{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T17:59:29Z","timestamp":1759514369952},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"unspecified","delay-in-days":884,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec id=\"S0317167100014049_abs1\"><jats:title>Background:<\/jats:title><jats:p>This study aims to assess current practices of Canadian physicians providing botulinum toxin-A (BoNT-A) treatments for children with hypertonia and to contrast these with international \u201cbest practice\u201d recommendations, in order to identify practice variability and opportunities for knowledge translation.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100014049_abs2\"><jats:title>Methods:<\/jats:title><jats:p>Thirteen Canadian physicians assembled to develop and analyze results of a cross-sectional electronic survey, sent to 50 physicians across Canada.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100014049_abs3\"><jats:title>Results:<\/jats:title><jats:p>Seventy-eight percent (39\/50) of physicians completed the survey. The most frequently identified assessment tools were Gross Motor Function Classification System, Modified Tardieu Scale and neurological examination. Goal-setting tools were infrequently utilized. Common indications for BoNT-A injections and the muscles injected were identified. Significant variability was identified in using BoNT-A for hip displacement associated with hypertonia. The most frequent adverse event reported was localized weakness; 54% reporting this \u201coccasionally\u201c and 15% \u201cfrequently\u201d. Generalized weakness, fatigue, ptosis, diplopia, dysphagia, aspiration, respiratory distress, dysphonia and urinary incontinence were reported rarely or never. For dosage, 52% identified 16 Units\/kg body weight of Botox\u00ae as maximum. A majority (64%) reported a maximum 400 Units for injection at one time. For localization, electrical stimulation and ultrasound were used infrequently (38% and 19% respectively). Distraction was the most frequently used pain-management technique (64%).<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100014049_abs4\"><jats:title>Conclusions:<\/jats:title><jats:p>Canadian physicians generally adhere to international best practices when using BoNT-A to treat paediatric hypertonia. Two knowledge-translation opportunities were identified: use of individualized goal setting prior to BoNT-A and enhancing localization techniques. Physicians reported a good safety profile of BoNT-A in children.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0317167100014049","type":"journal-article","created":{"date-parts":[[2014,12,12]],"date-time":"2014-12-12T15:03:41Z","timestamp":1418396621000},"page":"508-515","source":"Crossref","is-referenced-by-count":9,"title":["Botulinum Toxin-A use in Paediatric Hypertonia: Canadian Practice Patterns"],"prefix":"10.1017","volume":"39","author":[{"given":"D.","family":"Fehlings","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Beauchamp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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Ottawa: Information Update; Health Canada reviewing issue of distant toxin spread potentially associated with Botox and Botox Cosmetic; [about 3 screens]. [updated 2008 Feb 20; cited 2011 Aug 8]. Available from: http:\/\/www.hc-sc.gc.ca\/ahc-asc\/media\/advisoriesavis\/_2008\/2008_32-eng.php"},{"key":"S0317167100014049_ref011","doi-asserted-by":"publisher","DOI":"10.1177\/0269215508099860"},{"key":"S0317167100014049_ref014","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2010.03814.x"},{"key":"S0317167100014049_ref022","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.10.025"},{"key":"S0317167100014049_ref020","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2010.01424.x"},{"key":"S0317167100014049_ref016","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22661"},{"key":"S0317167100014049_ref013","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31817c115b"},{"key":"S0317167100014049_ref004","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03127.x"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167100014049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,24]],"date-time":"2022-04-24T09:55:01Z","timestamp":1650794101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167100014049\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,7]]}},"alternative-id":["S0317167100014049"],"URL":"https:\/\/doi.org\/10.1017\/s0317167100014049","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7]]}}}