Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework
Objective: To establish a scope of practice, competency (through education) and governance framework for ultrasound image guided injection of botulinum toxin in the management of spasticity Design: Delphi study Setting: International, web-based survey Participants: A purposively selected multidiscip...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Archives of Rehabilitation Research and Clinical Translation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109523000617 |
| _version_ | 1827591567364325376 |
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| author | Stephen A. Ashford, PhD Gary Morris, MSc Michael J. Smith, PhD |
| author_facet | Stephen A. Ashford, PhD Gary Morris, MSc Michael J. Smith, PhD |
| author_sort | Stephen A. Ashford, PhD |
| collection | DOAJ |
| description | Objective: To establish a scope of practice, competency (through education) and governance framework for ultrasound image guided injection of botulinum toxin in the management of spasticity Design: Delphi study Setting: International, web-based survey Participants: A purposively selected multidisciplinary (physicians, physiotherapists, occupational therapists) panel of experts (n=15) in the use of ultrasound image guided injection of botulinum toxin for management of spasticity. Panel members were predominantly based in the UK (11/15). Interventions: In round 1, open-ended questions were posed relating to potential scope of practice for ‘ultrasound imaging in spasticity management’; (specifically relating to ultrasound image guided injection of Botulinum Toxin) education/competency and governance considerations. In round 2, respondents were asked to rate their level of agreement with the statements generated. Outcome measures: 5-point Likert scale used for rating the statements. Threshold for consensus agreement was set at 70% or above. Results: Three different scopes of practice relating to ultrasound imaging in spasticity management were accepted. The primary scope of practice was the use of ultrasound imaging to guide safe and accurate delivery of botulinum toxin. Relating to this primary scope, 7 competency requirements were agreed relating to areas including image optimization and interpretation, needle visualization and safety. A singular, broad governance statement was generated. Conclusion: Relating specifically to guided injection of botulinum toxin for management of spasticity, we present a scope of practice, competency, and governance framework. These are integrated within a framework approach to provide a mechanism for increased patient access to accurate, safe, and effective focal spasticity treatment. The framework supports focused training routes, greater inter-profession communication and wider clinical community engagement in spasticity management using this modality. |
| first_indexed | 2024-03-09T01:34:34Z |
| format | Article |
| id | doaj.art-ca3d5eda0031413a8c90a93e134e981b |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-03-09T01:34:34Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-ca3d5eda0031413a8c90a93e134e981b2023-12-09T06:07:40ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952023-12-0154100299Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance frameworkStephen A. Ashford, PhD0Gary Morris, MSc1Michael J. Smith, PhD2Regional Hyper-acute Rehabilitation Unit, London North West University healthcare NHS Trust & Department of Palliative Care, King's College London, London, EnglandSchool of Healthcare Sciences, Cardiff University, Cardiff, Wales; Hywel Dda University Health Board, Carmarthen, Wales; Corresponding author Gary Morris, School of Healthcare Sciences, Ty Dewi Sant, Heath Park Campus, Cardiff University, CF14 4XN. Tel: +44(0)2920874000 Email: MorrisGR2@Cardiff.ac.ukSchool of Healthcare Sciences, Cardiff University, Cardiff, WalesObjective: To establish a scope of practice, competency (through education) and governance framework for ultrasound image guided injection of botulinum toxin in the management of spasticity Design: Delphi study Setting: International, web-based survey Participants: A purposively selected multidisciplinary (physicians, physiotherapists, occupational therapists) panel of experts (n=15) in the use of ultrasound image guided injection of botulinum toxin for management of spasticity. Panel members were predominantly based in the UK (11/15). Interventions: In round 1, open-ended questions were posed relating to potential scope of practice for ‘ultrasound imaging in spasticity management’; (specifically relating to ultrasound image guided injection of Botulinum Toxin) education/competency and governance considerations. In round 2, respondents were asked to rate their level of agreement with the statements generated. Outcome measures: 5-point Likert scale used for rating the statements. Threshold for consensus agreement was set at 70% or above. Results: Three different scopes of practice relating to ultrasound imaging in spasticity management were accepted. The primary scope of practice was the use of ultrasound imaging to guide safe and accurate delivery of botulinum toxin. Relating to this primary scope, 7 competency requirements were agreed relating to areas including image optimization and interpretation, needle visualization and safety. A singular, broad governance statement was generated. Conclusion: Relating specifically to guided injection of botulinum toxin for management of spasticity, we present a scope of practice, competency, and governance framework. These are integrated within a framework approach to provide a mechanism for increased patient access to accurate, safe, and effective focal spasticity treatment. The framework supports focused training routes, greater inter-profession communication and wider clinical community engagement in spasticity management using this modality.http://www.sciencedirect.com/science/article/pii/S2590109523000617Botulinum NeurotoxinsDelphi method Muscle spasticityRehabilitationUltrasound Interventional |
| spellingShingle | Stephen A. Ashford, PhD Gary Morris, MSc Michael J. Smith, PhD Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework Archives of Rehabilitation Research and Clinical Translation Botulinum Neurotoxins Delphi method Muscle spasticity Rehabilitation Ultrasound Interventional |
| title | Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework |
| title_full | Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework |
| title_fullStr | Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework |
| title_full_unstemmed | Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework |
| title_short | Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework |
| title_sort | ultrasound image guided injection of botulinum toxin for the management of spasticity a delphi study to develop recommendations for a scope of practice competency and governance framework |
| topic | Botulinum Neurotoxins Delphi method Muscle spasticity Rehabilitation Ultrasound Interventional |
| url | http://www.sciencedirect.com/science/article/pii/S2590109523000617 |
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