Table 3.

Adaptive Aids or Devices (Kinesiotape, Splints, Vibrotactile stimulation, Orthotic device, TENS and FES)

Adaptive Aids or (kinesiotapes, splints, orthotic devices, vibrotactile stimulators, TENs) (n = 24)
Author	Study design	Participant characteristics				Intervention		Assessment outcomes	Results	AAN class
			Active group	Control group		Active	Control
Focal Cervical Dystonia
Xu. et al., 202484 USA	Pre-post	N	44		Treatment	Vibrotactile stimulation	NA	Perceived pain score (0–100 pain scale)	Significant improvement in pain	III
		M/F	15/29		Details	Small electric vibratory motors stimulated sternocleidomastoid ± trapezius muscles
		Age (y)	61.8		Frequency/Duration	45 min stimulation, single session
Pelosin et al., 201383 Italy	RCT cross-over	N	12		Treatment	Kinesiotaping	Sham taping	VAS, TWSTRS (pain, severity)	Significant improvement in pain No significant improvement in dystonia severity	II
		M/F	4/8		Details	Kinesiotape applied to skin over affected muscles
		Age (y)	55 ± 9		Frequency/Duration	Taping every day, 2 w/condition, 1m/washout, 2m
Laryngeal dystonia
Khosravani. et al., 201985 USA	Pre-post	N	13		Type	Vibrotactile stimulation	NA	Voice analysis (performance)	9 participants had less voice breaks & better voice quality	IV
		M/F	5/8		Details	vibro-motors attached to skin over thyroid cartilage were used during vocalization for laryngeal vibration
		Age (y)	58 ± 12		Frequency/Duration	Single session for ~30min
Focal limb dystonia
Bravi. et al., 201986 Italy	Cross-over	Type	Musician’s dystonia		Treatment	Kinesiotaping	Sham Kinesiotaping	VAS (performance)	No significant improvement in music performance	III
		N	7		Details	Kinesiotape applied to skin over affected dystonic fingers as well as compensatory fingers
		M/F	NA
		Age (y)	35 ± 9		Frequency/Duration	Single session lasting ~ 8 min
Oborzyński. et al., 201898 Poland	Pre-post	Type	Writer’s cramp		Treatment	Immobilization with splints	NA	BFMDRS, Arm Dystonia Disability Scale (severity)	No significant improvement	III
		N	9		Details	Thermoplastic splint designed for each individual’s dystonia was applied to immobilize dystonic fingers and wrist
		M/F	1/8		Frequency/Duration	1 h/d, 5 d/w, 3 w
		Age (y)	44.3 ± 10.6
Barrett. et al., 2013104 Netherlands	Case report	Type	Lower limb dystonia		Treatment	Functional electrical stimulation of peroneal nerve	NA	6-min walk test, single leg stance time, TUG time (performance)	Improvement in 6-min walk & single leg stance time Worsened TUG time	IV
		N	1		Details	Fitted with radio frequency-controlled device that patient used on daily basis
		M/F	F
		Age (y)	62		Frequency/Duration	Daily, 18 months
Singam. et al., 2013100 USA	Pre-post	Type	Writer’s cramp		Treatment	Sensorimotor retuning with writing orthotic device	NA	WCRS, VAS (performance)	Improvement in writing performance	III
		N	11		Details	Modifying standard handwriting posture with plastic orthotic device
		M/F	NA
		Age (y)	53 ± 12		Frequency/Duration	Daily home practice, 2 w
Pelosin. et al., 201383 Italy	RCT cross-over	Type	Writer’s cramp		Treatment	Kinesiotaping	Sham taping	VAS, WCRS (pain, severity)	Significant decrease in pain in both groups but no change in dystonia severity	II
		N	10		Details	Kinesiotape applied to skin over the affected muscle
		M/F	3/7
		Age (y)	48 ± 6		Frequency/Duration	Taping every day, 2 w/condition, 1m/washout, 2m
Waissman. et al., 201390 Brazil	Pre-post	Type	Writer’s cramp		Treatment	Immobilization of dystonic fingers with splint	NA	BFMDRS, Analog Pain Scale (severity, pain)	Significant improvement in pain & dystonia severity	III
		N	12		Details	Writing training followed by finger immobilization with specific ring in eight splints
