Evaluating Pre-Treatment Vestibular Physical Therapy Rehab for Patients With Vestibular Schwannomas

The study is a pilot efficacy study. The investigators aim to estimate mean baseline and post-treatment balance scores among Vestibular Schwannomas (VS) patients undergoing pretreatment rehab (PREHAB) or no PREHAB when managed with either surgery or radiosurgery.

Inclusion Criteria:Provision of signed and dated informed consent formMale or female participants ≥18 years of age.Initial diagnosis of a Vestibular Schwannoma confirmed by a physician with an internal auditory canal (IAC) MRI, in accordance with standard or institutional practiceVS patients who present with a tumor size ≤2.5 cm and will be treated with surgery or SRSEastern Cooperative Oncology Group (ECOG) Performance Status <2Within 14 days of study registration, participants must have normal laboratory values that support safe treatment, at the discretion of the treating investigatorBe willing to adhere to outlined study protocol criteria and complete self-reported questionnaires (translations may be made available if the patient' primary language is not English).For females of reproductive potential: must have a negative urine or serum pregnancy test 7 prior to enrollment and agreement to use of highly effective contraception method during study participation and for an additional 24 weeks after the completion of stereotactic radiosurgery.Exclusion Criteria:Subjects less than 18 years of agePrior treatment of VS including radiotherapy or surgery or treatment for disease recurrence or planned salvage procedurePre-existing, secondary vestibular diagnoses (e.g., Meniere's, intractable benign paroxysmal positional vertigo (BPPV), vestibular migraine, 3PD).Other medical comorbidities know to significantly impair/affect balance and/or vestibular function testing (e.g., prior stroke, uncorrected visual impairment or blindness, etc.)Anticipated radiation other than stereotactic (fractionated)Inability to undergo MRI scans safelyAllergy to Gadolinium contrast used for MRI scansWomen of childbearing potential who are known to be pregnant or are unwilling to use an acceptable method of contraception from the time of informed consent until completion of study related treatment and additional 24 weeks following stereotactic radiosurgery administration.