Abstract

INTRODUCTION

Botulinum toxin type-A is frequently injected for focal treatment of spasticity which it is appear in post-stroke, traumatic brain, spinal cord injury, multiple sclerosis and cerebral palsy at the rehabilitation clinics. Manual injection without guidence, electromyography-electrical stimulation guided and ultrasonography guided interventions are commonly used in botulinum toxin injections. In this study, we aimed to learn preferences and reasons of the residents for botulinum toxin injection tecniques.

METHODS

Twelve physical medicine and rehabilitation residents who have applied at least five times each of these techniques under the supervision completed survey questionnaire.

RESULTS

The application techniques are preferred for their following features; reliability, effectiveness, size and location of the muscle to be applied. The most common preferred technique in upper extremity application is ultrasonography. Reliability was in the forefront of the first preference of ultrasonography. However, in lower extremity injections, the residents first choice was manual injection, and ultrasonography was the second. In pediatric patients, the first choice was ultrasonography. The choice of the applied intervention technique was also differing depending on the muscle location and size. Residents preferred manual injection for gastrocnemius-soleus and biceps; ultrasonography for tibialis posterior, forearm and hand muscles.

DISCUSSION AND CONCLUSION

The residents preferences were affected with the muscle size and location, the time required for, the reliability of the methods. Accordingly, they preferred ultrasonography for forearm and hand muscles, and difficultly localized leg muscles. For easily localized leg muscles, they preferred manual injection technique because they found it a practical and quick method.