Exercise with visual feedback improves postural stability after vestibular schwannoma surgery

Abstract

We analyzed the effect of 2-week individualized visual feedback-based balance training on the postural control of patients undergoing retrosigmoid microsurgical removal of vestibular schwannoma. We performed prospective evaluation of 17 patients allocated into two groups: feedback group (9 patients, mean age 37 years) and standard physiotherapy group (8 patients, mean age 44 years). Patients in both the groups were treated once per day by intensive rehabilitation from 5th to 14th postoperative day. Rehabilitation of patients in the feedback group was performed using the visual feedback and force platform. Results were evaluated on the beginning and at the end of rehabilitation program (e.g. 5th and 14th postoperative day). Outcome measures included posturography during quiet stance under four different conditions by the modified Clinical Test for Sensory Interaction of Balance. Body sway was evaluated from center of foot pressure. Compensation of Center of pressure (CoP) parameters in stance on firm surface was similar in the control and feedback groups. However, in stance on foam surface with eyes closed the patients from the feedback group were better compensated and CoP parameters differed significantly (p < 0.05). This prospective clinical study suggests that specific exercises with visual feedback improve vestibulospinal compensation in patients after vestibular schwannoma surgery and thus can improve their quality of life.

Whole-Body Vibration Training Improves Balance, Muscle Strength and Glycosylated Hemoglobin in Elderly Patients with Diabetic Neuropathy

“…Because ML postural sway is highly correlated with fall risk, the decreases in ML postural sway observed in the present study are considered to be clinically meaningful (Maki et al 1994;Stel et al 2003). Furthermore, a number of studies concerning fall prevention in the elderly have repeatedly emphasized that a decrease in postural sway is substantially correlated with fall prevention (Allet et al 2010;Cakrt et al 2010).…”

Vestibular rehabilitation in elderly patients with central vestibular dysfunction: a prospective, randomized pilot study

“…The information available on the role of posturography in vestibular rehabilitation is still rather limited, however. While posturography-assisted rehabilitation using visual feedback seems to reduce sway during stance and to improve postural control (Cakrt et al 2010), little is known about its usefulness in rehabilitation programs, particularly for elderly patients with central vestibular dysfunctions. The use of vestibular exercises to treat patients with chronic peripheral vestibular lesions has become relatively popular.…”

Minimally Invasive Endoscopic and Endoscopy-Assisted Microsurgery of Vestibular Schwannoma

“…The transition zone (Obersteiner-Redlich zone) of the superior or inferior vestibular nerves where the covering myelin changes from a central to a peripheral type or vestibular ganglion are estimated to be the site of pathologic proliferation of Schwann cells leading to tumor (Tallan et al 1993, Zverina, 2010. Thus acoustic neuroma or neurinoma represent misnomers.…”

“…There are two distinct clinical presentations for vestibular schwannomas: Sporadic unilateral tumor is the most common form occurring in 95% of cases, and the rare hereditary bilateral tumors which are typically a sign of neurofibromatosis type 2. Vestibular schwannomas have an incidence of 10 to 15 per million per year and represent the most common tumor in neurotology (Myrseth et al 2007, Zverina, 2010. These tumors account for approximately 10% of all intracranial and 80 to 95% of cerebellopontine angle tumors (Springborg et al 2008).…”

“…The growth rate of vestibular schwannoma varies and can be categorized into one of three patterns: slow (1-2 mm/ year), medium (2-4 mm/ year), and fast (1-2 cm/ year). The majority of tumors grow slowly and in some cases spontaneous regression was reported (Zverina et al 2010). If not treated, vestibular schwannomas can reach a remarkable size causing severe compression of the brainstem and cerebellum eventually leading to hydrocephalus and intracranial hypertension (Zverina, 2010).…”