Neuroscience based treatment and training for dystonia | Cervical Dystonia | Writer’s Cramp | Focal Dystonia
‘Dystonia is a syndrome characterised by sustained muscle contractions, producing twisting, repetitive, and patterned movements, or abnormal postures. The dystonic syndromes include a large group of diseases that have been classified into various aetiological categories, such as primary, dystonia-plus, heredodegenerative, and secondary. The diverse clinical features of these disorders are reflected in the traditional clinical classification based on age at onset, distribution of symptoms, and site of onset. However, with an increased awareness of the molecular and environmental causes, the classification schemes have changed to reflect different genetic forms of dystonia. To date, at least 13 dystonic syndromes have been distinguished on a genetic basis and their loci are referred to as DYT1 to DYT13′. de Carvalho et al. (2002)
The Dystonia Society provides information and support here
Dystonia is a chronic disorder characterised by an aberration in the control of movement. Sustained co-contraction of opposing agonist and antagonist muscles can cause repetitive and twisting movements, or abnormal postures. Cervical dystonia (CD), often referred to as spasmodic torticollis, is a type of focal dystonia involving the muscles of the neck and sometimes the shoulders. Patel et al. (2012)
Dystonia causes distress, sometimes pain and can impact enormously upon one’s lifestyle. Talking to people with dystonia in depth about their experiences and how they cope and adapt to the condition, it is clear that it is a real challenge. The loss of control of posturing, movement and precision can affect one’s ability to work, socialise and take part in everyday activities.
Modern neuroscience has taught us a great deal about the way in which our brains plan and control movement. There are a number of influences upon this process including habits we may have adopted to compensate, stress, body awareness and sensory feedback.
The knowledge base that has grown from the research allows us to be able to identify features of dystonia in the clinical setting that are salient and measurable. We can target these changes in the motor system at a brain level with specific training that includes sensory discrimination and graded motor imagery alongside hands-on therapy to develop sensory feedback and ease tension, and motor control exercises with enhancements to optimise the outcomes. The programme that you will follow progresses gradually at your pace and includes techniques and strategies to tackle the non-motor features of the problem that include stress and anxiety.
Frequently patients follow the treatment programme following a botox injection, taking advantage of a period of quiescence from the spasm and contractions.