At Spot

Welcome to Post Botulinum Toxin Injections or post SDR Therapy Management

Physiotherapy review :

Physiotherapy is a vital part of treatment post botulinum toxin and post SDR

It is essential that adequate therapeutic intervention is available before proceeding with injections or SDR

It is recommended that at a minimum weekly therapy intervention is provided post injections or SDR for a block of 4-6 weeks or throughout life span depending on the client needs.

Consider an orthosis to enhance maintenance of muscle length and enable practice of functional skills – timely access to an orthotic is critical after injections

Each child should be monitored by a physiotherapist to assess the impact of the injections or post SDR and guide further intervention as appropriate.

Home exercise programme should be adjusted according to the effect and goals of the injections or post SDR

Casting :

Baseline outcome measures (ROM, spasticity assessment (tardieu), video etc.) should be completed at 2 months post injection or post SDR

Below knee serial cast can be made based on the level of tightness or contracture and as required .

If necessary a removable cast or turtle brace can be suggested to be used until new AFO is supplied.

For children with midfoot deformity or tightness, e.g. varus foot or adducted forefoot with tight plantarfascia, a night splint can be recommended to stretch out of this position. Turtle brace is been successful as a night time splint and day time splint and clients can buy from the clinic as required.