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New research · Physical Medicine & Rehabilitation
Toxins · 1w
StudyToxins · 2026

The Benefits of Advanced Botulinum Neurotoxin Injection Training from a Spasticity Management Fellowship.

John McGuire, Karin Goodfriend, Sarah Golus … Nicholas Ketchum
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Physical Medicine & RehabilitationStudy

Fellowship-trained physicians devote far more of their practice to botulinum neurotoxin injections

The Benefits of Advanced Botulinum Neurotoxin Injection Training from a Spasticity Management Fellowship.

John McGuire … Nicholas Ketchum
Toxins · 2026
Purpose

Residency programs in the United States lack the necessary training for physicians to confidently and competently inject botulinum neurotoxin (botulinum neurotoxin) and manage complex spasticity patients.

Methods

Graduates from our Physical Medicine and Rehabilitation residency from 2008 to 2024 were surveyed.

n = 15 RT and 14 FT physicians
Results

of fellowship-trained doctors' practice involves botulinum toxin injections, far more than residency-trained pee

RT BoNT practice
5%
FT BoNT practice
52%
More results

Spasticity and dystonia treatments comprised an average of 10% of the RT and 62% of the FT clinical practice.

“
Conclusion · 1 of 2

Disabling spasticity is undertreated in this country, partly due to a shortage of training programs for physicians to become skilled and confident at injecting botulinum neurotoxin and comprehensive spasticity management.

Conclusion · 2 of 2

FT programs can help meet this unmet need by increasing the number of physicians who can provide specialized botulinum neurotoxin injections and spasticity management.

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