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Journal of Neurosurgical Sciences 2000 December;44(4):220-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Investigation and comparison of the effects of rehabilitation on balance and coordination problems in patients with posterior fossa and cerebellopontine angle tumours

Karakaya M. 1, Kose N. 1, Otman S. 1, Ozgen T. 2

1 School of Physical Therapy and Rehabilitation, Neurosurgery Unit, Hacettepe University, Ankara, Turkey; 2 Department of Neurosurgery, Hacettepe University, Ankara, Turkey


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Background. This ­study was ­planned to inves­ti­gate and com­pare the ­effects of ­acute reha­bil­i­ta­tion pro­gramme on bal­ance and coor­di­na­tion prob­lems in ­patients ­with pos­te­ri­or fos­sa and cer­e­bel­lo­pon­tine ­angle ­tumours.
Methods. This ­study was car­ried out at Hacettepe University, School of Physical Therapy and Rehabilita-­tion, neu­ro­sur­gi­cal reha­bil­i­ta­tion ­unit on 40 ­patients ­whose ­ages var­ied ­between 18-60 ­years. Subjects ­were sub­di­vid­ed ­into two ­groups. Group I con­sist­ed of 20 ­patients ­with pos­te­ri­or fos­sa ­tumour, ­while the ­group II was com­posed of 20 ­patients ­with cer­e­bel­lo­pon­tine ­angle ­tumour. Patients ­were eval­u­at­ed accord­ing to the local­isa­tion of the ­tumour, the num­ber of the sur­gi­cal oper­a­tions, the lev­el of the sur­gi­cal exci­sion of the ­tumour, percent of having ­shunt, radio­ther­a­py and chem­o­ther­a­py. Balance prob­lems ­were ­assessed accord­ing to Mokken’s func­tion­al inde­pen­dence assess­ment ­scale in 5 select­ed posi­tions and stand­ing bal­ance was ­also eval­u­at­ed accord­ing to the meth­od of Bohannon. The reha­bil­i­ta­tion of the ­patients includ­ed bal­ance and coor­di­na­tion train­ing. The ­patients ­were re-eval­u­at­ed ­before ­their dis­charge and the ­results of the two eval­u­a­tions ­were com­pared.
Results. A sig­nif­i­cant improve­ment was ­found in the sec­ond ­group ­when pre- and ­post-treat­ment eval­u­a­tions ­were com­pared. There ­were ­more coor­di­na­tion prob­lems in ­group l in the pretreat­ment peri­od. Both ­groups ­showed sig­nif­i­cant improve­ment of coor­di­na­tion prob­lems ­after the treat­ment. However, ­this improve­ment was ­more obvi­ous in the sec­ond ­group (p<0.05). There was a neg­a­tive sig­nif­i­cant cor­re­la­tion ­between the ­decrease of bal­ance prob­lems and the ­amount of the ­tumour ­excided (I Group r=-0.51, II Group r=-0.57).
Conclusions. It can be con­clud­ed ­that reha­bil­i­ta­tion approach­es are effec­tive in bal­ance and coor­di­na­tion prob­lems ­observed in ­both ­tumour ­groups, but the respons­es to treat­ment are ­more obvi­ous in the cer­e­bel­lo­pon­tine ­angle ­tumours, ­which ­have bet­ter prog­no­sis.

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