Spasmodic torticollis: Investigation and treatment using EMG feedback training

Comparison of six spasmodic torticollis patients with individually matched controls showed elevated sternomastoid EMG levels on both sides of the neck and restricted ability to rotate the head. The direction of abnormal neck posture or movements was consistently related to the side of more restricted movement, but not to the side of higher EMG. The torticollis patients received treatment according to a single case experimental design of the form, A-B-BC-C-BC (A=baseline, B=EMG Feedback, C=home management). "Home management" consisted of tasks such as carrying out neck exercises, and practicing relaxing in front of a mirror. Outcome measures included cervical EMG, ranges of neck movements, hourly torticollis ratings, and the length of time patients could hold their heads in the midline. EMG feedback training resulted in lower levels of EMG activity but the effects were weak and patient levels did not reach those achieved by control subjects. All the patients improved to some extent, but none was symptom-free following treatment.