Arnold-Chiari malformation, or ACM, may also be referred to as cerebellomedullary malformation syndrome, Arnold-Chiari deformity, Arnold-Chiari syndrome, Chiari malformation or simply Chiari. It is a structural defect that affects the cerebellum, or the area in your brain that controls balance. Certain types of exercise should be avoided, but activities that help balance, headache and neck pain and stiffness are encouraged.
Just as experts use different terms to describe this syndrome, they also differ on the number of types of the malformation that are recognized. According to the Arkansas Spinal Cord Commission, there are three types. Comer Children's Hospital of the University of Chicago recognizes four types of malformations. This article will focus on type I which can go unnoticed in childhood until you begin to experience symptoms such as headache, neck pain and balance problems during adolescence or adulthood. Because ACM affects your balance, you may suffer from problems with dizziness, muscle weakness and numbness, headaches, eye problems and challenges with coordination. Individuals with type II have symptoms that can be managed with medication and type III can result in permanent paralysis. Comer's also recognizes type IV, which is characterized by an absence of normal brain development. The type of ACM you have will dictate the exercises that are best for you.
Before beginning any exercises, check with your health care provider or physical therapist for approval. Activities that prevent neck stress are essential. Walking is a good place to begin, but be sure to wear highly cushioned and supportive shoes to reduce neck and cerebellum pounding while moving. Cycling and aquatic exercises are also useful. According to neurosurgeon Jon Oro, M.D., any exercise that puts stress on your neck should be avoided. He suggests avoiding weightlifting and other exercises that require you to bend your neck down.
Since balance can be a challenge in type I ACM, an exercise routine called Brandt-Daroff may be useful to help improve your symptoms. Sit on your bed near the middle with your legs over the side. Lie down on your right side and turn your head to a 45-degree angle so that you are looking up at the ceiling. Hold this position until any dizziness symptoms pass. Sit up and look straight ahead for 30 seconds. Repeat the exercise by lying on your left side and repeating the steps. To avoid falling, ask someone to accompany you while you perform these exercises.
Dr. Murray Grossman suggests that if you suffer from headaches, exercises that you perform when you are in the shower might help. But before you begin any exercises, discuss them with your health care provider who will determine if they are safe for you. Grossman suggests standing in the shower with the water directed at the back of your neck and shoulders. Slowly and gently turn your head as though you were attempting to look behind you. Do not over stretch your muscles or rotate your neck too far. Do not bend your neck down.
- Healing Moves Foundation; Exercise Tips for Chiari Patients; Jan. 6, 2010
- National Institute of Neurological Disorders and Stroke; NINDS Chiari Malformation Information Page; Feb. 16, 2011
- Comer Children's Hospital, University of Chicago: Chiari Malformation
- American Syringomyelia & Chiari Alliance Project: Chiari Malformation
- Arkansas Spinal Cord Commission; Arnold-Chiari Malformation; Thomas Farley, MA; August 2005
- University of Maryland Medical Center: Brandt-Daroff Exercises