Investigation of the Effects of Exercise on Patients With Chiari Malformation
Investigation of the Effects of Exercise on Patients With Chiari Malformation
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.
Inclusion Criteria:

 -  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.

 Exclusion Criteria:

 -  Motor type defect due to CM Type 1,

 -  Presence of primary neurological disease other than CM Type 1, severe cognitive
 impairment (> 24 from the Mini Mental State Assessment),

 -  peripheral vestibular problem and history of orthopedic surgery,

 -  patients who had musculoskeletal problems in the last 6 months and who received
 physiotherapy rehabilitation program in the last 6 months,