Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/324
Title: The use of botulinum toxin type A in the management of adult-onset focal spasticity: A survey of Australian allied health professionals.
Epworth Authors: Williams, Gavin
Olver, John
de Graaff, Stephen
Other Authors: Singer, Barbara
Keywords: Epworth Monash Rehabilitation Medicine Unit, Richmond, Victoria, Australia
Botulinum Toxins
Muscle Hypertonia
Muscle Spasticity
Physical Therapy Modalities
Rehabilitation
Recovery of Function
Physiotherapists
Occupational Therapy
Data Collection
Surveys
Outcome Assessment (Health Care)
Patient Outcome Assessment
Assessment, Patient Outcomes
Outcomes Assessments, Patient
Allied Health Personnel
Neurotoxins
Issue Date: Aug-2012
Publisher: Wiley
Citation: Australian Occupational Therapy Journal 2012 Aug;59(4):257-64
Abstract: BACKGROUND: Recently, the European Journal of Neurology published international consensus statements for the assessment, treatment and aftercare associated with the use of botulinum neurotoxin type A. This survey examined current allied health practice in relation to botulinum neurotoxin type A use in Australia in the light of these guidelines. METHODS: An electronic questionnaire was distributed to members of neurology groups of the Australian Physiotherapy Association and Occupational Therapy Australia. The questionnaire explored assessment processes used, familiarity with pharmaceutical benefits scheme indications for botulinum neurotoxin type A use, goal setting and outcome measurement, follow-up therapy and access to spasticity management services. RESULTS: The 123 survey respondents (81 from the Australian Physiotherapy Association - response rate 16.2%, 42 from Occupational Therapy Australia - response rate 6.4%) reported that focal spasticity was a major problem for which botulinum neurotoxin type A was a primary intervention. The Tardieu scale was more frequently used than the modified Ashworth scale (82% vs. 48%). Most therapists (76.3%) reported being confident diagnosing spasticity and its functional implications (84.2%), but fewer were confident discussing referral for botulinum neurotoxin type A with doctors (56.1%). Goals were set in conjunction with the client (93.6%). Barriers to injection and adjunctive therapy (motor training etc.) included waiting times for botulinum neurotoxin type A injection, access to specialist adjunctive therapists and referral for treatment. CONCLUSIONS: Allied health practitioners in Australia report clinical practice to be closely aligned with international guidelines for the use of botulinum neurotoxin type A in adult spasticity. Therapist confidence in advocating for botulinum neurotoxin type A injection, consistent use of objective measures of spasticity and treatment outcomes and barriers to providing adjunctive therapy need to be addressed.
URI: http://hdl.handle.net/11434/324
DOI: 10.1111/j.1440-1630.2012.01027.x
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/22934898
ISSN: 1440-1630
Journal Title: Australian Occupational Therapy Journal
Type: Journal Article
Affiliated Organisations: The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Western Australia, Australia
Type of Clinical Study or Trial: Survey
Appears in Collections:Neurosciences
Rehabilitation

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