Background Treatment of choice for cervical dystonia comprises botulinum neurotoxin therapy. Whether additional physiotherapy can achieve better results is unclear.
Objectives To show effects of physiotherapy as an add-on treatment to botulinum neurotoxin therapy.
Methods 18 patients participated in this prospective interventional study (DRKS00006562) consisting of 2, 3-month periods. In the first period, usual botulinum toxin was applied. The second period comprised an additional multimodal physiotherapy program. Outcome measures were: range of motion, SF-36, Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), surface electromyography.
Results In the comparison first phase vs. second phase patients showed significant improvements in range of motion (flexion/extension: 16.3 ± 25.4; rotation: 19.1 ± 24.6), TWSTRS (severity: 3.8 ± 3.0; disability: 1.7 ± 2.0; pain: 4.4 ± 4,1) and in mental health (SF-36: 5.9 ± 7.5); p <0.05, respectively. No significant changes were seen in the lateral flexion ROM, physical health (SF-36) and the surface electromyography.
Conclusion Multimodal physiotherapy is a feasible and save additional treatment option for patients with cervical dystonia. An add-on physiotherapy program can achieve better treatment outcomes. Patients benefited especially with improved range of motion, and reduced pain and severity of symptoms.