The Effect of Cervical Proprioceptive Neuromuscular Facilitation along with Pressure Biofeedback on improving Severity, Range of Motion and Quality of Life in patients with Chronic Cervical Dystonia A Pre Post Interventional study

Title

The Effect of Cervical Proprioceptive Neuromuscular Facilitation along with Pressure Biofeedback on improving Severity, Range of Motion and Quality of Life in patients with chronic Cervical Dystonia – a pre-post interventional study

Overview

This study investigates the combined effect of Cervical Proprioceptive Neuromuscular Facilitation (PNF) and Pressure Biofeedback in patients with chronic Cervical Dystonia (CD), a neurological movement disorder characterized by involuntary muscle contractions in the neck, leading to abnormal postures, pain, reduced range of motion (ROM), and diminished quality of life (QoL).

Objectives

To assess whether the intervention improves:

1. Severity of cervical dystonia

2. Range of motion of the cervical spine

3. Quality of life of affected individuals

Rationale

Current first-line treatments like Botulinum Toxin injections provide symptomatic relief but often leave residual disability. There is limited research on combining PNF with pressure biofeedback as a therapeutic alternative for CD.

Methodology

Design: Pre-post interventional study

Sample Size: 25 participants

Duration: 8 weeks - 3 sessions per week

Population: Adults aged 20 to 60 with chronic CD, diagnosed greater than 1 year, TWSTRS score more than 35, no BoNT in last 6 months

Tools Used:

1. CD Severity Scale (CDSS) for severity

2. Goniometer for ROM

3. CDQoL-24 Questionnaire for quality of life

4. TWSTRS for baseline inclusion

Intervention

PNF: Targeting cervical flexors, extensors, lateral flexors, and rotators using the Contract Relax Antagonist Contract (CRAC) technique

Pressure Biofeedback: Sub-occipital positioning of a pressure sensor to facilitate deep neck flexor activation and control

Data Analysis

Pre- and post-intervention data will be compared using Paired t-test or Wilcoxon Signed Rank Test depending on data normality.

p-value less than 0.05 considered significant.

Data analyzed using SPSS v29

Primary Hypothesis

Null Hypothesis (H0)

There will be no significant effect of Cervical Proprioceptive Neuromuscular Facilitation along with Pressure Biofeedback on severity, range of motion, and quality of life in patients with chronic Cervical Dystonia.

Alternative Hypothesis (H1)

There will be a significant effect of Cervical Proprioceptive Neuromuscular Facilitation along with Pressure Biofeedback on severity, range of motion, and quality of life in patients with chronic Cervical Dystonia.