title: The effect of early customized vestibular rehabilitation on balance after acoustic neuroma resection.
abstract: OBJECTIVE
  To compare the effect of early customized vestibular rehabilitation with general instructions in patients after acoustic neuroma surgery.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Fifty-three patients after surgery.
  
  
  METHODS
  A prospective assessor-blinded, randomized controlled trial.
  
  
  METHODS
  After stratification for age (<50 years; >or=50 years), patients were randomly allocated into groups receiving general instructions or customized vestibular rehabilitation protocols for 12 weeks.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Neuro- and Psychomotor Physical Therapy, Department of Health Sciences, University College of Antwerp, Merksem, Belgium. 1.vereeck@ha.be
authors.forename: Luc
authors.initials: L
authors.lastname: Vereeck
authors.forename: Floris L
authors.initials: FL
authors.lastname: Wuyts
authors.forename: Steven
authors.initials: S
authors.lastname: Truijen
authors.forename: Claudia
authors.initials: C
authors.lastname: De Valck
authors.forename: Paul H
authors.initials: PH
authors.lastname: Van de Heyning
mesh_terms: D004244:Dizziness / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000556:secondary*; D013506:Otologic Surgical Procedures; D004856:Postural Balance