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Effects of Vestibular Rehabilitation Therapy on Postural Control and Quality of Life in Patients after a Surgical Microvascular Decompression of the Cochleo-Vestibular Nerve

Bernard-Demanze L *,Montava M ,Mattei A ,Lavieille JP,Lacour M

Introduction: The purpose of this study was to evaluate the effectiveness of a vestibular rehabilitation therapy (VRT) on the static and dynamic postural control and on the quality of life in patients after a surgical microvascular decompression of the cochleo-vestibular nerve. Method: Eight patients with a neurovascular conflict were submitted to a surgical microvascular decompression at the Hospital (France). Four patients (G1 group) benefited from VRT whereas four other patients (G2 group) returned to their daily life functions and professional activities without VRT. VRT combined exercises on both rotary chair and dynamic post-urography platform and started 7 days after surgery. Evaluation of the postural performance with (EO) and without vision (EC) and during optokinetic stimulation, was carried out in the two groups before (REF), seven days (DAYS 7) and two months (DAYS 67) after the surgery. Questionnaires on the quality of life (SF-36) were administered on DAYS 67 in both groups. Results: The statistical test performed on the posturography data collected under static and dynamic conditions did not show any significant differences between the two groups in EO, EC and during optokinetic stimulation before surgery and on DAYS 7. By contrast, the postural performance in static and dynamic conditions was significantly improved (p<0.05) in the patients who benefited from the VRT with (EO) and without (EC) vision on DAYS 67. Maintaining balance on an unstable platform with optokinetic stimulation was impossible on DAYS 67 for the patients without VRT whereas the patients with VRT succeeded in this more challenging condition. The SF-36 questionnaire was also better in the patients who benefited from the VRT compared to the patients without VRT. Conclusion: This pilot study shows that VRT improves significantly the postural control and the quality of life as well after surgical microvascular decompression. This conclusion must be confirmed on a larger group of patients.