, demonstrating satisfactory psychometric measurement properties including convergent construct validity and reliability parameters: internal consistency, test-retest reliability, SEM, and MDC as an evaluative measure. The NPQ-R, with its additional subscales addressing associated symptoms and symptom behavior, represents both the patient and clinician perspective on PPPD-specific problems. Therefore, we recommend utilizing the NPQ-R for a comprehensive assessment of PPPD.



Publication History

Article published online:
23 October 2025

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