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Dystonia: Current Knowledge and Treatment

Research Priorities in Limb and Task-Specific Dystonias

1. In epidemiological studies conducted in different parts of the world, the most commonly affected regions of the body are the upper limbs.

A. True B. False

2. In writer’s cramp when writing with the unaffected non-dominant hand, the normal voluntary movement can provoke or cause recapitulation of the dystonic movements in the affected hand, even though it is not engaged in the writing task.

A. True B. False

3. Patients with runner’s dystonia often describe their initial symptom as:

A. A subtle change in their gait or running stride. B. A limp. C. A sense of pulling, cramping, or stiffness triggered by running and improved with rest. D. All of the above.

4. A possible clinical clue to the diagnosis of RD is a marked improvement in, or complete absence of, symptoms when the patient walks or runs backwards.

A. True B. False

5. One distinguishing clinical feature of peripherally induced dystonia from other dystonias is the:

A. Frequency of pain as a presenting complaint. B. Presence of psychological factors. C. Sensorimotor reorganization. D. All of the above.

6. Which of the following is an important factor in measurements of plasticity?

A. The stimulus strength and the number of paired stimuli delivered. B. The state of muscle activity. C. The time of the day. D. All of the above.

7. Much evidence suggests that repetition, in-and-of-itself, is the sole driver for the development of a task-specific dystonia.

A. True B. False

8. Vibration of a hand produces a blood flow response in contralateral sensorimotor cortex and supplementary motor area. People with isolated hand dystonia, including a subgroup with only right-handed writer’s cramp, show an approximately _____ reduction in these blood flow responses, similar to findings in other isolated dystonias.

A. 10% B. 25% C. 40% D. 55%

9. Conventional rehabilitation methods, such as _____, are frequently used in clinical settings when patients are referred for physical or occupational therapy.

A. Stretching B. Strengthening exercises C. Manual therapy D. All of the above

Exploring factors related to physical activity in cervical dystonia

10. In the clinical physiotherapy setting, individuals with cervical dystonia often report that _____ hinders them from performing physical activity, indicating this is a contributory factor to reduced participation in physical activities.

A. Pain B. Health status C. Fear of falling D. Self-efficacy

11. This study found which of the following to have emerged as the most strongly related variable for physical activity for the total group, the male group, and the female group?

A. Age B. Employment C. Self-efficacy D. All of the above

12. Age is a limiting factor for physical activity for:

A. Men B. Women C. Both (A) and (B) D. None of the above

Unmet Needs in the Management of Cervical Dystonia

13. Botulinum neurotoxin injections are the treatment of choice for cervical dystonia.

A. True B. False

14. A currently accepted definition of secondary non-responsiveness implies insufficiently improved posture after _____ or more unsuccessful injection cycles in cervical dystonia patients previously achieving satisfactory results.

A. 1 B. 2 C. 3 D. 4

15. A well-known cause of non-responsiveness is the development of antibodies against BoNT formulation, which has been described with all of the following formulations, except for:

A. IncobotulinumtoxinA B. OnabotulinumtoxinA C. AbobotulinumtoxinA D. RimabotulinumtoxinB

16. Studies show that psychiatric comorbidity is the most important predictor of poorer health-related QoL, especially for the domains of general health, role functioning, bodily pain, and emotional and mental health.

A. True B. False


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