The effect of two different rehabilitation treatments in cervical dystonia: preliminary results in four patients

Abstract

The most widespread approach to rehabilitation of cervical dystonia is electromyographic (EMG) biofeedback. However, consensus is lacking regarding the true effectiveness of this technique. The aim of this study was to evaluate how cervical dystonia was influenced by two rehabilitative treatments, namely a standard biofeedback program and a novel physiotherapy program consisting of postural reeducation exercises and passive elongation of myofascial cervical structures. Both programs were consecutively administered to 4 patients with cervical dystonia. The study design was a behavioral analysis of single cases. The main outcome measures were a head realignment test, a disability questionnaire and a pain visual analogue scale (VAS). Each patient's performance was evaluated before the study and after the first and second program. Furthermore, the disability questionnaire and the pain VAS were administered 3, 6, and 9 months after the end of the treatments. The physiotherapy program showed therapeutic effects comparable to those of EMG biofeedback. Reductions of disability and of pain were still present 3-9 months after the end of the treatments. These preliminary results suggest that the physiotherapy program proposed in the present study may be a promising method for rehabilitation of cervical dystonia.