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Neurological Sciences
Published in: Neurological Sciences 1/2020

01-01-2020 | Torticollis Spasticus | Original Article

Sensorimotor Perceptive Rehabilitation Integrated (SPRInt) program: exercises with augmented movement feedback associated to botulinum neurotoxin in idiopathic cervical dystonia—an observational study

Authors: Anna Castagna, Antonio Caronni, Alessandro Crippa, Luciana Sciumè, Giulia Giacobbi, Chiara Corrini, Angelo Montesano, Marina Ramella

Published in: Neurological Sciences | Issue 1/2020

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Abstract

Background

Idiopathic cervical dystonia (ICD) is a focal dystonia affecting neck muscles. Botulinum neurotoxin (BoNT) is the first-line treatment of ICD and different physical therapies (including exercise) are often proposed as adjunct treatments. However, the actual effectiveness of exercise in ICD is unclear. The aim of the current work is to assess the potential effectiveness of the Sensorimotor Perceptive Rehabilitation Integrated (SPRInt) exercise program as adjunct therapy for ICD.

Methods

Fifteen ICD patients received BoNT injections in the neck muscles and, 12 weeks later, received BoNT a second time and SPRInt started. SPRInt consists in 18 exercise sessions in which augmented feedback of movement (including visual and acoustic feedback) is extensively used. Dystonia burden was measured by the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Patients were evaluated immediately before, 6 and 12 weeks after each BoNT injection.

Results

Six weeks after the first BoNT injection (i.e., at BoNT peak effect), TWSTRS total score was better than baseline and remained improved at 12 weeks. TWSTRS disability domain slightly improved 6 weeks after the first BoNT injection, but after 6 more weeks returned to its baseline level. Disability improved more at SPRInt end (i.e., 6 weeks after the second BoNT injection), being even lower than after toxin alone. With a single-subject analysis, 4/10 patients who did not improve disability after BoNT improved after SPRInt plus BoNT.

Conclusions

SPRInt plus BoNT can be more effective than BoNT alone in improving cervical dystonia patients’ difficulties in the activities of daily living.

Trial registration

Appendix
Available only for authorised users
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Metadata
Title
Sensorimotor Perceptive Rehabilitation Integrated (SPRInt) program: exercises with augmented movement feedback associated to botulinum neurotoxin in idiopathic cervical dystonia—an observational study
Authors
Anna Castagna
Antonio Caronni
Alessandro Crippa
Luciana Sciumè
Giulia Giacobbi
Chiara Corrini
Angelo Montesano
Marina Ramella
Publication date
01-01-2020
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 1/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-04061-5

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