Acoustic neuromas are benign, slow-growing tumors on the vestibular nerve, the nerve which controls balance. These neuromas, more properly referred to as vestibular schwannomas, can cause symptoms which include headaches, hearing loss and severe vertigo. A specialized form of physical therapy known as vestibular rehabilitation or balance rehabilitation helps patients deal with the vertigo and resultant danger of falling.
Balance Exercises
Physical therapists use a number of common exercises to help their patients re-learn their sense of balance. Exercises involve common tasks such as reading or walking while moving the head or eyes back and forth to challenge the sense of balance. The therapist tailors the treatments to each patient's individual symptoms for better results.
Fall Prevention
Lack of balance can cause patients to fall in situations such as getting out of bed in the morning or bending over in the dark. Falls can be dangerous, especially for older patients. Balance rehabilitation includes educating patients on fall prevention by helping them understand when falls are more likely and how to minimize vertigo during daily activities. For example, a patient might be taught to sit up on the edge of the bed in the morning and take a few seconds to orient himself before standing.
Facial Muscles
In addition to causing balance problems, acoustic neuromas can cause weakness in facial muscles. Physical therapy can correct that by teaching patients exercises designed to strengthen the affected muscles. Patients who perform these exercises can return their facial muscles to normal strength.
Self-Directed Exercises
A therapist-directed vestibular rehabilitation program is better than self-directed exercises, but some patients cannot afford regular therapy visits. Some clinics will provide at-home therapeutic programs which can be performed without the need of a therapist. One of the earliest examples of self-directed vestibular rehabilitation is the Cawthorne Cooksey program. Patients can perform the exercises alone, but it is safer if they are supervised by a friend or relative due to the risk of falling.
Alternatives
Both the American Hearing Research Foundation and the University of Maryland Medical Center report that other activities appear to help patients deal with the vertigo from acoustic neuroma, though there is no medical evidence measuring their effectiveness. Tai chi has been found to help patients with balance problems, as have other non-strenuous activities such as bowling or golf. Patients should be careful in these unsupervised settings that they don't injure themselves in a fall due to their weak sense of balance.
References
- American Hearing Research Foundation: Balance and Vestibular Rehabilitation Therapy; Timothy C. Hain, MD; October 2008
- American Physical Therapy Association; Acoustic Neuroma; Lisa Farrell, PT, PhD; 2010
- University Of Maryland Medical Center: Acoustic Neuroma/Vestibular Schwannoma
- University Of Maryland Medical Center: The Vestibular System and Vertigo
