Abstract：
BACKGROUND: Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete\'s ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined.
METHODS: We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely.
METHODS: An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer.
CONCLUSIONS: This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.
METHODS: We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely.
METHODS: An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer.
CONCLUSIONS: This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.
摘要：
背景：运动相关的肌张力障碍是一种罕见的活动特异性肌张力障碍，可严重损害运动员的表演能力。由于缺乏有关病情的数据，很难诊断，而且经常被忽视，尚未定义黄金标准治疗。
方法：我们介绍了一个罕见且具有挑战性的运动相关肌张力障碍案例，该案例影响了一名24岁的男性职业足球运动员。患者表现为右下肢严重僵硬和肌张力障碍，尤其是脚踝和脚。症状在我们门诊就诊前1年以上。他开始抱怨下肢僵硬和难以移动，尤其是他的右腿,最初踢足球时，但在正常行走时也是如此。在介绍时，他无法奔跑，行走困难，只在右脚外侧支撑他的体重。他还报告了涉及口腔肌肉组织的运动技巧和反向运动技巧，以便更自由地移动下肢。
方法：基于姿势康复的综合康复方法，神经肌肉康复，和牙科干预被用来成功地治疗这种情况。该方法包括：（1）使用Mézières-Bertelè方法进行姿势康复，以减少肌肉僵硬，（2）神经肌肉再教育与太极拳运动和肌电图引导的生物反馈，和（3）牙科干预和吞咽康复，以限制受损的口腔习惯（由于他受损的下肢运动和口腔肌肉组织的运动技巧之间的关系）。经过7个月的综合康复，病人重返职业足球。
结论：本病例报告强调了综合康复治疗运动性肌张力障碍的潜在疗效，特别是在传统治疗可能无效的情况下。这种方法可以被认为是管理这种罕见的一种有价值的选择，但是使人衰弱，运动员的条件。需要进一步的研究来评估这种方法在更大人群中的有效性。
方法：我们介绍了一个罕见且具有挑战性的运动相关肌张力障碍案例，该案例影响了一名24岁的男性职业足球运动员。患者表现为右下肢严重僵硬和肌张力障碍，尤其是脚踝和脚。症状在我们门诊就诊前1年以上。他开始抱怨下肢僵硬和难以移动，尤其是他的右腿,最初踢足球时，但在正常行走时也是如此。在介绍时，他无法奔跑，行走困难，只在右脚外侧支撑他的体重。他还报告了涉及口腔肌肉组织的运动技巧和反向运动技巧，以便更自由地移动下肢。
方法：基于姿势康复的综合康复方法，神经肌肉康复，和牙科干预被用来成功地治疗这种情况。该方法包括：（1）使用Mézières-Bertelè方法进行姿势康复，以减少肌肉僵硬，（2）神经肌肉再教育与太极拳运动和肌电图引导的生物反馈，和（3）牙科干预和吞咽康复，以限制受损的口腔习惯（由于他受损的下肢运动和口腔肌肉组织的运动技巧之间的关系）。经过7个月的综合康复，病人重返职业足球。
结论：本病例报告强调了综合康复治疗运动性肌张力障碍的潜在疗效，特别是在传统治疗可能无效的情况下。这种方法可以被认为是管理这种罕见的一种有价值的选择，但是使人衰弱，运动员的条件。需要进一步的研究来评估这种方法在更大人群中的有效性。
