This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Vereeck, L. Articles by Van de Heyning, P. H Search for Related Content PubMed PubMed Citation Articles by Vereeck, L. Articles by Van de Heyning, P. H Pubmed/NCBI databases Medline Plus Health Information Acoustic Neuroma Dizziness and Vertigo Social Bookmarking                         What's this?

The effect of early customized vestibular rehabilitation on balance after acoustic neuroma resection

Division of Neuro- and Psychomotor Physical Therapy, Department of Health Sciences, University College of Antwerp, Merksem, Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Faculty of Medicine, University of Antwerp, Antwerpen, 1.vereeck{at}ha.be

Floris L Wuyts

AUREA, Department of Otorhinolaryngology, Antwerp University Hospital, Edegem and Faculty of Science, Department of Biomedical Physics, University of Antwerp, Antwerpen

Steven Truijen

Division of Neuro- and Psychomotor Physical Therapy, Department of Health Sciences, University College of Antwerp

Claudia De Valck

AUREA, Department of Otorhinolaryngology, Antwerp University Hospital, Edegem and Faculty of Medicine, University of Antwerp, Antwerpen, Belgium

Paul H Van de Heyning

AUREA, Department of Otorhinolaryngology, Antwerp University Hospital, Edegem and Faculty of Medicine, University of Antwerp, Antwerpen, Belgium

Objective: To compare the effect of early customized vestibular rehabilitation with general instructions in patients after acoustic neuroma surgery.

Setting: Tertiary referral centre.

Subjects: Fifty-three patients after surgery.

Design: A prospective assessor-blinded, randomized controlled trial.

Interventions: After stratification for age (<50 years; 50 years), patients were randomly allocated into groups receiving general instructions or customized vestibular rehabilitation protocols for 12 weeks.

Outcome measures: Standing Balance Sum, Timed Up and Go test, Tandem Gait and Dynamic Gait Index. Balance performance was assessed preoperatively, at discharge (one week after surgery), three, six, nine, 12, 26 and 52 weeks after surgery.

Results and discussion: All subjects clearly improved within the first six weeks after surgery. However, older subjects receiving vestibular rehabilitation performed significantly (P<0.05) better on standing balance, Timed Up and Go test and Tandem Gait, when compared with the older group that received only general instructions. This effect persisted up to 12 weeks and also became apparent on the Dynamic Gait Index. In addition, the older vestibular rehabilitation group had better balance scores at 12 weeks when compared with their original preoperative scores (P<0.05). This pattern remained even up to one year after surgery (P<0.05).

Conclusion: In patients over 50, early vestibular rehabilitation facilitates recovery of postural control after acoustic neuroma surgery. Customized vestibular rehabilitation should be given in addition to general instructions that stress the need of exposure to movement. Retention of the early beneficial effects even one year after surgery stresses the importance of customized vestibular rehabilitation.

Clinical Rehabilitation, Vol. 22, No. 8, 698-713 (2008)
DOI: 10.1177/0269215508089066


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?