Yıl: 2023 Cilt: 53 Sayı: 1 Sayfa Aralığı: 405 - 412 Metin Dili: İngilizce DOI: 10.55730/1300-0144.5597 İndeks Tarihi: 29-03-2023

Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia

Öz:
Background/aim: Impaired trunk control is common in neurological disorders; however, trunk control has not been examined in patients with cervical dystonia (CD). Therefore, the primary aim was to compare trunk control between patients with CD and healthy people. The secondary aim was to investigate the relationship between trunk control and balance, functional mobility, and disease severity in patients with CD. Materials and methods: This cross-sectional study included 32 patients with CD and 32 healthy people. Trunk control was compared using the trunk impairment scale (TIS) that consists of three subscales: static sitting balance, dynamic sitting balance, and trunk coordination between two groups. Balance was assessed using Berg Balance Scale, four square step test, and one-leg stance test. The Timed Up and Go Test was measured to determine functional mobility. Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate disease severity. Results: Patients with CD demonstrated worse performance on the TIS-total with TIS-dynamic sitting subscale and TIS-trunk coordination subscale (p < 0.001, p < 0.001, and p < 0.001), except for TIS-static sitting subscale (p = 0.078) compared to healthy people. TIS-total scores had moderate to strong correlations with balance, functional mobility, and disease severity (range r between 0.786 and 0.536, p < 0.05 for all). There was no correlation between TIS-total scores and disease severity (p = 0.102). Conclusion: Patients with CD had impaired trunk control, especially in dynamic sitting balance and trunk coordination. Impaired trunk control was also associated with balance and functional mobility but not disease severity. These findings suggest that trunk control deficits should receive attention in the assessment and treatment of patients with CD.
Anahtar Kelime: Cervical dystonia trunk control balance functional mobility disease severity

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Albanese A, Asmus F, Bhatia K, Elia AE, Elibol B et al. EFNS guidelines on diagnosis and treatment of primary dystonias. European Journal of Neurology 2011; 18 (1): 5-18. https://doi. org/10.1111/j.1468-1331.2010.03042.x
  • 2. Albanese A, Bhatia K, Bressman SB, DeLong MR, Fahn S et al. Phenomenology and classification of dystonia: a consensus update. Movement Disorders 2013; 28 (7): 863-73. https://doi. org/10.1002/mds.25475
  • 3. Chan J, Brin MF, Fahn S. Idiopathic cervical dystonia: clinical characteristics. Movement Disorders: Official Journal of the Movement Disorder Society 1991; 6 (2): 119-26. https://doi. org/10.1002/mds.870060206
  • 4. Jinnah H, Hess EJ. A new twist on the anatomy of dystonia: the basal ganglia and the cerebellum? Neurology 2006; 67 (10): 1740- 1741. https://doi.org/10.1212/01.wnl.0000246112.19504.61
  • 5. Jinnah H, Hess EJ. Evolving concepts in the pathogenesis of dystonia. Parkinsonism & Related Disorders 2018; 46: 62-65. https://doi.org/10.1016/j.parkreldis.2017.08.001
  • 6. Münchau A, Bronstein A. Role of the vestibular system in the pathophysiology of spasmodic torticollis. Journal of Neurology, Neurosurgery & Psychiatry 2001; 71 (3): 285-288. https://doi. org/10.1136/jnnp.71.3.285
  • 7. Bradnam LV, Meiring RM, Boyce M, McCambridge A. Neurorehabilitation in dystonia: a holistic perspective. Journal of Neural Transmission 2021; 128 (4): 549-558. https://doi. org/10.1007/s00702-020-02265-0
  • 8. Barr C, Barnard R, Edwards L, Lennon S, Bradnam L. Impairments of balance, stepping reactions and gait in people with cervical dystonia. Gait & Posture 2017; 55: 55-61. https://doi. org/10.1016/j.gaitpost.2017.04.004
  • 9. Winter DA. Human balance and posture control during standing and walking. Gait & Posture 1995; 3 (4): 193-214. https://doi. org/10.1016/0966-6362(96)82849-9
