Wikipedia reference-linkDystonia is complex and I would not be comfortable prescribing specific exercises without a proper assessment. I think your uncle warrants an assessment from a neurological physiotherapist who has experience in dystonia.

If that is not possible here are some overall principles and a suggested resources:

  • If one approaches it from a motor control point of view, the problem is excessive activity in the wrong muscles at the wrong time.
  • Maintaining a supported posture with good alignment so he can relax for starters
  • Try writing slowly and very gently. Patients often excessively co-contract their muscles in an attempt to control the dystonic movement but this can make matters worse. and keep the size of the writing larger than usual
  • Practice performing lines, circles, ellipses and other geometrical shapes making them as smooth as possible. These more simplified shapes may are often easier to perform as an intermediary step.
  • Having an optimal grip can reduce the effort required to hold the pen. Therefore an ergonomic pen which has a grip of 1.5 to 2 cm and is very comfortable to hold may help.

    Resources:

    The Dystonia Medical Research Foundation has some good tips under non drug therapies:

    http://www.dystonia-foundation.org/p...rapies/110.php


One take home message from the DMRF is not to get fixated just on physical treatments but paying attention to participation in life and personal satisfaction is important.

There is a guy who runs this site and sometimes contributes here who has a number of resources and suggestions on physiotherapy for various types of dystonia and it is definitely worth checking out his website. This has many suggestions and tips for dystonia generally and specific to focal dystonias. I think he also offers free consultation. Fernando takes a very holistic approach:

http://www.distoweb.com/

It has to be said however that there is virtually no evidence to date for physiotherapy for dystonia - no clinical trials. So it is hard to advocate for a particular approach. It is an area that desperately needs some good clinical research.