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Abstract
Ultrasound guided (US) botulinum toxin A (BT-A) intramuscular injection is an established treatment for the iliopsoas muscle (IM) spasticity, but it is not always possible to use it. The EMG-techniques of IM examination have already been described (Katsavrias et. al, 2005) but not for the intramuscular injection of BT-A. To describe a technique with EMG guidance for the intramuscular injection of BT-A to treat spasticity of the IM and evaluate the efficacy of this technique. The EMG-guided technique for BT-A injection was used on 9 patients (aged 7–59 years) with unilateral or bilateral spasticity of the IM. BT-A dose range from 30 U to 50 U for IncobotulinumtoxinA and OnabotulinumtoxinA, 120 U for AbobotulinumtoxinA. Outcome measures included Modified Ashworth Scale (MAS) for muscle tone and Range of Motion (ROM), assessed before the treatment and after 3, 6 and 12 months. After one year from the first EMG-guided injection of BT-A, MAS score decreased from 3.8 to 1.8 and ROM score increased from −53.1 to −20.8 (p < 0.0001 for all; ANOVA). This EMG-guided technique allows accurate guidance for the injection of BT-A of the IM and it can be considered a viable alternative to the US-guided technique.
Published Version
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