Synergistic Effects of Botulinum Toxin and Physical Therapy in Primary Cervical Dystonia (P1.032)
Bibliographic record
Abstract
OBJECTIVE To compare standard botulinum toxin (BoNT) versus BoNT combined with physical therapy (PT) in primary cervical dystonia (PCD). BACKGROUND PCD is frequently a source of disability, depression and decreased quality of life. BoNT is the gold standard treatment for PCD however the response can be suboptimal in many patients. BoNT efficacy wears off between doses even in patients who have good response. DESIGN/METHODS PCD subjects with suboptimal benefits on BoNT (10 weeks or lesser) were enrolled. These PCD subjects either received PT and BoNT (PT group) or BoNT alone. Toronto Western Spasmodic Torticollis Scale (TWSTRS) scores, SF-36 quality of life scores and visual analog scale (VAS) scores for pain were obtained at baseline, at peak BoNT benefits (approximately 3-6 weeks), and 12 weeks post BoNT. A PT program was initiated at baseline visit. A supervised session followed by a home exercise program was performed for six weeks. Subjects were contacted weekly to ensure compliance with the exercise program. RESULTS Fifteen subjects (7 male, 8 female, mean age 64.5 ± 5.4 years, mean disease duration 14.4 ± 10.9 years) were recruited. At baseline, the mean TWSTRS disability score was 9.9 ± 5.3 (PT group) and 5.8 ± 3.3 (non-PT group), TWSTRS pain score was 8.9 ± 5.8 (PT group) and 6 ± 5.2 (non-PT group) and VAS pain score was 3.6 ± 3.1 (PT group) and 1.19 ± 1.31 (non-PT group). Repeated Measures ANOVA was used. The change in TWSTRS pain score and VAS pain score at 6 weeks peak BoNT benefits in PT group was significantly greater than non-PT group. Improvement in SF-36 physical component scale approached significance in the PT group. CONCLUSIONS Preliminary results suggest BoNT combined with PT improve pain and quality of life greater than BoNT alone. A larger clinical trial is needed for further validation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".