Influence of Rehabilitation Medicine Residency Training
in Performing Chemodenervation in Children with
Cerebral Palsy in Thailand
Montana Buntragulpoontawee MD*,
Timothy E O’Brien PhD**, Apichana Kovindha MD*
Affiliation :
* Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
** Department of Mathematics and Statistics, Loyola University of Chicago, Illinois, USA
Background : Chemodenervation (CD) involves injecting drugs such as phenol, botulinum toxin, or alcohol to reduce muscle
spasticity. However, they interfere with daily activities of children with cerebral palsy (CP). Rehabilitation residency training
in Thailand currently requires performing a minimum of five CD procedures. However, the effect of this policy on post-training
practice is unknown.
Objective : To explore the influence of CD training during residency on post-training clinical practice and their current use
of it in treating CP patients.
Material and Method: The questionnaires were sent to 431 Thai physiatrists nationwide by both electronic and postal mails.
The responses were collected within a three-month period.
Results : Of 116 (27%) respondents with usable questionnaires, 85 (73%) were trained during their residency to perform
CD and 46 (40%) performed it in their practice. Those trained to perform CD were more likely in their subsequent practice
to do so (p = 0.0140), and younger age was associated with performing it (p = 0.0055). The number of CD procedures
performed during residency correlated directly with reported confidence in performing the procedure in later practice
(p<0.0001). The most common reasons for not performing CD were few CP cases in their care, and unavailable equipment
or injection agent.
Conclusion : Although only a cross-sectional study, the findings suggest that increasing the number of CD procedures
required in rehabilitation residency may increase the use of CD to benefit CP patients in future clinical practice.
Keywords : Rehabilitation medicine, Residency training, Chemodenervation, Cerebral palsy
All Articles
Download