Efficacy of Physiotherapeutic Interventions in the Postoperative Period of Craniectomy for Arnold-Chiari Type I Malformation

Abstract

Introduction: Rehabilitation of patients with Arnold-Chiari Malformation type I (MC-I) is highly relevant clinically and scientifically, considering the functional impact of the disease on balance, gait, motor coordination, and independence in activities of daily living. Even after surgical intervention, many patients maintain physical limitations, making physiotherapy essential for functional recovery and improved quality of life. Objective: This study aims to analyze the effects of physiotherapy intervention in the postoperative period of decompressive craniectomy in patients with MC-I. Materials and Methods: This is an integrative literature review, conducted in the PubMed, SciELO, and Google Scholar databases, using descriptors related to physiotherapy, craniectomy, and Chiari malformation. Initially, 5,013 studies were identified; after removing duplicates, applying eligibility criteria, and screening, 51 studies were included in the final sample. Scientific Contribution: The results indicate that decompressive craniectomy promotes clinical and functional improvement in approximately 75% of patients, although residual deficits may persist. Physiotherapeutic approaches showed benefits in motor, respiratory, and vestibular rehabilitation, including improved balance, pain reduction, increased muscle strength, and greater functional independence. Individualized protocols based on the International Classification of Functioning, Disability and Health (ICF) demonstrated positive results, with up to a 100% increase in respiratory strength and significant improvement in functional and gait tests. However, they also highlight important gaps, such as the scarcity of experimental studies, the lack of standardization of physiotherapy protocols, and limitations in the follow-up time of patients, indicating the need for more comprehensive research. Conclusion: It is concluded that physiotherapy plays a fundamental role in the rehabilitation of patients with Arnold-Chiari Malformation after decompressive craniectomy, contributing to functional improvement, symptom reduction, and increased autonomy. However, studies with greater methodological rigor, larger samples, and longitudinal follow-up are necessary to strengthen the scientific evidence and consolidate more effective therapeutic protocols for this population.