Rehabilitation approaches in cervical dystonia

Abstract

Cervical dystonia (CD) is a form of focal muscular dystonia. The pathophysiology of CD includes central and peripheral sensorimotor mechanisms that lead to a pathological posture, imbalance, gait disturbances, and pain. Current CD treatment guidelines include botulinum toxin (BT) injections as first-line therapy. It has been established that a combination of BT injections and rehabilitation programs can reduce the disease severity, disability, and pain, improve the quality of life, and increase the duration and intensity of the BT. Even though different opinions exist on rehabilitation standards in patients with CD, several strategies are distinguished for its different types. Currently, complex kinesiotherapy for CD is being introduced, proposed by the French specialist J.P. Bleton and based on sensorimotor retraining. Other rehabilitation methods include biofeedback, transcutaneous electrical neurostimulation, and proprioceptive rehabilitation. Each of these methods has its own pathophysiological rationale in CD.