Table 2 Summary finding of included studies
Author, year of publication | Study design | Patients (M,F) | Duration of CD (year, Mean ± SD) | Intervention (and its duration) for experimental group | Control | Outcome Measures | Follow-up | Result | Include in meta-analysis of PT versus no-PT on disease outcomes |
|---|---|---|---|---|---|---|---|---|---|
Werner et al., 2019 | Monocentric prospective interventional | 18 (M = 3, F = 15) | 7.5 (± 6.6) | BoNT + PT: 12 sessions of 45 min at ratio of 2x/week (30 min PT session and 15 min TENS application) for a total of 6 months | BoNT alone | Cervical ROM (ZEBRIS), QoL (SF-36), TWSTRS (total, severity, disability, and pain scale) | After 6 weeks (T1) and on the last day of the first phase (T2). | Significant improvement in TWSTRS severity, disability and pain measures after intervention | Yes |
Van den Dool, 2019 | RCT | 72 (M = 30, F = 42) | 12.7 (± 10.4) | BoNT + Specialized PT consisting of 30 min sessions of exercises with emphasis on motor training for 12 months and daily home exercises. | BoNT treatment and regular PT 1x/week | TWSTRS (total, severity, disability, and pain scale), BDI, BAI, SF-36, CDQ-24 | / | Both specialized PT and regular PT improved on the TWSTRS disability scale and general health over time. | No (Compared two type of PT) |
Useros-Olmo et al., 2018 | Case-control | 27 (M = 5, F = 22) | Intervention 14,2 ± 9.5; control 11 ± 4.5 | Four sessions of relaxation therapy of aquatic therapy (50 min) and autogenic training (15 min) at ratio of 1x/week with daily home exercises of autogenic training over 1 month. | No intervention | QoL (SF-36), TWSTRS (pain), VAS, BDI-II, state-trate anxiety (STAI) | / | Significant reduction in the PT group of pain, improved QoL with improved physical and mental health | No (not RCT) |
Tassorelli et al., 2006 | RCT | 40 (M = 13, F:27) | 6.9 ± 2.69 | BoNT + PT daily 60 to 90 min sessions specific PT of stretching, exercises and biofeedback training for 2 weeks. | BoNT alone | Tsui scale, TWSTRS (total and pain scale) | / | Significant reduction in disability scale and subjective pain scores, lower BoNT dose is needed. | Yes |
Stanković et al., 2017 | RCT | 14 | 13.5 ± 6.4 months | BoNT + PT The PT was given five times a week in the period of two weeks. | BoNT alone | TWSTRS (pain and disability), Tsui scale | 6 months | PT combined with BoNT brought significant effect for pain, disability reduction. | No (Compared PT vs. PT with BoNT) |
Smania et al., 2018 | case series | 4 (M = 1, F = 3) | 21.2 months | 30 PT sessions of one hour consisting of 20 min elongation techniques, 40 min of active postural reeducation at ratio of 4x/week during 6 weeks | 1 h sessions of EMG biofeedback at ratio of 5x/week during 6 weeks | HRT, DQ, VAS | 9 months. | Significant reduction of daily life disability and pain in both groups. Head-trunk alignment improved in both groups | No (not RCT) |
Queiroz et al., 2012 | Case-control | 40 (M = 20, F = 20) | Median disease duration in intervention and control group is 9 (2.7–16) and 16 (6.5–17.5) respectively. | BoNT + PT sessions of 1h15 including motor learning exercise, stretching, active and passive mobilization of the cervical spine (1 h)/ and FES (15 min) for four weeks, five days a week, one hour and 15 min per session. | BoNT injection | TWSTRS (severity, disability, and pain) and QOL (SF-36) | / | Significant decrease of disease severity in both groups, PT group showed also a sig.decrease in pain, disability and improvement in physical and mental health | No (not RCT) |
Pelosin et al., 2013 | RCT | 14 (M = 6, F = 8) | 9.2 (± 6.3) | Kinesiotape on the dystonic SCM 14 days intervention with a new tape every 4days | Sham tape | VAS for pain, TWSTRS, somatosensory evoked potentials | / | 45% reduction of pain after kinesiotape and no effect of tape on disease severity. 20% reduction of STDt in the affected body part | No (compared Kinesiotape vs. sham tape) |
Hu et al., 2018 | RCT | PT group were 8 (M = 4, F = 4), no PT group were 8 (F = 5, M = 3) and 10 controls | 14.4 (± 10.9) | BoNT + PT including 1 session of deep massage, muscle elongation, stretching, instruction for home based exercises (stretching, ROM exercises) 15 min/day, 5x/week, for 6 weeks with weekly telephone calls | BoNT alone | TWSTRS (total, disability, and pain), VAS, SF-36 | 6 weeks | 30% reduction of TWSTRS severity and pain in the PT group after intervention compared to the control group, changes in sensorimotor plasticity after BoNT with PT correlated with changes on TWSTRS whereas the control group showed no differences | No (reported the parameter of outcome differently) |
Counsell et al., 2015 | RCT | 110 (M = 69, F = 85) | Intervention: 13,7 (± 9.3); control: 13,4 (± 7,4) | BoNT + Physiotherapy according to the Bleton technique 45 min sessions with home exercises, during 24 weeks at ratio of 1x/week | BoNT + standard PT care | TWSTRS, CDIP-58, Global impression of change, QoL (EQ-5D) | 28 weeks | No difference between the improvement in the intervention or control group both interventions reduces disease severity and non-motor symptoms | No (compared two type of PT) |
Castagna et al., 2019 | Case-series | 14 (M = 7, F = 7) | 6 (± 7) | BoNT + PT 45 min sessions of passive mobilization (10 min) and Active sensorimotor exercises with augmented feedback (35 min), 18 at ratio of 3x/week | BoNT alone | TWSTRS, self-rating anxiety scale (SAS), BDI-II, and QoL (EQ-5D-5 L) | / | Total TWSTRS score was lower, no effect on anxiety, depression or quality of life | No (not RCT) |
Boyce et al., 2013 | RCT | 20 (M = 6, F = 14) | 10.2 (± 7.9) | 8 PT sessions during 12 weeks, 30 min sessions of neck exercises, motor relearning and whole body relaxation with home exercises 4x/week | Whole body relaxation, with home exercise program | TWSTRS (total, disability, severity, and pain), CDQ-24, BDI-II, active cervical ROM measures | 4 weeks | Significant reduction on TWSTRS, BDI and improvement of cervical ROM in both groups. | No (compared two type of PT) |
Zetterberg et al., 2008 | Case-series | 6 (M = 4, F = 2) | / | PT for 4 week, 45 min sessions of stretching, endurance and strength exercises, muscle relaxation, postural orientation, 9x/week (2x/day except for 1 day) | None | CDQ-24, cervical dystonia postural orientation index (POI), Movement energy index (MEI), VAS, TWSTRS, | 6 months | Significant improvement of pain, disease severity, disablity and QoL which remained after 6 months follow-up | No (not RCT) |
Dec-Ćwiek et al., 2022 | RCT | 19 (M = 4, F = 15) | 27.8 ± 12.4 | BoNT + kinesiotape were performed for four consecutive weeks once per week. | BoNT +/- Sham taping | TWSTRS (Total, severity, disability, and pain scale) and CDQ-24 | 12 weeks therapy in each Experimental therapy. | Kinesiotape had no additional effect on the disease severity of CD but might improve QoL. | No (compared Kinesiotape and sham tape |