6-week Results of Physiotherapy and Cognitive Behavioral Therapy in a Patient with Bilateral Lower Extremity Dystonia

The aim of this study was to investigate the effectiveness of physiotherapy and rehabilitation applications for balance and coordination problems caused by segmental bilateral lower extremity dystonia and simultaneously applied cognitive behavioral therapy (CBT). There are few studies in the literature about physiotherapy in lower extremity dystonia. In our study, the application of CBT in addition to physiotherapy in lower extremity dystonia makes our study unique and we aim to guide future studies. The patient, who was referred to the clinic due to balance and coordination disorders accompanied by lower extremity pathologies, underwent a 90-min rehabilitation program for 6 weeks, 3 sessions per week, with 60 min of exercise and 30 min of hydrotherapy in each session. Simultaneously with physiotherapy, the patient received psychotherapy with CBT by a specialist psychologist for 3 sessions per week. Static and dynamic balance exercises, lower limb coordination, gait training, relaxation training, breathing exercises, and Whirlpool were applied to the patient. The patient’s balance was evaluated with Berg Balance Scale and one-leg stand tests, quality of life with SF-36, mobility with Timed Stand and Sit Test, frequency and severity of dystonic spasms with Modified penn spasm frequency scale, pain with VAS Pain Scale, and anxiety with Beck Anxiety Scale. In this patient with lower extremity dystonia, it was concluded that the patient’s balance improved, quality of life and mobility increased, dystonic spasms and pain decreased with a 6-week physiotherapy and rehabilitation program, and anxiety decreased with concurrent CBT. As a result, physiotherapy and CBT can increase the functional capacity and quality of life of the person.

Keywords: Case report; Cognitive behavioral therapy; Lower extremity dystonia; Physiotherapy