  • 10. Leroux A, Fung J, Barbeau H. Postural adaptation to walking on inclined surfaces: I. Normal strategies. Gait & Posture 2002; 15 (1): 64-74. https://doi.org/10.1016/s0966-6362(01)00181-3
  • 11. Karthikbabu S, Chakrapani M, Ganeshan S, Rakshith KC, Nafeez S et al. A review on assessment and treatment of the trunk in stroke: A need or luxury. Neural Regeneration Research 2012; 7 (25): 1974-1977. https://doi.org/10.3969/j.issn.1673- 5374.2012.25.008
  • 12. Normann B, Arntzen EC. What are the relationships between trunk control, balance and walking in individuals with multiple sclerosis with minor to moderate disability? European Journal of Physiotherapy 2021; 23 (6): 377-383. https://doi.org/10.1080 /21679169.2020.1772870
  • 13. Van der Burg J, Van Wegen E, Rietberg M, Kwakkel G, Van Dieën J. Postural control of the trunk during unstable sitting in Parkinson’s disease. Parkinsonism & Related Disorders 2006; 12 (8): 492-498. https://doi.org/10.1016/j.parkreldis.2006.06.007
  • 14. Raats J, Arntzen EC, Lamers I, Feys P, Normann B. What is the distribution of trunk impairments and its relationship with disability level in individuals with multiple sclerosis? Multiple Sclerosis and Related Disorders 2022; 57: 103325. https://doi. org/10.1016/j.msard.2021.103325
  • 15. Verheyden G, Nieuwboer A, De Wit L, Thijs V, Dobbelaere J, et al. Time course of trunk, arm, leg, and functional recovery after ischemic stroke. Neurorehabilitation and Neural Repair 2008; 22 (2): 173-179. https://doi.org/10.1177/1545968307305456
  • 16. Adkin A, Bloem B, Allum J. Trunk sway measurements during stance and gait tasks in Parkinson’s disease. Gait & Posture 2005; 22 (3): 240-249. https://doi.org/10.1016/j.gaitpost.2004.09.009
  • 17. Korkmaz NC, Akman TC, Oren GK, Bir LS. Trunk control: The essence for upper limb functionality in patients with multiple sclerosis. Multiple Sclerosis and Related Disorders 2018; 24: 101-106. https://doi.org/10.1016/j.msard.2018.06.013
  • 18. Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clinical Rehabilitation 2006; 20 (5): 451-458. https://doi.org/10.1191/0269215505cr955oa
  • 19. Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clinical Rehabilitation 2004; 18 (3): 326-334. https:// doi.org/10.1191/0269215504cr733oa
  • 20. Berg K, Wood-Dauphine S, Williams J, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 1989; 41 (6): 304-311. https://doi.org/10.3138/ptc.41.6.304
  • 21. Steffen T, Seney M. Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short- form health survey, and the unified Parkinson disease rating scale in people with parkinsonism. Physical Therapy 2008; 88 (6): 733-746. https://doi.org/10.2522/ptj.20070214
  • 22. Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Archives of Physical Medicine and Rehabilitation 2002; 83 (11): 1566- 1571. https://doi.org/10.1053/apmr.2002.35469
  • 23. Duncan RP, Earhart GM. Four square step test performance in people with Parkinson disease. Journal of Neurologic Physical Therapy 2013; 37 (1): 2-8. https://doi.org/10.1097/ NPT.0b013e31827f0d7a
  • 24. Giorgetti MM, Harris BA, Jette A. Reliability of clinical balance outcome measures in the elderly. Physiotherapy Research International 1998; 3 (4): 274-283. https://doi.org/10.1002/ pri.150
  • 25. Chomiak T, Pereira FV, Hu B. The single-leg-stance test in Parkinson’s disease. Journal of Clinical Medicine Research 2015; 7 (3): 182-185. https://doi.org/10.14740/jocmr1878w
  • 26. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American geriatrics Society 1991; 39 (2): 142-148. https://doi. org/10.1111/j.1532-5415.1991.tb01616.x
  • 27. Consky E, Basinski A, Belle L, Ranawaya R, Lang A. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS): assessment of validity and inter-rater reliability. Neurology 1990; 40 (suppl 1): 445. https://doi.org/10.1212/wnl.40.11.1743
  • 28. Consky ES, Lang AE. Clinical assessments of patients with cervical dystonia. In: Jankovic J, Hallett M (editors). Therapy with botulinum toxin. New York, USA: Marcel Dekker; 1994. pp. 211-237.
