# The Benefits of Cognitive Therapeutic Exercise in Symptomatic Arnold–Chiari Syndrome Type I: A Case Report on Gait, Balance, and Pain Management

## TL;DR

A 43-year-old woman with Arnold–Chiari Syndrome Type I showed improved gait, balance, and pain after 11 months of cognitive therapeutic exercise.

## Contribution

Demonstrates the effectiveness of cognitive therapeutic exercise in managing symptoms of Chiari malformation.

## Key findings

- The patient experienced significant pain reduction after the rehabilitation protocol.
- Improvements in mental confusion and quality of life were observed at the 12-month follow-up.
- Cognitive therapeutic exercise enhanced the patient's ability to perform daily activities.

## Abstract

Background: Chiari malformation is a rare congenital condition in which the cerebellar tonsils herniate through the foramen magnum, causing symptoms related to compression of the surrounding structures. Rehabilitation plays a key role in the pre- and post-operative management of the syndrome, as it can improve strength, range of motion, motor coordination, pain management, and performance of activities of daily living. Methods: This article presents the case of a 43-year-old woman with Chiari malformation 1B who underwent resection of the filum terminale. She presented as an outpatient at the University Hospital “G. Martino” in Messina, complaining of difficulty walking, balance problems, lumbar pain, and heaviness in the lower limbs. Following a multidisciplinary assessment, she underwent an 11-month rehabilitation protocol based on cognitive therapeutic exercise. Results: The patient achieved significant improvements in pain, mental confusion, and quality of life after treatment and at the 12-month follow-up. Conclusions: The results of this study highlight the significant benefits of cognitive therapeutic exercises in Chiari malformation, with improvements in several key areas, including quality of life, pain management, and ability to perform activities of daily living.