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Sensory-motor rehabilitation therapy for task-specific focal hand dystonia: A feasibility study

Butler, K; Sadnicka, A; Freeman, J; Meppelink, A-M; Parees, I; Marsden, J; Edwards, MJ (2018) Sensory-motor rehabilitation therapy for task-specific focal hand dystonia: A feasibility study. HAND THERAPY, 23 (2). pp. 53-63. ISSN 1758-9983 https://doi.org/10.1177/1758998318764219
SGUL Authors: Edwards, Mark John James Sadnicka, Anna

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Abstract

Introduction Medical treatments have limited long-term effect in task-specific dystonia. Whilst evidence supports the use of rehabilitation, no randomised controlled trials have been undertaken. This small-scale study determined the feasibility of implementing and evaluating a mixed sensory–motor task-specific dystonia rehabilitative programme. Methods Participants with writer’s or musician’s dystonia were recruited from a movement disorder and hand therapy clinic. Feasibility measures were recruitment rate, retention, session attendance, adherence to exercises. Self-report measures at 0, 3 and 6 months included: Arm Dystonia Disability Scale (ADDS), Tubiana and Chamagne Scale (TCS), Brief Illness Perception Questionnaire (BIPQ), Health Status (EQ-5D 5L), Clinical Global Impression Scale (CGI). Task performance was video-recorded at baseline and 6 months. At 6 months, interviews explored participant experiences of the intervention. Results Fifteen patients were recruited over 6 months (rate 2.5/month, musician’s dystonia = 8, writer’s dystonia = 7). Complete data sets were collected for twelve people(80%). The programme comprised a maximum six sessions plus daily home exercises. Nine completed the home programme at ≥75%. No adverse events were reported. Effect sizes at 3 and 6 months, respectively, were ADDS 3-month = 0.28, 6-month = 0.23; TCS 3-month = 0.13, 6-month = 0.53; BIPQ 3-month = 0.38, 6-month = 0.71; EQ-5D-5L 3-month = 0.34, 6-month = 0.59; video analysis at 6 months = 0.78. Eleven (92%) improved on the CGI. Interviews supported acceptability of the intervention. Conclusions This intervention was feasible to deliver with high retention, adherence and acceptability. Improvements occurred across measures. This informs the development of future randomised controlled trials.

Item Type: Article
Additional Information: Butler, K; Sadnicka, A; Freeman, J; Meppelink, A-M; Parees, I; Marsden, J; Edwards, MJ (2018) Sensory-motor rehabilitation therapy for task-specific focal hand dystonia: A feasibility study. HAND THERAPY, 23 (2). pp. 53-63. Copyright © 2018 (SAGE Publications). Reprinted by permission of SAGE Publications. https://doi.org/10.1177/2F1758998318764219
Keywords: Musicians' dystonia, writers' dystonia, sensory-motor rehabilitation therapy, hand therapy, Musicians' dystonia, writers' dystonia, sensory-motor rehabilitation therapy, hand therapy, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: HAND THERAPY
ISSN: 1758-9983
Dates:
DateEvent
1 June 2018Published
26 March 2018Published Online
12 February 2018Accepted
Publisher License: Publisher's own licence
Web of Science ID: WOS:000432067400002
URI: https://openaccess.sgul.ac.uk/id/eprint/109901
Publisher's version: https://doi.org/10.1177/1758998318764219

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