		M/F	7/5
		Age (y)	52 ± 16		Frequency/Duration	Supervised: 60min/d, 2 d/w, 8 w + Home: daily, 8 w
Berque. et al., 201394 UK	Pre-post	Type	Musician’s dystonia		Treatment	Immobilization of non-dystonic compensatory finger movements with splint	NA	Frequency of abnormal movement (severity)	Significant improvement in dystonia severity	IV
		N	4		Details	Retraining of motor control at slow speed + immobilization with splint
		M/F	7/1		Frequency/Duration	Supervised: 2 h/d, 1 w + Home: 30–60 min/day, 4 y
		Age (y)	48 (30–55)
Rosset-Llobet. et al., 201189 Spain	Case report	Type	Musician’s dystonia		Treatment	Sensorimotor retuning: Immobilization of non-dystonic compensatory finger movements with splint	NA	Subjective assessment (subjective)	Improvement in subjective symptoms	IV
		N	1		Details	Splinting of non-dystonic fingers and exercises for dystonic fingers
		M/F	M
		Age (y)	45		Frequency/Duration	Daily practice, 1 y
Meunier. et al., 2011103 France	RCT cross-over	Type	Primary writing tremor		Treatment	TENS applied to wrist flexor muscles	Sham stimulation	Fahn–Tolosa–Marin Tremor Rating Scale (severity)	TENS at 5 and 25 Hz did not have any effect while TENS at 50 Hz worsened the clinical condition.	II
		N	9		Details	120 % RMT, 250 μs, 5, 25 or 50 Hz, in 2-s trains separated by 2-s pauses
		M/F	9/0
		Age (y)	62 ± 13		Frequency/Duration	14 sessions (7 days for per week for two consecutive weeks) lasting 20 min each
Waissman. et al., 201091 Brazil	Pre-post	Type	Writer’s cramp		Treatment	Immobilization of dystonic fingers with splint	NA	BFMDRS, Jedynak Writing Evaluation, pain scale (severity, performance, pain)	Improvements in all measures	III
		N	2		Details	Writing training followed by finger immobilization with specific splints
		M/F	1/1
		Age (y)	24, 44		Frequency/Duration	Supervised: 60min/d, 2 d/w, 8 w + Home: daily, 8 w
Berque. et al., 201095 UK	Pre-post	Type	Musician’s dystonia		Treatment	Immobilization of non-dystonic compensatory finger movements with splint	NA	Frequency of abnormal movement (severity)	Significant improvement in dystonia severity	IV
		N	8		Details	Retraining of motor control at slow speed + immobilization with splint
		M/F	7/1		Frequency/Duration	Supervised: 2 h/d, 1 w + Home: 30–60 min/day, 1 y
		Age (y)	48 (30–55)
Trompetto. et al., 2009105 Italy	Cross-over	Type	Writer’s cramp		Treatment	Extracorporeal shockwave therapy	Placebo shock	UDRS, Arm dystonia disability scale	Improvement in dystonia severity	III
		N	3		Details	800–3000 pulses to dystonic muscles in hand
		M/F	0/3
		Age (y)	41,47,25		Frequency/Duration	1 session/w, 4 w
Zeuner. et al., 200887 Germany	RCT	Type	Writer’s cramp		Treatment	Immobilization of non-dystonic compensatory finger movements followed by retraining	task non-specific motor re-training, use of therapeutic putty	WCRS (severity, performance)	Both groups significantly improved in dystonia severity & writing performance (pre-post)	I
		N	26		Details	Drawing & writing exercises with stax finger splints (pen attached)
		M/F	14/12
		Age (y)	49 ± 12		Frequency/Duration	35–60 min/d, daily, 8 w
Tinazzi. et al., 2006102 Italy	Case-control	Type	Writer’s cramp	Healthy control	Treatment	TENS over forearm agonist & antagonist muscles	NA	Writing performance	Significant improvement in writing time	III
		N	10	14	Details	1.5 mA below motor threshold, 2s trains at 150 Hz
		M/F	8/6	NA
		Age (y)	33	NA	Frequency/Duration	30 min/session, 5 sessions/w, 3w
Tinazzi. et al., 2005101 Italy	RCT cross-over	Type	Writer’s cramp		Treatment	TENS over forearm flexor muscles	Sham ultrasound	Dystonia movement scale, writing test, VAS (severity, subjective, performance)	Significant improvement in all outcomes	II
