{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:42:50Z","timestamp":1777880570670,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2009,4,1]],"date-time":"2009-04-01T00:00:00Z","timestamp":1238544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:p>A 56-year-old man became quadriplegic, bed bound, and carer-dependent secondary to cervical osteomyelitis. Three years later, he presented with generalised spasticity, crouched posture, and a large sacral pressure sore. The severe spasticity in his hips and knees prevented ischial sitting. Injections of botulinum toxin type A to both hamstrings and gastrosoleuii controlled the flexor spasticity of his lower limbs and facilitated rehabilitation and wound healing through proper positioning, wound care, stretching, and weight-bearing exercises. A few weeks later, the patient could better position himself in bed (prone lying) and on his wheelchair (ischial sitting). His spasm-related pain lessened and his mobility and activities of daily living improved. The sacral pressure sore healed completely a few months later. The patient could sleep better, feed with set-up and adaptive aids, groom, dress, and transfer himself with minimal assistance. The effects of botulinum toxin extended beyond just spasticity reduction. His upper extremity function, mobility, and social well-being were all improved through better positioning.<\/jats:p>","DOI":"10.1177\/230949900901700121","type":"journal-article","created":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T17:14:58Z","timestamp":1475601298000},"page":"96-99","source":"Crossref","is-referenced-by-count":8,"title":["Botulinum Toxin Type a for Rehabilitation after a Spinal Cord Injury: A Case Report"],"prefix":"10.1177","volume":"17","author":[{"given":"AS","family":"Naicker","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, HUKM, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SA","family":"Roohi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Musculoskeletal Medicine, Faculty of Medicine and Health Sciences, UPM, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JLL","family":"Chan","sequence":"additional","affiliation":[{"name":"Physiotherapy Unit, HSC Medical Centre, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,4,1]]},"reference":[{"key":"bibr1-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-9651(03)00097-4"},{"key":"bibr2-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.1.26"},{"key":"bibr3-230949900901700121","first-page":"566","volume":"71","author":"Maynard FM","year":"1990","journal-title":"Arch Phys Med Rehabil"},{"key":"bibr4-230949900901700121","unstructured":"Brodal P. The central nervous system: Structure and function. New York: Oxford University Press; 1998:367."},{"key":"bibr5-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101757"},{"key":"bibr6-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-198902000-00009"},{"key":"bibr7-230949900901700121","first-page":"605","volume":"60","author":"Nepomuceno C","year":"1979","journal-title":"Arch Phys Med Rehabil"},{"key":"bibr8-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112151-00024"},{"key":"bibr9-230949900901700121","unstructured":"Siddall PJ, Yeziereski RP, Looser JD. Pain following spinal cord injury: Clinical features, prevalence and taxonomy. IASP Newsletter 2000:3\u20137."},{"key":"bibr10-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-999-0069-y"},{"key":"bibr11-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.62.2.198"},{"key":"bibr12-230949900901700121","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20011"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/230949900901700121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/230949900901700121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:15:24Z","timestamp":1777594524000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/230949900901700121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,4]]}},"alternative-id":["10.1177\/230949900901700121"],"URL":"https:\/\/doi.org\/10.1177\/230949900901700121","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4]]}}}