Dystonia

Disease

Dystonia is a disorder characterized by involuntary muscle contractions that cause slow repetitive movements as well as abnormal postures. There are several types of dystonia. Some may affect a specific muscle, a group of muscles or several muscles of the body. The origin of the majority of cases of dystonia is not known however, there are in some cases a genetic cause. Regardless of the origin of the dystonia itself, it would seem that the symptoms are related to a dysfunction in the basal ganglia, a region of the brain important for the control of movements. Dystonia can occur in both children and adults. In some cases, it may also be associated with other neurological disorders such as Parkinson’s disease and cerebral palsy.

Symptoms

Since dystonia can affect different muscles, the symptoms may vary from person to person. Depending on the affected muscles, symptoms can begin with cramps at the foot, after exercise or sporadically, at the level of the hand after writing or at the neck and even eyelids. The variability is such that it is often possible to make certain movements while others using the same muscles will cause pain. It is also possible to observe additional symptoms such as tremors and difficulty speaking. The symptoms of dystonia may in some cases worsen over time, while in other cases, there will be no progression.

Several treatment options are available to control the symptoms of dystonia such as botulinum toxin injections (e.g. Botox®), several types of medications as well as surgeries. The use of aids (e.g. splints) and physiotherapy can also have beneficial effects.

Exercise and Illness

Unfortunately, there are very few studies that have examined the effect of physical activity on the symptoms of dystonia. A recent study has demonstrated the beneficial effect of a program including stretching to optimize the effect of botulinum toxin injection on pain and quality of life [1]. Another study demonstrated that a specific training program to strengthen musculature in people with cervical dystonia was safe and tended to be beneficial [2]. A recent case study also suggests that an adapted training program can improve the control of affected muscles and thus reduce the dose of medication needed [3]. An important aspect to note is that in some cases symptoms can occur as a result of intense exercise so it is essential to consult a specialist before starting a training program.

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Sources

[1] Queiroz et al. (2012) Physical therapy program for cervical dystonia: a study of 20 cases. Functional Neurology; 27(3): 187-192.

[2] Boyce et al. (2013) Active exercise for individuals with cervical dystonia: a pilot randomized controlled trial. Clinical Rehabilitation; 27(3): 226-235.

[3] Voos et al. (2014) Case report: Physical therapy management of axial dystonia. Physiotherapy: Theory and Practice; 30(1):56-61.

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