{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:38:23Z","timestamp":1747186703219,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe current rehabilitation paediatricians' use of intramuscular botulinum toxin\u2010A (BoNT\u2010A) to manage hypertonicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In late 2019, 32 of the 35 identified Australian rehabilitation paediatricians who use BoNT\u2010A to manage paediatric hypertonicity completed the survey. Annually, they administer just over 3750 courses of BoNT\u2010A to manage hypertonicity with a mean of 11\u2009years of clinical experience. Sedation was used by all but 1 clinician who used a number of other strategies during the procedure. Mean (and median) maximum dose of OnabotulinumtoxinA (Botox) was 400 Units (range 300\u2013450 Units). Only three clinicians indicated that they used AbobotulinumtoxinA (Dysport) \u2013 the other BoNT\u2010A preparation approved for children available in Australia; analysis of its use was not performed. Dose modifications were made by clinicians according to a patient's response to a previous course of BoNT\u2010A (88% of respondents); patient experience of a previous adverse event (78%); history of aspiration or dysphagia (65 and 63%, respectively); and the presence of dystonia; and where the patient was GMFCS level V (53% each). Intervals between courses ranged from 3 to 24\u2009months with the variation due to clinical circumstances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinical practice in BoNT\u2010A management of paediatric hypertonicity was largely consistent in regard to maximum doses of OnabotulinumtoxinA (Botox) used. Dose modification and time between injection courses varied according to individual clinical presentation. Procedural sedation was used extensively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15589","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T08:33:27Z","timestamp":1622018007000},"page":"1662-1665","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Current Australian clinical practice in use of botulinum toxin\u2010A to manage paediatric hypertonicity"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4748-8181","authenticated-orcid":false,"given":"Stephen J","family":"O'Flaherty","sequence":"first","affiliation":[{"name":"Rehab2Kids Sydney Children's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8124-3631","authenticated-orcid":false,"given":"Kirsty","family":"Stewart","sequence":"additional","affiliation":[{"name":"KidsRehab The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199307000-00013"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1994.tb11864.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12246"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-020-1022-z"},{"key":"e_1_2_7_6_1","unstructured":"MIMS Australia. Product Information on Botox\u00ae Powder. In MIMS Online; 2019. Available from:https:\/\/www.mimsonline.com.au.acs.hcn.com.au\/Search\/FullPI.aspx?ModuleName=Product%20Info&searchKeyword=Botox&PreviousPage=~\/Search\/QuickSearch.aspx&SearchType=&ID=29600001_2"},{"key":"e_1_2_7_7_1","unstructured":"MIMS Australia. Product Information on Dysport\u00ae Powder. In MIMS Online; 2019.Available from:https:\/\/www.mimsonline.com.au.acs.hcn.com.au\/Search\/FullPI.aspx?ModuleName=Product%20Info&searchKeyword=Dysport+Powder+for+injection&PreviousPage=~\/Search\/QuickSearch.aspx&SearchType=&ID=58040001_2"},{"volume-title":"NeuroKids Child Neurology Workbook: Diagnosis and Therapy. Mind Maps","year":"2017","author":"Verlag K","key":"e_1_2_7_8_1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2018.06.004"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2010.03814.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0749"},{"key":"e_1_2_7_12_1","article-title":"Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy","author":"Blumetti FC","year":"2019","journal-title":"Cochrane Database Syst. 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Available from:https:\/\/www.aacpdm.org\/publications\/care-pathways\/dystonia[accessed October 2019]."}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.15589","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.15589","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.15589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:25:43Z","timestamp":1692638743000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.15589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,26]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/jpc.15589"],"URL":"https:\/\/doi.org\/10.1111\/jpc.15589","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"type":"print","value":"1034-4810"},{"type":"electronic","value":"1440-1754"}],"subject":[],"published":{"date-parts":[[2021,5,26]]},"assertion":[{"value":"2020-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}