  • 29. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. Upper Saddle River, NJ, USA: Pearson/Prentice Hall; 2009.
  • 30. Anastasopoulos D, Nasios G, Mergner T, Maurer C. Idiopathic spasmodic torticollis is not associated with abnormal kinesthetic perception from neck proprioceptive and vestibular afferences. Journal of Neurology 2003; 250 (5): 546-555. https:// doi.org/10.1007/s00415-003-1034-z
  • 31. Shaikh AG, Wong AL, Zee DS, Jinnah HA. Keeping your head on target. Journal of Neuroscience 2013; 33 (27): 11281-11295. https://doi.org/10.1523/JNEUROSCI.3415-12.2013
  • 32. Shaikh AG. Abnormal head oscillations in neuro-ophthalmology and neuro-otology. Current Opinion in Neurology 2016; 29 (1): 94-103. https://doi.org/10.1097/WCO.0000000000000277
  • 33. Kavanagh JJ, Barrett R, Morrison S. Upper body accelerations during walking in healthy young and elderly men. Gait & Posture 2004; 20 (3): 291-298. https://doi.org/10.1016/j. gaitpost.2003.10.004
  • 34. Pettorossi VE, Schieppati M. Neck proprioception shapes body orientation and perception of motion. Frontiers in Human Neuroscience 2014; 8: 895. https://doi.org/10.3389/ fnhum.2014.00895
  • 35. Anastasopoulos D, Maurer C, Mergner T. Interactions between voluntary head control and neck proprioceptive reflexes in cervical dystonia. Parkinsonism & Related Disorders 2014; 20 (11): 1165-1170. https://doi.org/10.1016/j. parkreldis.2014.08.008
  • 36. Münchau A, Corna S, Gresty M, Bhatia K, Palmer J et al. Abnormal interaction between vestibular and voluntary head control in patients with spasmodic torticollis. Brain 2001; 124 (1): 47-59. https://doi.org/10.1093/brain/124.1.47
  • 37. Siggelkow S, Kossev A, Moll C, Däuper J, Dengler R et al. Impaired sensorimotor integration in cervical dystonia: a study using transcranial magnetic stimulation and muscle vibration. Journal of Clinical Neurophysiology 2002; 19 (3): 232-239. https://doi.org/10.1097/00004691-200206000-00006
  • 38. Tinazzi M, Fiorio M, Bertolasi L, Aglioti SM. Timing of tactile and visuo-tactile events is impaired in patients with cervical dystonia. Journal of Neurology 2004; 251 (1): 85-90. https:// doi.org/10.1007/s00415-004-0282-x
  • 39. Molloy F, Carr T, Zeuner K, Dambrosia J, Hallett M. Abnormalities of spatial discrimination in focal and generalized dystonia. Brain 2003; 126 (10): 2175-2182. https://doi.org/10.1093/ brain/awg219
  • 40. Bradley D, Whelan R, Kimmich O, O’Riordan S, Mulrooney N et al. Temporal discrimination thresholds in adult-onset primary torsion dystonia: an analysis by task type and by dystonia phenotype. Journal of Neurology 2012; 259 (1): 77-82. https:// doi.org/10.1007/s00415-011-6125-7
  • 41. Kimmich O, Molloy A, Whelan R, Williams L, Bradley D et al. Temporal discrimination, a cervical dystonia endophenotype: penetrance and functional correlates. Movement Disorders 2014; 29 (6): 804-811. https://doi.org/10.1002/mds.25822
  • 42. Antelmi E, Erro R, Rocchi L, Liguori R, Tinazzi M et al. Neurophysiological correlates of abnormal somatosensory temporal discrimination in dystonia. Movement Disorders 2017; 32 (1): 141-148. https://doi.org/10.1002/mds.26804
  • 43. Hsieh C-L, Sheu C-F, Hsueh I-P, Wang C-H. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke 2002; 33 (11): 2626-2630. https://doi.org/10.1161/01.str.0000033930.05931.93
