Chulalongkorn Medical Journal


Background : Post-operative patients after removal of vestibular schwannoma usuallysuffer from dizziness and vertigo. So far, there is no well-establishedrehabilitation program to help these patients. Chulalongkorn-Vestibular-Balance-Exercise Program is hence designed to as a rehabilitation programthat stimulates improvement of the vestibular function. The program shouldhelp relieve the undesirable symptoms in these patients.Objective : To study the effect of Chulalongkorn-Vestibular-Balance-Exercise Programin improving vestibular compensation in patients with post-operativevestibular schwannoma removal at 1 month after the operation.Methods : Patients with vestibular schwannoma and admitted for surgery at KingChulalongkorn Memorial Hospital were recruited. They were explainedabout the study and signed their informed consent forms prior to surgeryand then randomized into 2 groups: exercise group and control group.Chulalongkorn-Vestibular-Balance-Exercise Program has simplified bothvestibular adaptation exercises (x1 viewing paradigm and 2 viewingparadigm) and habituation exercises into five illustrated, simple steps thatcan be performed at home after discharge. Both groups were assessed atone month post-operation; their scores were in 2 aspects: the subjectivesymptom of vertigo/ disequilibrium (visual analog score; VAS 0 - 10);the objective measure of imbalance (posturography).Results : In the exercise group, visual analog score in vertigo/disequilibrium postoperationwas 1.3/10 compared to 4.5/10 in control group at 1 month.Posturogram showed improvement in objective measurement in condition5 (use only vestibular clue) increased 23.53% from controls.Conclusion : Despite its simplicity, Chulalongkorn-Vestibular-Balance-Exercise Programcan effectively enhance vestibular compensation, as seen in the trend ofimprovement in patients’ balance status and vertigo/disequilibriumsymptoms in post-operative vestibular schwannoma patients at as earlyas one month.


Faculty of Medicine, Chulalongkorn University

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