Tele-Yoga for the Management of Cervical Dystonia: A Safety and Feasibility Trial

Background: Cervical dystonia impacts quality of life and activities of daily living. Botulinum toxin injections, the standard treatment, are not effective for all and often include bouts of recurring symptoms between injections. There is a need for supplementary treatments such as yoga, which has been shown to be beneficial for individuals with chronic neck pain and movement disorders. However, individuals with cervical dystonia experience barriers impeding access to in-person yoga. Thus, alternative delivery methods that can optimize access while maintaining safety must be investigated. The purpose of this study is to investigate the feasibility and safety of a synchronous one-on-one tele-yoga intervention for individuals with cervical dystonia. Methods: Individuals with cervical dystonia were enrolled in a single group pilot feasibility study consisting of a 6-weeks tele-yoga intervention bookended by two assessment sessions, ending with a 6-weeks follow-up period and associated final assessment session. The live one-on-one tele-yoga intervention consisted of breathing, postures, and relaxation and was delivered for 30 min twice weekly. Primary outcomes included adherence, adverse events, technological challenges, and usability. Secondary outcomes included enjoyment, yoga status at follow-up, clinically relevant questionnaires, and functional measures. Results: Of the fifteen individuals enrolled, one did not complete the follow-up assessment. Intervention adherence was 93%. No significant adverse events related to the intervention occurred. Manageable technological challenges occurred. Mean usability and enjoyment were high. Conclusions: The implementation of a one-on-one tele-yoga intervention for individuals with cervical dystonia is safe and feasible thus, efficacy trials should be initiated. Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/NCT04348669, NCT04348669