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. 2014 Mar 5;28(4):253–258.

Table I.

Survey questionnaire

Item Question Answer
Experience
1 Do you currently use BoNT-A in your clinical practice? Yes / No
2 Is there a specific service for treating patients with BoNT-A in your unit? Yes / No
3 How long is your clinical experience with BoNT-A? <2 years / 2–5 years / 5–10 years />10 years
4 What clinical conditions do you treat with BoNT-A? spasticity / dystonia / cerebral palsy / other
5 How many patients/year do you treat with BoNT-A? patients/year for each of the above-mentioned conditions
6 Do you use BoNT-A to treat muscle overactivity associated with painful conditions? Yes / No
Clinical practice
1 How do you evaluate patients in order to plan a treatment strategy based on the injection of BoNT-A? clinical evaluation / validated scales / instrumental evaluation
2 How do you evaluate patients after BoNT-A injection? clinical evaluation / validated scales / instrumental evaluation
3 How frequently do you re-inject patients with BoNT-A? injections / year
4 Do you inject BoNT-A according to the recommended dilutions? Yes / No
5 Do you consider the recommended BoNT-A doses adequate? Yes / No
6 Do you initiate BoNT-A therapy at low doses, titrating them upwards as effects become evident? Yes / No
7 Do you alter BoNT-A dosages during the course of BoNT-A treatments? Yes / No
8 Which technique do you use for injecting BoNT-A in the above-mentioned clinical conditions? palpation / electrical stimulation / electromyography / ultrasonography
9 Do you prescribe (when appropriate) rehabilitation procedures after BoNT-A injection? Yes / No
10 Have you ever reported at least one adverse reaction to BoNT-A in your clinical practice? If so, why did it occur? Yes / No
Education
1 How many courses on the use of BoNT-A have you attended in the past year? number
2 How many courses on the use of BoNT-A have you attended in the past five years? number
3 What kind of courses on BoNT-A would you like to attend in the future? description

BoNT-A=botulinum toxin type A