{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:16:06Z","timestamp":1760235366864,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T00:00:00Z","timestamp":1629590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013116","name":"Merz Pharmaceuticals","doi-asserted-by":"publisher","award":["not applicable, unrestricted educational grant"],"award-info":[{"award-number":["not applicable, unrestricted educational grant"]}],"id":[{"id":"10.13039\/501100013116","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>The COVID-19 pandemic severely impacted the function of medical facilities and rehabilitation services worldwide, including toxin services delivering Botulinum toxin treatments for neuromuscular conditions such as spasticity, dystonia, and sialorrhea. The aim of this paper is to understand how toxin services have dealt with the situation and what strategies have been adopted to continue services. The recommendations are based on a virtual round table held with toxin services experts from different European countries who shared their experiences and discussed the best practices. The challenges for toxin services were reviewed based on the experts\u2019 experiences and on relevant literature from 2020 and 2021. A set of recommendations and best practices were compiled, focusing firstly on guidance for clinical practice, including assessing patients\u2019 health and risk status and the urgency of their treatment. Secondly, it was discussed how patients on botulinum toxin therapy can be cared for and supported during the pandemic, and how modern technology and tele-medicine platforms can be generally used to optimize effectiveness and safety of toxin treatments. The technological advances prompted by the COVID-19 crisis can result in better and more modern patient care in the future.<\/jats:p>","DOI":"10.3390\/toxins13080584","type":"journal-article","created":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T23:00:09Z","timestamp":1629673209000},"page":"584","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Botulinum Toxin Services for Neurorehabiliation: Recommendations for Challenges and Opportunities during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"13","author":[{"given":"Ganesh","family":"Bavikatte","sequence":"first","affiliation":[{"name":"The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Jacinto","sequence":"additional","affiliation":[{"name":"Alcoit\u00e3o Rehabilitation Medicine Centre, 2645-019 Alcabideche, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Deltombe","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine & Rehabilitation, CHU UCL Namur Site Godinne, 5530 Yvoir, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joerg","family":"Wissel","sequence":"additional","affiliation":[{"name":"Department of Neurorehabilitation and Physical Therapy, Vivantes Hospital Spandau, 13585 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,22]]},"reference":[{"key":"ref_1","unstructured":"Phillips, M., Turner-Stokes, L., Wade, D., and Walton, K. 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