An integrated multimodal intervention of remedial and adaptive approaches in secondary dystonia of hand: A case report

Purpose: To evaluate an integrated approach of remedial and adaptive interventions that were employed to improve functional independence of a young woman with childhood-onset secondary dystonia of the right hand. Methods: The intervention involved inhibiting dystonic movements, functional training with correct movement patterns, and activity modifications. The techniques combined multiple modalities (static and dynamic orthoses, electrical stimulation, purposeful activities, and adaptations), therapeutic exercises (stretching, inhibitory strategies and strengthening), sensorimotor training and motor learning strategies. Results: After a year-long intervention of supervised therapy sessions and home programmes, there were improvements in dystonia severity (25%), hand functions (38%) and disability scores (30.3%). Conclusion: The intervention outlined is a positive therapeutic approach to enhance function in secondary dystonia of the hand.