Lack of influence of EMG biofeedback in relaxation training for spasmodic torticollis

Abstract

Reports in the American and Japanese literature have suggested that electromyographic (EMG) biofeedback is effective in the treatment of spasmodic torticollis but no conclusive evidence has been reported from controlled studies. A controlled study was therefore undertaken in 11 subjects with spasmodic torticollis. Five patients were randomly allocated to a course of television- monitored relaxation while the remaining six were treated with television- monitored relaxation plus EMG biofeedback. The effects of intervention were assessed by questionnaires, clinical assessment and measurement of integrated EMG activity in both sternomastoid muscles during a five-minute observation period under controlled conditions. The subjects' range of voluntary neck movements and their capacity to suppress their involuntary movements were measured using a computer-assisted movement detection system (Coda 3, Charnwood Dynamics) and standardized videotape recordings, the latter being assessed by two experienced clinicians who did not know the sequence of the recordings. Subjective improvements in symptoms were reported in both groups of subjects, who appeared to gain from the opportunity to discuss harrowing aspects of their experience. However, these subjective results were not associated with any significant changes in the objective measures used and thus provided no support for the use of EMG biofeedback in torticollis.