Vol. 7, Issue 1, Part B (2025)

Cervical Dystonia (CD) is a chronic focal movement disorder marked by involuntary cervical muscle contractions, resulting in abnormal head postures, persistent neck pain, restricted range of motion, and significant functional disability. Although botulinum toxin injections remain the standard medical intervention, they do not fully resolve muscular imbalance, proprioceptive deficits, or abnormal cervical coordination. Physiotherapy therefore plays a critical complementary role in restoring cervical mobility, neuromuscular control, and functional capacity. Manual therapy (MT) is frequently used to decrease hypertonicity, improve soft-tissue extensibility, and modulate pain; motor control exercises (MCE) aim to retrain cervical alignment, proprioception, and activation of deep stabilizing musculature. However, limited comparative research exists evaluating the added benefit of combining MT with MCE over MCE alone.
The present study compared the effects of a combined MT + MCE program versus MCE alone on pain intensity, cervical mobility, muscle activity, and disability in adults with cervical dystonia. Thirty-six participants were randomized into two groups and received 12 weeks of supervised intervention. Outcome measures included the Visual Analogue Scale (VAS), cervical range of motion (CROM), surface electromyography (sEMG), and the Neck Disability Index (NDI). Statistical analysis revealed significantly greater improvements in Group A (MT + MCE), with reductions of 69.7% in pain, 39% in muscle overactivity, and 56.3% in disability, alongside a 37.6% increase in cervical mobility.
The findings indicate that manual therapy enhances the neuromuscular environment, allowing patients to perform motor control exercises more effectively. The integration of MT with MCE should therefore be considered a preferred rehabilitation strategy for optimizing pain relief, mobility restoration, and functional recovery in individuals with cervical dystonia.