{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:46:54Z","timestamp":1790293614513,"version":"4.1.0"},"reference-count":25,"publisher":"Ubiquity Press, Ltd.","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TOHM"],"abstract":"<jats:p>Background: Cervical dystonia (CD) is the most common form of focal dystonia in adults. Studies show that physiotherapy (PT) in combination with BoNT has an effect on pain in cervical dystonia. We intended to test this hypothesis in a real-world setting to answer the question of whether pain is a good target symptom for prescribing PT. We also aimed to assess which form of PT is most appropriate for the treatment of pain.\nMethods: Study design: cross-sectional survey-based study of 91 patients with a confirmed diagnosis of cervical dystonia. The survey consisted of a questionnaire on type, frequency and content of physiotherapy, an assessment of quality of life with the Craniocervical Dystonia Questionnaire 24 (CDQ 24) and subjective pain scores.\nResults: 53.8% of patients received physiotherapy, mostly a mixture of exercises to either correct the abnormal posture or to reduce the muscle tone. Additional therapies included stress-reducing exercises (14.3%), psychotherapy (9.9%) and EMG biofeedback (2.2%). Patients who received PT showed a non-significant tendency towards higher pain scores. The severity of dystonia-associated pain was significantly associated with the patients\u2019 quality of life (F (1,54) = 22.9, adjusted R2 = 0.286, p &lt; 0.001).\nDiscussion: Pain is a frequent problem in patients with CD and severely affects quality of life. Physiotherapy could therefore be a valuable treatment option for patients with CD and pain.\nHighlights\nOur uncontrolled study illustrates the high frequency of physiotherapy in addition to BoNT treatment in a real-life cohort of patients with cervical dystonia. We were able to show that PT reduces patients\u2019 perceived pain in a patient reported outcome measure. This highlights the importance of PT in reducing CD-related pain, which considerably impairs quality of life.<\/jats:p>","DOI":"10.5334\/tohm.867","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T08:22:15Z","timestamp":1709713335000},"page":"11","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Physiotherapy in the Treatment of Pain in Cervical Dystonia"],"prefix":"10.5334","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9729-3551","authenticated-orcid":false,"given":"Clemens","family":"Jacksch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3067-5239","authenticated-orcid":false,"given":"Sebastian","family":"Loens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Tadic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-1782","authenticated-orcid":false,"given":"Tobias","family":"B\u00e4umer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten E.","family":"Zeuner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"key20240306082211_B1","doi-asserted-by":"crossref","first-page":"03","DOI":"10.5334\/tohm.170","article-title":"Descriptive Epidemiology of Cervical Dystonia","volume":"3","year":"2013","journal-title":"Tremor and Other Hyperkinetic Movements"},{"key":"key20240306082211_B2","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/mds.25475","article-title":"Phenomenology and classification of dystonia: A consensus update: Dystonia: Phenomenology and classification","volume":"28","year":"2013","journal-title":"Mov Disord"},{"key":"key20240306082211_B3","doi-asserted-by":"crossref","first-page":"105400","DOI":"10.1016\/j.parkreldis.2023.105400","article-title":"Tremor is associated with familial clustering of dystonia","volume":"110","year":"2023","journal-title":"Parkinsonism & 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brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial","volume":"11","year":"2012","journal-title":"The Lancet Neurology"},{"key":"key20240306082211_B9","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s42466-022-00214-8","article-title":"Long-term efficacy with deep brain stimulation of the globus pallidus internus in cervical dystonia: a retrospective monocentric study","volume":"4","year":"2022","journal-title":"Neurol Res Pract"},{"key":"key20240306082211_B10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40734-016-0047-6","article-title":"Medical treatment of dystonia","volume":"3","year":"2016","journal-title":"J Clin Mov Disord"},{"key":"key20240306082211_B11","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.ncl.2020.01.003","article-title":"Medical and Surgical Treatments for Dystonia","volume":"38","year":"2020","journal-title":"Neurologic Clinics"},{"key":"key20240306082211_B12","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1007\/s00415-013-7220-8","article-title":"The effectiveness of physiotherapy for cervical dystonia: a systematic literature review","volume":"261","year":"2014","journal-title":"J Neurol"},{"key":"key20240306082211_B13","doi-asserted-by":"crossref","first-page":"784","DOI":"10.3390\/toxins14110784","article-title":"Physiotherapy for Cervical Dystonia: A Systematic Review of Randomised Controlled Trials","volume":"14","year":"2022","journal-title":"Toxins"},{"key":"key20240306082211_B14","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1468-1331.2010.03061.x","article-title":"Physiotherapy of focal dystonia: a physiotherapist\u2019s personal experience: Physiotherapy of focal dystonia","volume":"17","year":"2010","journal-title":"European Journal of Neurology"},{"key":"key20240306082211_B15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.parkreldis.2015.12.010","article-title":"A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia","volume":"23","year":"2016","journal-title":"Parkinsonism & Related Disorders"},{"key":"key20240306082211_B16","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/1471-2377-13-85","article-title":"Cervical dystonia: effectiveness of a standardized physical therapy program; study design and protocol of a single blind randomized controlled trial","volume":"13","year":"2013","journal-title":"BMC Neurol"},{"key":"key20240306082211_B17","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/jnnp.2003.013441","article-title":"Craniocervical dystonia questionnaire (CDQ-24): development and validation of a disease-specific quality of life instrument","volume":"75","year":"2004","journal-title":"Journal of Neurology, Neurosurgery & 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