Cervical dystonia is a form of adult-onset, focal dystonia characterized by involuntary contractions of the neck muscles, leading to a disabling, abnormal head posture. CD has a great impact on the activities of daily living (ADL) and quality of life. Currently, the most widely used and recommended first line treatment is botulinum toxin type A (BoNT/A) injections. Physiotherapy is a potentially useful adjuvant, but little is known about its effectiveness. Consequently, our objective was to investigate the effectiveness of physiotherapy alone or as an adjuvant treatment to BoNT/A injections in cervical dystonia (CD) by means of a systematic literature review. Two online databases, PubMed and Web of Science, were searched for articles describing the effectiveness of physiotherapy treatment for CD. After screening, based on predefined in- and exclusion criteria, 16 studies were retained. Their methodological quality was assessed according to Cochrane guidelines. The methodological quality of most studies was low. Examples of shortcomings are small sample sizes, lack of randomization or blinding, and diversity in therapeutic techniques and outcome measures. Only seven studies were clinical trials; the remaining were either case reports or case series. The reported physiotherapy treatments included EMG biofeedback training, muscular elongation, postural exercises and electrotherapy. Improvements in head position, pain, cervical range of motion, quality of life and ADL have been reported, which is promising. Cautious interpretation on the effectiveness of physiotherapy as an adjuvant therapy is required. Before firm conclusions can be drawn, additional high quality trials are needed.

Cervical Dystonia (CD) is a rare movement disorder characterized by an abnormal head position. This cross-sectional study describes the health status and severity of disability using an internationally agreed language by applying the International Classification of Functioning, Disability and Health (ICF). Two disease-specific rating scales were administered to 30 patients with CD. By linking the individual answers to the ICF model, the frequency and severity of reported impairments and restrictions were estimated using a count-based method. Results showed that patients most frequently reported impairments linked to "neuromusculoskeletal and movement-related functions" and "mental functions." Most restrictions in activities were related to "interpersonal interactions and relations," "major life areas," and "community, social, and civic life." One third of the reported impairments can be labeled as severe disability. The findings show that CD causes disability in multiple levels of a patients' functioning in life, well beyond the cervical area.

With the growing demand for helmet mounted displays on motorcycle helmets, it is essential not to compromise the peripheral vision of the motorcyclist. The relevant European standard of motorcycle helmet visors ECE 22-05, equivalent to the DOT standard FMVSS 218, states that the visor should permit peripheral vision horizontally through an arc of 105° from the helmet midline and vertically through an arc of 52°, which is located 7° upwards and 45° downward from the eyes. Consequently, this study compares a 3D environment to a human testing environment and an controlled testing environment using standard headforms to create an objective method to verify the correct field of view of motorcycle helmets. Firstly, the 3D environment is developed in Solidworks and provides a simulation set up that validates the necessary field of view in reference to the ECE 22-05. This environment is matched up to the testing environment with test subjects that are familiar with the use of a motorcycle helmet. The fields of view were determined by 12 indication points for 9 different motorcycle helmet models. The downwards tilt of the helmet of each test subject was individually determined. Each participant was additionally tested with a control helmet. The control helmet was also 3D scanned for use in the 3D environment. This provides a reference for the tilt of the helmet in the other two objective evaluation methods. With an average downwards angle of 21.1 degrees down, the control helmet has a success rate of 66.7% in the testing environment with the test subjects, although a number of external factors influence the determination of the field of view of the test subjects. Lastly, a field of view was generated by means of a human headform model into which a Ricoh Theta 360 camera was inserted. This results in an objective field of view for the control helmet. The synthesized downwards angle was implemented in the 3D environment to generate a 3D render of the field of view with the 3D scan of the control helmet. The render shows a similar field of view to the field of view generated by the Ricoh Theta 360 camera, resulting in a confirmation of the validity of the 3D model. Combining these three methods of testing, guarantees an objective evaluation of motorcycle helmet visors.