The Impact of Surgery on Balance, Gait, Upper limb Dexterity and Dizziness in Patients with Posterior Fossa Tumours

Introduction: Tumours of the posterior fossa of the cranium are associated with significant impairments, morbidity and mortality. Limited evidence is available in the adult population, of the potential impact a surgical intervention can have on function, in this tumour type. The rehabilitation practices utilised to treat the associated impairments have also received limited investigation. Aims/Objectives: The primary aim of this research study was to characterise the impact of surgery on balance, gait, upper limb dexterity and dizziness in patients with posterior fossa tumours. Secondary aims of the study were to profile the demographic and tumour characteristics of the study participants. Methods: This was a prospective cohort study, which recruited thirteen participants over an eighteen month period. A comprehensive testing battery was completed over four time-points, of six months duration, to categorise the impact of surgery. A systematic review of rehabilitation practices in the management of impairments, associated with posterior fossa tumours, was also completed. Results: Thirteen participants, of mean age 48.8 ± 15.7, were recruited to the study. An improvement in the primary outcome, equilibrium and balance, was observed post-operatively, while surgical impact on gait speed, upper limb dexterity and dizziness resulted in negative consequences. Significant morbidity and mortality was associated with surgery in this population, impacting on data collection and analysis. Conclusions and Implications: Surgical intervention for the presence of a tumour in the posterior fossa, resulted in a decrease in gait speed and upper limb dexterity, an increase in dizziness and improvement in balance, post-operatively. The most frequently occurring tumour type was metastases, indicating the high risk of mortality associated with a tumour of this region of the brain. The testing battery used in this research project provides the foundation for comprehensive assessment and treatment of this population of patients, in future care.