The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin
Background/Aim. Botulinum toxin is a basic, recommended method of treatment in controlling cervical dystonia (CD). Physical therapy has limited effect due to the nature of the disease that is a result of a disorder in structures and relationships of the basal ganglia. The aim of this study was to an...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2018-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700016S.pdf |
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| author | Stanković Ivona Čolović Hristina Živković Vesna Stamenović Jelena Stanković Anita Zlatanović Dragan Živković Danijela Stanković Tamara |
| author_facet | Stanković Ivona Čolović Hristina Živković Vesna Stamenović Jelena Stanković Anita Zlatanović Dragan Živković Danijela Stanković Tamara |
| author_sort | Stanković Ivona |
| collection | DOAJ |
| description | Background/Aim. Botulinum toxin is a basic, recommended method of treatment in controlling cervical dystonia (CD). Physical therapy has limited effect due to the nature of the disease that is a result of a disorder in structures and relationships of the basal ganglia. The aim of this study was to analyze the effect of physical therapy applied as monotherapy, or with parallel application of botulinum toxin in patients with CD. Methods. Randomized controlled clinical pilot study included 14 patients diagnosed with idiopathic CD. All patients were initially assessed by using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Torticollis Rating Scale (Tsui scale). In the control group, composed of 5 patients, the treatment included only physical therapy. The experimental group (9 patients) was first given botulinum toxin, and physical therapy was applied after five days. Physical therapy was conducted five times a week in the period of two weeks at the Clinic. Patients of both groups were instructed to continue with the physical therapy at home. The effects of treatment were analyzed after 1, 3 and 6 months using TWSTRS and Tsui scale. Results. At the beginning of the investigation, the differences in TWSTRS and Tsui scale between the groups were not significant. In the control group, after 1 month, significant improvement was achieved in all three parts of the TWSTRS. After 3 and 6 months, the effects of physical therapy were reduced to control levels. In the experimental group, highly significant increase of all parameters of TWSTRS was noted after 1, 3 and 6 months. In the control group, highly significant decrease of changes in Tsui scale was noticed only after one month while in the experimental group, it was maintained after 3 and 6 months. Conclusion. Application of physical therapy provides a significant improvement in disease severity, but the effect is better and of longer duration when combined with the botulinum toxin. |
| format | Article |
| id | doaj-art-e9cff6867b2f4497ba667e281e97a5f3 |
| institution | Kabale University |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-e9cff6867b2f4497ba667e281e97a5f32025-08-20T03:26:34ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-0175101035104010.2298/VSP161115016S0042-84501700016SThe effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxinStanković Ivona0Čolović Hristina1Živković Vesna2Stamenović Jelena3Stanković Anita4Zlatanović Dragan5Živković Danijela6Stanković Tamara7Clinical Center Niš, Clinic for Physical Medicine and Rehabilitation, Niš + Faculty of Medicine, NišClinical Center Niš, Clinic for Physical Medicine and Rehabilitation, Niš + Faculty of Medicine, NišClinical Center Niš, Clinic for Physical Medicine and Rehabilitation, Niš + Faculty of Medicine, NišFaculty of Medicine, Niš + Clinical Center Niš, Neurology Clinic, NišClinical Center Niš, Clinic for Physical Medicine and Rehabilitation, NišClinical Center Niš, Clinic for Physical Medicine and Rehabilitation, Niš + Faculty of Medicine, NišFaculty for Sports and Physical Education, NišFaculty of Medicine, NišBackground/Aim. Botulinum toxin is a basic, recommended method of treatment in controlling cervical dystonia (CD). Physical therapy has limited effect due to the nature of the disease that is a result of a disorder in structures and relationships of the basal ganglia. The aim of this study was to analyze the effect of physical therapy applied as monotherapy, or with parallel application of botulinum toxin in patients with CD. Methods. Randomized controlled clinical pilot study included 14 patients diagnosed with idiopathic CD. All patients were initially assessed by using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Torticollis Rating Scale (Tsui scale). In the control group, composed of 5 patients, the treatment included only physical therapy. The experimental group (9 patients) was first given botulinum toxin, and physical therapy was applied after five days. Physical therapy was conducted five times a week in the period of two weeks at the Clinic. Patients of both groups were instructed to continue with the physical therapy at home. The effects of treatment were analyzed after 1, 3 and 6 months using TWSTRS and Tsui scale. Results. At the beginning of the investigation, the differences in TWSTRS and Tsui scale between the groups were not significant. In the control group, after 1 month, significant improvement was achieved in all three parts of the TWSTRS. After 3 and 6 months, the effects of physical therapy were reduced to control levels. In the experimental group, highly significant increase of all parameters of TWSTRS was noted after 1, 3 and 6 months. In the control group, highly significant decrease of changes in Tsui scale was noticed only after one month while in the experimental group, it was maintained after 3 and 6 months. Conclusion. Application of physical therapy provides a significant improvement in disease severity, but the effect is better and of longer duration when combined with the botulinum toxin.http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700016S.pdfcervical dystonia, primaryphysical therapy modalitiesbotulinum toxinsclassification |
| spellingShingle | Stanković Ivona Čolović Hristina Živković Vesna Stamenović Jelena Stanković Anita Zlatanović Dragan Živković Danijela Stanković Tamara The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin Vojnosanitetski Pregled cervical dystonia, primary physical therapy modalities botulinum toxins classification |
| title | The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| title_full | The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| title_fullStr | The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| title_full_unstemmed | The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| title_short | The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| title_sort | effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin |
| topic | cervical dystonia, primary physical therapy modalities botulinum toxins classification |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700016S.pdf |
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