Abstract
Abstract Cervical dystonia (CD) is a focal dystonia affecting cervical muscles leading to abnormal postures and movements of the head, neck and shoulders. Cervical dystonia is a chronic disease with unwanted side effects. Although muscle contractions represent the most visible disease feature, associated symptoms such as pain are frequent and relevant contributors to disability. At the same time, pain constitutesone of the most important factors in term of poor quality of life (QOL) and is one of the most affected QOL domains in CD patients. However, the mechanism underlying the pain associated with CD remains unclear. There are no therapeutic controlled trials that have evaluated pain or QOL as a primary outcome, but the available data suggest that therapeutic interventions that improve dystonia also alleviate pain and have a beneficial effect on QOL. Recent studies have demonstrated that Electromyography (EMG) biofeedback is a good option for treatment of CD. The main aim of present research was to investigate the effect of EMG biofeedback on pain and health related quality of life of cervical dystonia patients. To do so, a sample of 30 subjects with cervical dystonia was selected for experimental and control groups by an accessible sampling procedure. Subjects were assessed with the pain subscale of Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Short-form Health Survey with 36 questions (SF-36) in two stages (pre-test, post-test). The obtained data were analyzed through covariance analysis method. After 30 sessions of EMG biofeedback training, the mean scores of pain in the experimental group were significantly diminished. Also, the mean of SF-36 scores in the experimental group showed a significantly higher increase in comparison to that of the control group. The results suggested that EMG biofeedback was effective on pain and health related QOL of CD patients.
Highlights
IntroductionIts main clinical feature is torsion of the neck, which is the consequence of anomalous and involuntary contractions of the cervical muscles [2]
Cervical dystonia (CD) is the most frequent form of adult-onset focal dystonia [1]
The main aim of the present study was to investigate the effect of EMG biofeedback training on pain and quality of life of cervical dystonia patients
Summary
Its main clinical feature is torsion of the neck, which is the consequence of anomalous and involuntary contractions of the cervical muscles [2]. CD is often defined as “spasmodic torticollis” While this term recalls the main clinical feature of CD, it does not provide any information about the nature of the disease [3]. Pain is most frequently localized to the back of the neck and shoulders, it may involve the head, upper chest, upper arms, and other areas [8]. A small study has suggested a decreased threshold of pain perception in CD patients, which could point to the involvement of central processes in addition to local muscle involvement [9]. Other potential causes of pain in CD are orthopedic complications including cervical spine degeneration, spondylosis, disc herniation, vertebral subluxations and fractures, radiculopathies and myelopathies [10]
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