		N	10		Details	50 Hz, 250 μs, below pain threshold, 2s trains
		M/F	5/5
		Age (y)	33 ± 4		Frequency/Duration	20 min/session, 5 sessions/w, 2w
Zeuner. et al., 200588 USA	Pre-post	Type	Writer’s cramp		Treatment	Immobilization of non-dystonic compensatory finger/wrist and motor training of affected fingers	NA	BFMDRS, kinematic analysis of handwriting (severity, performance)	Mild subjective improvement	III
		N	10		Details	Train each finger individually with splint & pen
		M/F	NA
		Age (y)	54.0 ± 8.4		Frequency/Duration	25 min/d for 1w + 50 min/d for 3–7w
Pesenti. et al., 200496 Italy	Case series	Type	Musician’s dystonia	Writer’s cramp	Treatment	Dystonic hand immobilization	NA	Subjective and performance scale, hand grip test (subjective, performance, function)	Variable outcomes at follow-up	IV
		N	15	4	Details	Immobilization with plastic splint applied to fingers and wrist
		M/F	NA
		Age (y)	NA		Frequency/Duration	Daily, 4–5 w
Candia. et al., 200299 Germany	Pre-post	Type	Musician’s dystonia, Embouchure dystonia		Treatment	Sensory motor retuning	NA	Dystonia evaluation scale, music performance test (severity, performance)	Pianists & guitarists showed improvement Not embouchure dystonia	IV
		N	11		Details	Immobilizes one or more compensatory finger(s) with splint; Repetitive exercises for dystonic finger
		M/F	8/3
		Age (y)	40 (30–70)		Frequency/Duration	Supervised: 1.5–2.5 hr/day, 8d + Home: 1 hr, daily, 1y
Priori. et al., 200193 Italy	Pre-post	Type	Musician’s dystonia		Treatment	Immobilization therapy with splint	NA	Arm dystonia disability scale, Tubiana Chamagne score (severity, subjective, performance)	Significant improvement in dystonia severity & music performance (pianists, guitarists, drummers)	IV
		N	8		Details	Finger & wrist joints of dystonic hand immobilized with plastic splint
		M/F	7/1
		Age (y)	30 ± 6		Frequency/Duration	4.5 ± 0.75 w
Candia. et al., 199992 Germany	Pre-post	Type	Musician’s dystonia		Treatment	Sensory motor retuning	NA	Dystonia evaluation scale (severity)	Significant improvement in dystonia severity	IV
		N	5		Details	Immobilization by splint(s) of one or more compensatory digits other than focal dystonic finger. Repetitive exercises for dystonic finger
		M/F	NA
		Age (y)	NA		Frequency/Duration	1.5 – 2.5 h/d, 8d
Focal limb dystonia
Ferrara. et al., 2011106	Pre-post	N	12		Treatment	TENS over muscles that were maximally affected	NA	Psychogenic Movement Disorders Rating Scale (severity)	5/12 showed significant improvement in dystonia severity	IV
		M/F	NA		Details	Stimulus strength was titrated to produce a tingling sensation in the stimulated area without muscle twitching or pain, 2-sec trains, 150 Hz
		Age (y)	NA		Frequency/Duration	30 min/day, daily, 6.9 ± 4.7 m

Values are shown as mean (standard deviation or SD), if SD was not available in the article min - max were shown if possible. AAN class, American Academy of Neurology classification framework; number of patients, n; male, M; female, F; year, y; month, week, w; hour, h; minute, min; second, s; not applicable, NA; Randomized controlled trial, RCT; Visual Analogue Scale, VAS; Toronto Western spasmodic torticollis rating scale, TWSTRS; Writer’s cramp rating scale, WCRS; electroencephalography, EEG; functional electrical stimulation, FES; timed up and go test, TUG; The Burke–Fahn–Marsden Dystonia Rating Scale, BFMDRS; the Unified Dystonia Rating Scale, UDRS; nerve conduction study, NCS; Somatosensory Evoked Potential test, SEP; Radial extracorporeal shockwave therapy, rESWT; Transcutaneous electrical nerve stimulation, TENS; Motor evoked potentials, MEP; Physical therapy, PT; resting motor threshold, RMT.