Before abandoning an activity due to dystonia, one should consider modifying the task to foster posture and muscle control. A person with trouble writing may try to use the shoulder and arm to write, rather than the wrist and fingers. Writing on a vertical surface such as a chalk/writing board or putting the table at an angle may help writing.
Sports involving asymmetrical movements of the trunk, such as golf or baseball, should generally be avoided, especially for individuals with cervical dystonia. Lower stress exercises such as water exercise, walking (if using a treadmill, it should be level), yoga, ballet, low-impact aerobics, or stationary bike riding without moving handlebars are less likely to worsen symptoms.
Rest periods during a workout or physical activity are valuable. Frequent 5- to 10-minute breaks promote muscle relaxation and proper posture. Lying down or sitting in a high-backed chair with arms supported during a break may help the muscles thoroughly relax.
Rest periods are equally important while doing chores around the house or running errands. Take one task at a time! taking breaks and pacing oneself are important.
The physical therapist may examine a person's daily routine and make recommendations to improve efficiency and safety. A stand-up vacuum may be easier to use than a canister model. It may be more comfortable to chop vegetables while sitting in a high-backed chair with arms supported rather than while standing at a counter. Unnecessary weight should be removed from purses, briefcases, or backpacks. If possible, purses or bags should be carried on the side opposite the dystonia. Waist packs are often an ideal alternative to bags with straps or handles.
Stress management
elements of stress management may be incorporated into a physical therapy program, and relaxation exercises may be tailored to address specific motor problems.
Relaxation techniques may vary from deep breathing, visualization, and progressive muscle relaxation to local and generalized stretching. Stress management may also mean taking more time for leisurely activities. Yoga or a soft martial art such as tai chi may increase fitness and relaxation simultaneously. Meditation can create a mental refuge from stress and aggravation
stretching and strengthening
a physical therapist or physician is likely to demonstrate and prescribe exercises to stretch muscles and increase flexibility. Various types of strengthening exercises may be recommended to build up underused muscles and prevent weakening of the bones.
A physician or therapist may use certain equipment to activate the muscles. Neuromuscular electrical stimulation (nmes) may stimulate and strengthen the antagonist muscles (which oppose the dystonia spasm) while the overly active agonist muscles (which cause the dystonia spasm) are relaxed with botulinum toxin. Biofeedback involves using surface electrodes to identify and relax overly active muscles and to increase control and activation of the passive muscles.
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