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. 2024 Mar 6:14:11.
doi: 10.5334/tohm.867. eCollection 2024.

Impact of Physiotherapy in the Treatment of Pain in Cervical Dystonia

Clemens Jacksch  1 , Sebastian Loens  2   3 , Joerg Mueller  4 , Vera Tadic  5 , Tobias Bäumer  2   3 , Kirsten E Zeuner  1
Affiliations

Impact of Physiotherapy in the Treatment of Pain in Cervical Dystonia

Clemens Jacksch et al. Tremor Other Hyperkinet Mov (N Y). .

Abstract

Background: Cervical dystonia (CD) is the most common form of focal dystonia in adults. Studies show that physiotherapy (PT) in combination with BoNT has an effect on pain in cervical dystonia. We intended to test this hypothesis in a real-world setting to answer the question of whether pain is a good target symptom for prescribing PT. We also aimed to assess which form of PT is most appropriate for the treatment of pain.

Methods: Study design: cross-sectional survey-based study of 91 patients with a confirmed diagnosis of cervical dystonia. The survey consisted of a questionnaire on type, frequency and content of physiotherapy, an assessment of quality of life with the Craniocervical Dystonia Questionnaire 24 (CDQ 24) and subjective pain scores.

Results: 53.8% of patients received physiotherapy, mostly a mixture of exercises to either correct the abnormal posture or to reduce the muscle tone. Additional therapies included stress-reducing exercises (14.3%), psychotherapy (9.9%) and EMG biofeedback (2.2%). Patients who received PT showed a non-significant tendency towards higher pain scores. The severity of dystonia-associated pain was significantly associated with the patients' quality of life (F (1,54) = 22.9, adjusted R2 = 0.286, p < 0.001).

Discussion: Pain is a frequent problem in patients with CD and severely affects quality of life. Physiotherapy could therefore be a valuable treatment option for patients with CD and pain.

Highlights: Our uncontrolled study illustrates the high frequency of physiotherapy in addition to BoNT treatment in a real-life cohort of patients with cervical dystonia. We were able to show that PT reduces patients' perceived pain in a patient reported outcome measure. This highlights the importance of PT in reducing CD-related pain, which considerably impairs quality of life.

Keywords: botulinum neurotoxin; cervical dystonia; pain; physiotherapy; quality of life.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Distribution of the different techniques used in the study cohort (dark grey: exercises for posture correction, light grey: exercises for reducing muscle tone)
Figure 1
Distribution of the different techniques used in the study cohort (dark grey: exercises for posture correction, light grey: exercises for reducing muscle tone).
Score of the Numeric Rating Scale in patients with and without physiotherapy
Figure 2
Score of the Numeric Rating Scale in patients with and without physiotherapy.
See this image and copyright information in PMC

References

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