Long-Term Specialized Physical Therapy in Cervical Dystonia: Outcomes of a Randomized Controlled Trial

Ninety-six patients aged 30 years or older with primary cervical dystonia were randomized to receive 12 months of treatment with a specialized physical therapy program for cervical dystonia or 12 months of standard physical therapy. The primary outcome of interest was patient disability as assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) disability sub-score. Secondary outcomes of interest included pain, motor severity of dystonia, anxiety, depression, self-perceived improvement, quality of life and health care costs. Follow-up was performed after the completion of treatment. The results of the study revealed no significant differences in the improvement of all clinical outcomes except the Short Form 36 (SF-36) general health sub-scale, which displayed significantly greater improvement in the specialized physical therapy group compared to the standard physical therapy group. While the total cost was not significantly different between the two groups, significant differences were observed between the two groups in treatment costs and travel costs.