  • 44. Nilsagard Y, Carling A, Davidsson O, Franzén L, Forsberg A. Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis: A validation study. Physiotherapy Theory and Practice 2017; 33 (10): 772-779. https://doi.org/10.1080/09593985.2017.1346025
  • 45. Massion J. Movement, posture and equilibrium: interaction and coordination. Progress in Neurobiology 1992; 38 (1): 35-56. https://doi.org/10.1016/0301-0082(92)90034-c
  • 46. Vacherot F, Vaugoyeau M, Mallau S, Soulayrol S, Assaiante C et al. Postural control and sensory integration in cervical dystonia. Clinical Neurophysiology 2007; 118 (5): 1019-1027. https:// doi.org/10.1016/j.clinph.2007.01.013
  • 47. Assaiante C, Mallau S, Viel S, Jover M, Schmitz C. Development of postural control in healthy children: a functional approach. Neural Plasticity 2005; 12 (2-3): 109-118. https://doi. org/10.1155/NP.2005.109
  • 48. Isho T, Usuda S. Association of trunk control with mobility performance and accelerometry-based gait characteristics in hemiparetic patients with subacute stroke. Gait & Posture 2016; 44: 89-93. https://doi.org/10.1016/j.gaitpost.2015.11.011
  • 49. Özgül Ünlüer N, Özkan T, Ertuğrul Yaşa M, Ateş Y, Anlar Ö. Investigation of the Relationship Between Trunk Motor Control and Balance, Functional Mobility, and Gait Capacity in Patients with Multiple Sclerosis. Turkish Journal of Neurology/Turk Noroloji Dergisi 2021; 27: 283-288. https:// doi.org/10.4274/tnd.2021.41017
  • 50. Davies PM. Problems associated with the loss of selective trunk activity in hemiplegia. In: Davies PM (editor). Right in the middle: selective trunk activity in the treatment of adult hemiplegia. Heidelberg, Berlin, Germany: Springer- Verlag; 1990: 31-65.
  • 51. Saeys W, Vereeck L, Truijen S, Lafosse C, Wuyts FP et al. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabilitation and Neural Repair 2012; 26 (3): 231-238. https://doi. org/10.1177/1545968311416822
  • 52. Granacher U, Lacroix A, Muehlbauer T, Roettger K, Gollhofer A. Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults. Gerontology 2013; 59 (2): 105-113. https://doi.org/10.1159/000343152
  • 53. Freeman J, Gear M, Pauli A, Cowan P, Finnigan C et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Multiple Sclerosis Journal 2010; 16 (11): 1377-1384. https://doi.org/10.1177/1352458510378126
  • 54. Kumar A, Schmeler MR, Karmarkar AM, Collins DM, Cooper R et al. Test-retest reliability of the functional mobility assessment (FMA): a pilot study. Disability and Rehabilitation: Assistive Technology 2013; 8 (3): 213-219. https://doi.org/10.3109/174 83107.2012.688240
  • 55. Moreau MS, Séverac Cauquil A, Costes Salon MC. Static and dynamic balance function in spasmodic torticollis. Movement Disorders: Official Journal of the Movement Disorder Society 1999; 14 (1): 87-94. https://doi.org/10.1002/1531- 8257(199901)14:1<87::aid-mds1015>3.0.co;2-c
  • 56. Müller J, Ebersbach G, Wissel J, Poewe W. Dynamic balance function in phasic cervical dystonia following botulinum toxin therapy. Movement Disorders 2001; 16 (5): 934-937. https:// doi.org/10.1002/mds.1164
  • 57. Baione V, Ferrazzano G, Celletti C, De Rosa M, Belvisi D et al. Attention-demanding cognitive tasks worsen postural control in patients with cervical dystonia: a case-control study. Frontiers in Neurology 2021; 12: 666438. https://doi. org/10.3389/fneur.2021.666438
  • 58. Paracka L, Wegner F, Escher C, Klietz M, de Zwaan M et al. Body concept and quality of life in patients with idiopathic dystonia. Brain Sciences 2020; 10 (8):488. https://doi.org/10.3390/ brainsci10080488
