Static and dynamic balance function in spasmodic torticollis

Abstract

The consequences of abnormal head posture on static and dynamic balance skill were studied in a group of 10 patients with idiopathic spasmodic torticollis (ST). In static conditions, body sway was assessed using a conventional force platform with eyes open and with eyes closed. Standardized dynamic balance conditions were produced using a rocking platform; lateral and anteroposterior dynamic balance skills were assessed by measuring linear displacement both of the body base and of the head. Dynamic tests were repeated 6 weeks after botulinum toxin treatment in all patients. Patients' results were compared with those obtained from 10 control subjects. In static conditions, ST patients did not differ from control subjects, but in dynamic conditions, balance parameters were greater in the patient group than in the control group. This was true for the lateral direction and for dynamic balance parameters recorded both before and after botulinum toxin treatment. Eye closure significantly increased dynamic balance parameters in both groups. However, the effect of eye closure was greater in the patient group than the control group, especially for lateral sway, suggesting that patients used vision to compensate for the dynamic balance disturbance induced by the spasmodic torticollis. Despite a significant improvement of head posture in all patients after botulinum toxin treatment, no significant changes in dynamic balance parameters were observed between the first and second test. The possible origins of the dynamic balance disturbance observed in ST patients are discussed.