Investigation of the Effects of Exercise on Patients With Chiari Malformation
Condition: Chiari Malformation Type I; Proprioceptive Disorders; Coordination and Balance Disturbances; Syringomyelia; Basilar Invagination; Exercise Addiction; Atlanto-Axial Subluxation
MeSH terms: Arnold-Chiari Malformation; Somatosensory Disorders; Syringomyelia; Congenital Abnormalities
Study type: Interventional

Summary: 
      Chiari Malformation (CM) is a posterior brain anomaly caused by the displacement of the brain
      stem and cerebellum into the cervical spinal canal. There are 8 types of Chiari malformations
      described today that vary according to the severity of the anomaly.

      In CM Type 1, cerebrospinal fluid (CSF) circulation deteriorated along with the foramen
      magnum and the cerebellar tonsillar decreased to at least 5 mm below the foramen magnum.
      Depending on this situation, headache, cerebellar findings, muscle strength, and sensory loss
      and so on. and adversely affect the daily life of the patient.

      When establishing an exercise program for the symptoms of CM type 1, it should be taken into
      consideration that somatosensory, visual, vestibular system and cerebellum are in close
      relationship with each other and balance and coordination result from this close
      relationship.

      When the literature is reviewed for exercise programs aimed at reducing instability in the
      cervical region, it is seen that 80% of the stability of the cervical spine originates from
      the muscular system and its importance in the treatment process is being investigated more
      and more day by day. However, no randomized controlled study was performed on these subjects.
      This study was planned to investigate the effects of two different exercise programs on pain,
      balance, coordination, proprioception, functional capacity, body posture, daily life
      activities and quality of life. The study was planned to involve at least 20 individuals with
      CM Type 1 who were not surgical indications in the 18-65 age range. The study was designed as
      a randomized, self-controlled study. Demographic data and characteristics of the subjects who
      meet the inclusion criteria and agree to participate in the study will be recorded at the
      beginning of the study. Patients will be evaluated in two different time periods. The first
      evaluations will be performed on the first day when patients are referred to rehabilitation
      by the physician. Following this assessment, all patients will be assigned numbers, which
      will be divided into two groups using a simple randomization method in the form of drawing
      lots. A total of 18 sessions 3 times a week for six weeks, the first group will receive
      symptomatic exercise program and the second group will focus on the deep muscles in the
      cervical region, especially the stabilizer, and a "Motor learning-based" exercise program
      that includes gradual control of these muscles. After 6 weeks, the first evaluations will be
      repeated in both groups.
    


Intervention name(s): Motor learning based exercise
Intervention type(s): Behavioral
Intervention description(s): Symptomatic exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment