The effect of botulinum toxin type A combined with rehabilitation on spasmodic torticollis

Objective To observe the impact of an injection of botulinum toxin type A combined with rehabilitation on the quality of life (QOL) of patients with spasmodic torticollis.Methods Thirty-eight patients with spasmodic torticollis were randomly divided into a combined treatment group and control group.Both groups were given a local muscular injection of botulinum toxin type A.One week later the combined group was given rehabilitation training.Both groups were assessed using the Toronto torticollis rating scale (TWSTRS),Tsui's scale and a health survey (SF-36) one week and eight weeks after the injection.Results Eight weeks after the injection,severity,disability,pain,physical functioning,vitality,mental health and Tsui scores had all increased significantly in the combined treatment group compared with before treatment.Physical functioning,pain,vitality,mental health and Tsui scores had also improved significantly compared with the control group.In the control group,only severity and Tsui scores were significantly improved compared with before treatment.Throughout the course of treatment there were no significant adverse reactions.Conclusions Combining botulinum toxin type A with rehabilitation has synergistic effects on spasmodic torticollis.It can significantly reduce disability scores,relieve pain and improve quality of life. Key words: Botulinum toxin type A;  Spasmodic torticollis;  Rehabilitation;  Quality of life