The EFFECTS OF SENSORIMOTOR RETRAINING IN ADDITION TO CONVENTIONAL PHYSICAL THERAPY ON PAIN, INVOLUNTARY CONTRACTIONS AND CRAMPS IN FOCAL HAND DYSTONIA PATIENTS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Retraining the brain to move more effectively is one approach to addressing movement dysfunction caused by task-specific focal hand dystonia.

Objective: to compare the effects of sensorimotor retraining with conventional physical therapy on pain, involuntary contractions and cramps in focal hand dystonia patients

Material and Methods: it was a randomized controlled trial conducted on 34 patients, equally divided into the sensorimotor retraining and the conventional groups. The study was completed in nine months after the approval of synopsis from ethical committee. The patients included were of both genders, aged 18 to 40 years, diagnosed with focal hand dystonia independently by two neurologists and handwriting score of four on the fahn-tolosa-marin tremor rating scale. The outcomes were assessed for pain, involuntary movements and cramps. The continuous variables were presented as mean and standard deviation. The categorical variables were presented as frequency and percentage.

Results: The results showed mean and standard deviation for pain at baseline, at weeks 6 and 12 found to be 6.06±0.75 3±0.79 and 1.12±1.11, while in the conventional group, 6.12±0.93, 4.53±1.07 and 2.82±1.24. For the dystonia scale at baseline, at weeks 6 and 12 found to be 6.06±0.75, 3±0.79 and 1.12±1.11 in the experimental group, while in another group, 63.47±1.81, 70.41±2.5 and 77.06±3. Fahn-Tolosa-Marin grades at baseline, at weeks 6 and 12 found to be 2.76±0.66, 1.71±0.59, 1.24±0.66 in the experimental group and 2.53±0.62, 2.06±0.24 and 1.71±0.47 in the conventional group, for visual analogue scale cramps at baseline, week 6 and 12 it found to be 70±5.66, 60.29±5.88 and 49.65±5.90 in the experimental group and 70.29±5.81, 63.35±5.96 and 55.24±6.12 in other groups respectively. There was a significant difference in all post-interventional assessments in favour of the experimental group (p-value<0.000) except for dystonia and visual analogue scale cramps at intermediate evaluation (p=.0701 and 0.142).

Conclusion: This study concluded that there was a significant improvement in pain and involuntary movements, while dystonia and cramping improved equally in both groups without a significant difference at week 6. However, there was a significant improvement in pain, dystonia, involuntary movement and cramping score at week 12.