{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:05Z","timestamp":1760145725526,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merz Therapeutics GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Our objective was to provide expert consensus on best practices for anatomy teaching and training on ultrasound-guided botulinum neurotoxin type A (BoNT-A) injection for specialists involved in treating spasticity and dystonia. Nine experts (three neurologists; six physical medicine and rehabilitation physicians) participated in a three-round modified Delphi process. Over three rounds, experts reached consensus on 15 of 16 statements describing best practices for anatomy and BoNT-A injection training. They unanimously agreed that knowledge of the target audience, including their needs and current competency, is crucial when designing training programs. Experts also agreed that alignment between instructors is essential to ensure consistency of approach over time and between regions, and that training programs should be simple, adaptable, and \u201chands-on\u201d to enhance engagement and learning. Consensus was also reached for several other key areas of training program development. The best-practice principles identified by expert consensus could aid in the development of effective, standardized programs for anatomy teaching and BoNT-A injection training for the purposes of treating spasticity and dystonia. This will enhance the exchange of knowledge, skills, and educational approaches between global experts, allowing more specialists to treat important movement disorders and ultimately improving patient outcomes.<\/jats:p>","DOI":"10.3390\/toxins16080371","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T06:28:51Z","timestamp":1724308131000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Delphi Analysis: Optimizing Anatomy Teaching and Ultrasound Training for Botulinum Neurotoxin Type A Injection in Spasticity and Dystonia"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-9303","authenticated-orcid":false,"given":"Kimberly","family":"Heckert","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7682-1353","authenticated-orcid":false,"given":"Bo","family":"Biering-S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rigshospitalet, Glostrup, DK-2600 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-1782","authenticated-orcid":false,"given":"Tobias","family":"B\u00e4umer","sequence":"additional","affiliation":[{"name":"Institute of System Motor Science, Center of Brain, Behavior and Metabolism, University of L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Khan","sequence":"additional","affiliation":[{"name":"Hotel Dieu Shaver Health and Rehabilitation Centre, St. Catharines, ON L2T 4C2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Pagan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Georgetown University, Washington, DC 20007, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell","family":"Paulin","sequence":"additional","affiliation":[{"name":"Rehabilitation Associates of the Main Line, Main Line Health, Paoli, PA 19301, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4010-2402","authenticated-orcid":false,"given":"Todd","family":"Stitik","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07103, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0964-5908","authenticated-orcid":false,"given":"Monica","family":"Verduzco-Gutierrez","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, UT Health San Antonio, San Antonio, TX 78229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Reebye","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alter, K.E., and Karp, B.I. 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