Botulinum neurotoxin-A (BoNT-A) is commonly used as first line treatment for Cervical Dystonia (CD) and Spastic Paresis (SP). The Ixcellence Network® (IN) international survey aims to describe the current situation of training and practices among physicians performing BoNT-A injections.

A self-completion questionnaire, written by a multidisciplinary steering committee, was completed by experts managing patients with SP and CD, selected from the IN faculty, regarding their experience, training and confidence in different BoNT-A injection techniques and rehabilitation methods. Here we present a partial analysis of the 17 first respondents’ answers. Additional results from a database of more than 700 practitioners (IN attendees) will be available for the congress.

Seventeen physicians specialized in physical medicine and rehabilitation (9/17), neurology (7/17) and neuropediatrics (1/17) completed the questionnaire. They reported a mean experience of 22 years in their field (from 14 to 30 years) and 18 years in BoNT-A injection (from 5 to 25 years).

All received training prior to first injection, complete with dedicated sessions on guidance techniques: 15 on ultrasound, 11 on anatomical landmarks, 6 on electrostimulation (ES) and 7 on electromyography (EMG). In their current practice, BoNT-A injection was mostly performed without guidance or using ultrasound (16/17 respondents vs 11/17 for ES or EMG).

Fifteen physicians also attended specific training on rehabilitation methods for SP (11), CD (1) or both (3).

Overall, physicians who followed specific training in injection techniques or in rehabilitation reported greater self-confidence in using them.

Training on injection technique and rehabilitation for SP and CD management is variable. Nevertheless, attending specific courses was associated with greater self-confidence. Moreover, physicians mainly used the techniques and methods for which they were trained. These first results highlight the relevance of training in this field.