  • 59. Ferrazzano G, Berardelli I, Belvisi D, De Bartolo MI, Di Vita A et al. Awareness of Dystonic Posture in Patients With Cervical Dystonia. Frontiers in Psychology 2020; 11: 1434. https://doi. org/10.3389/fpsyg.2020.01434
  • 60. Ferrazzano G, Berardelli I, Conte A, Suppa A, Fabbrini G et al. Interoceptive sensitivity in patients with cervical dystonia. Parkinsonism & Related Disorders 2017; 44: 129-132. https:// doi.org/10.1016/j.parkreldis.2017.08.019
  • 61. Scontrini A, Conte A, Defazio G, Fiorio M, Fabbrini G et al. Somatosensory temporal discrimination in patients with primary focal dystonia. Journal of Neurology, Neurosurgery & Psychiatry 2009; 80 (12): 1315-1319. https://doi.org/10.1136/ jnnp.2009.178236
APA Söke F, Erkoc Ataoglu E, Oztekin M, Kocer B, karakoç s, Gülşen Ç, Çomoğlu S, BORA TOKCAER A (2023). Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. , 405 - 412. 10.55730/1300-0144.5597
Chicago Söke Fatih,Erkoc Ataoglu Esra,Oztekin Mehmet Fevzi,Kocer Bilge,karakoç selda,Gülşen Çağrı,Çomoğlu Selim Selçuk,BORA TOKCAER Ayse Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. (2023): 405 - 412. 10.55730/1300-0144.5597
MLA Söke Fatih,Erkoc Ataoglu Esra,Oztekin Mehmet Fevzi,Kocer Bilge,karakoç selda,Gülşen Çağrı,Çomoğlu Selim Selçuk,BORA TOKCAER Ayse Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. , 2023, ss.405 - 412. 10.55730/1300-0144.5597
AMA Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. . 2023; 405 - 412. 10.55730/1300-0144.5597
Vancouver Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. . 2023; 405 - 412. 10.55730/1300-0144.5597
IEEE Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A "Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia." , ss.405 - 412, 2023. 10.55730/1300-0144.5597
ISNAD Söke, Fatih vd. "Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia". (2023), 405-412. https://doi.org/10.55730/1300-0144.5597
APA Söke F, Erkoc Ataoglu E, Oztekin M, Kocer B, karakoç s, Gülşen Ç, Çomoğlu S, BORA TOKCAER A (2023). Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turkish Journal of Medical Sciences, 53(1), 405 - 412. 10.55730/1300-0144.5597
Chicago Söke Fatih,Erkoc Ataoglu Esra,Oztekin Mehmet Fevzi,Kocer Bilge,karakoç selda,Gülşen Çağrı,Çomoğlu Selim Selçuk,BORA TOKCAER Ayse Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turkish Journal of Medical Sciences 53, no.1 (2023): 405 - 412. 10.55730/1300-0144.5597
MLA Söke Fatih,Erkoc Ataoglu Esra,Oztekin Mehmet Fevzi,Kocer Bilge,karakoç selda,Gülşen Çağrı,Çomoğlu Selim Selçuk,BORA TOKCAER Ayse Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turkish Journal of Medical Sciences, vol.53, no.1, 2023, ss.405 - 412. 10.55730/1300-0144.5597
AMA Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turkish Journal of Medical Sciences. 2023; 53(1): 405 - 412. 10.55730/1300-0144.5597
Vancouver Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turkish Journal of Medical Sciences. 2023; 53(1): 405 - 412. 10.55730/1300-0144.5597
IEEE Söke F,Erkoc Ataoglu E,Oztekin M,Kocer B,karakoç s,Gülşen Ç,Çomoğlu S,BORA TOKCAER A "Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia." Turkish Journal of Medical Sciences, 53, ss.405 - 412, 2023. 10.55730/1300-0144.5597
ISNAD Söke, Fatih vd. "Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia". Turkish Journal of Medical Sciences 53/1 (2023), 405-412. https://doi.org/10.55730/1300-0144.5597