けい性斜頚に対するＥＭＧ‐生体フィードバック治療

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  • EMG biofeedback therapy to the patient with spasmodic torticollis.

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Since 1977 we have treated, eighteen cases of spasmodic torticollis without other neurological signs by electromyographic (EMG) feedback therapy. The patients were asked to relax the contracted nuchal muscles by using auditory and visual feedback displays of EMG.<br>If the patients' heads could turn to the front in sitting posture they were then asked to do the same way in standing posture, followed by stepping posture. We also used “mini-trainer” in order to make the patients possible to train in their ward or homes.<br>These included eleven men and seven women.<br>The following were obtained:<br>1) Total therapeutic efficacy of EMG-feedback: Thirteen patients (72%) showed improvement (ten marked and three moderate to mild) but five (28%) did not.<br>2) In fifteen patients with severe and moderate torticollis ten showed marked, three showed moderate to mild, two showed no improvement. Three patients with mild torticollis all showed no improvement. That is, the severer the symptom of torticollis was, the more improvement the patient showed with feedback therapy.<br>3) Summarized features of ten patients with marked improvement were: (1) Ages were among third to fifth decades, (2) Incentives were relatively definite, (3) Symptoms were severe and relief of them were much appreciated, (4) Active for feedback therapy, (5) They had their jobs and volition for social comeback.<br>4) Summarized features of five patients of no improvement were (1) Incentives were obscure, (2) Symptoms were mild and significance of the feedback therapy was not well understood, (3) They did not feel any inconvenience in doing their jobs.<br>Computed tomographic scans which were performed in 13 cases reavealed no definite abnormalities.<br>Most of the patients with spasmodic torticollis had various problems in their homes, jobs, human relationships and personal histories. It seemed necessary that EMG-feedback therapy should be performed with special efforts to solve these problems because spasmodic torticollis might have psychic factors as one of its causes.

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