Neck and hand focal dystonias
For focal dystonias, the use of physiotherpy in treating dystonia is well established internationally - but less so in the UK. It aims to give patients as much independence as possible. The objective of physiotherapy is to correct the postures and movements affected by dystonia through a set of targeted exercises. This type of therapy requires commitment as the process will involve daily exercises. However, if a patient is willing to commit, then it can be effective. In a Dystonia Society survey of those who had tried physiotherapy with a specialist neurophysiotherapist, 74% of respondents with neck (cervical) dystonia and 62% of those with focal hand dystonia reported it as being helpful.
Because of the specialised nature of dystonia, this treatment needs to be provided by a neurophysiotherapist familiar with the condition. If the physiotherapist does not know about dystonia, there is a danger they can prescribe exercises that can aggravate the condition.
For generalised dystonias, physiotherapy is often more focused on living with the dystonic movements in the most effective way rather than trying to correct them. Physiotherapists usually have a wider, more supportive role including:
- Supporting patient, parents and carers in other settings (e.g. school) about aspects including handling, positioning, and adapting activities to promote active participation
- Advising on general and specific exercise to maintain general health and well being or to address specific goals such as reducing pain/discomfort, strengthening and range of movement.
- Promoting mobility and advising on equipment such as seating, wheelchairs, mobility aids, leisure equipment
- Identifying issues which may warrant referral to other services such as Orthopaedics if appropriate.
Because of the specialised nature of dystonia, this treatment needs to be provided by a neurophysiotherapist familiar with the condition.
Dystonic Cerebral Palsy
Physiotherapy is a key treatment for all forms of cerebral palsy and will usually be started soon after diagnosis has been made. The focus is on helping the child find the best approach possible to coping physically with their condition. Physiotherapy and physical management programme should be incorporated into the school day to ensure that treatment and education run side by side.
Early physiotherapy treatment will usually give the best results. This will be individualised for your child but may include the following interventions: hands-on therapy to help your child to develop as much control of their movements as possible; use of specialised equipment such as a standing frame or walker to help them do as much as they can for themselves and join in with others; use of orthotics (splints) to help posture or functional abilities such as walking; and advice on exercise and activity for health enjoyment and participation. However it is important to realise that there may be a limit to what physiotherapy can achieve. It is often more about finding the best way to live with the condition rather than about trying to control it.
Last reviewed January 2014
The Dystonia Society provides the information on this page as general information only. It is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor.
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