Vestibular Rehabilitation Protocol in Unilateral Vestibular Schwannoma

Condition(s) studied

Investigational drug(s) / intervention(s)

No Intervention: Observational Cohort: Participants undergo the standard surgical treatment for unilateral vestibular schwannoma and complete protocol assessments (vHIT, posturography, DHI, and hospital length of stay). They do not receive any preoperative or postoperative vestibular rehabilitation.

Structured home-based vestibular telerehabilitation program: Structured home-based vestibular rehabilitation program delivered through the ReHub digital platform for 3 weeks before surgery and 3 weeks after surgery, including gaze stabilization, balance, and habituation exercises with remote supervision.

CE-marked clinical rotatory chair: Six supervised sessions of controlled vestibular stimulation delivered over 3 weeks using a CE-marked clinical rotatory chair following a progressive protocol in rotational velocity and post-rotation fixation tasks.

Study summary

Brief Summary

The purpose of this clinical trial is to evaluate whether different strategies of vestibular rehabilitation, performed before and after surgery, can improve recovery in adults diagnosed with unilateral vestibular schwannoma. The main questions the study aims to answer are:

Does preoperative vestibular telerehabilitation improve postoperative vestibular compensation compared with no intervention?

Does adding preoperative rotatory chair stimulation to telerehabilitation lead to greater improvements in balance, dizziness, or hospital length of stay?

The study includes three comparison groups:

No-intervention group: Participants do not receive pre- or postoperative rehabilitation, but complete all study assessments (vHIT, DHI, posturography, and hospital length of stay).

Telerehabilitation group: Participants complete a structured home-based vestibular telerehabilitation program (ReHub) for 3 weeks before surgery and again for 3 weeks after surgery.

Rotatory Chair + Telerehabilitation group: Participants receive the same telerehabilitation program as the telerehabilitation group, plus six supervised sessions of preoperative rotatory chair stimulation (two sessions per week for three weeks), following a progressive protocol in the ENT department using a CE-marked clinical rotatory chair.

Participants will:

Attend routine preoperative and postoperative assessments (vHIT, posturography, and DHI).

Complete home-based vestibular exercises through a digital telerehabilitation platform (Groups 2 and 3).

If assigned to the Rotatory Chair + Telerehabilitation group, attend six in-hospital sessions of controlled rotatory chair stimulation during the three weeks before surgery.

Undergo follow-up evaluations at 4 and 12 weeks after surgery.

This study aims to determine whether structured vestibular training conducted before and after surgery can enhance postoperative compensation and reduce symptom burden in patients undergoing vestibular schwannoma surgery.

Eligibility

Primary outcome measure(s)

• Video Hit Impulse Test (VHIT) — Baseline (4 weeks before surgery), and at 3 and 12 weeks after surgery
• posturography — Baseline (4 weeks before surgery), and at 3 and 12 weeks after surgery
• Dizzines Handicap Inventory — Baseline (4 weeks before surgery), and at 3 and 12 weeks after surgery
  a 25-item self-reported questionnaire assessing perceived handicap due to dizziness, with total scores ranging from 0 to 100. Higher scores indicate greater perceived disability.
• Lenght of hospital stay (LOS) — From surgery to hospital discharge (assessed at discharge)

Trial sites (1)