Botulinum toxin injections


Botulinum toxin injections

Botulinum toxin type A (Botox, Dysport) blocks the release of a neurotransmitter known as acetylcholine from nerve cells. Acetylcholine normally transmits nerve impulses to muscle cells, causing them to contract. Without acetylcholine, the affected nerve is unable to send a signal to the muscle it supplies, resulting in a weakened or paralysed muscle. The effect of Botox injections is restricted to the area being treated.

This module has been specifically designed to enable appropriate health professionals to undertake injection therapy using botulinum toxin for the management of patients/clients with limb spasticity or dystonia regardless of the form of botulinum toxin used in their trust. Learners will be supported in developing their skills and techniques in clinical reasoning, injection administration and after care to provide a comprehensive management approach.

The module aims to introduce students to the theory and practice of injection therapy as well as to develop their ability to clinically reason and integrate the use of injection therapy as part of their management of patients/clients with neurological dysfunction. The module consists of two main components. The first component will introduce students to the theory and practice associated with the use of injection therapy and the second component will be a period of mentored practice in the clinical environment.

Learning outcomes:

  1. Discuss critically the clinical significance and rationale behind Botulinum Toxin injection therapy and the mechanisms of the drug actions, and the possible interaction of the Botulinum Toxin with other body systems to prescribe safely, appropriately and cost effectively according to guidelines for injection. Apply effective and comprehensive examination and assessment of patients across the life span, and evaluate their suitability for Botulinum Toxin and maintain an appropriate and comprehensive recording system.
  2. Critically evaluate and clinically reason the suitability of patients with neurological dysfunction for Botulinum Toxin injection Therapy.
  3. Apply and critically appraise the evidence underpinning the Botulinum Toxin injection therapy and the clinical significance of potentially serious Botulinum Toxin interactions, taking account of the evidence-based practice and national/local guidelines.
  4. Critically analyse the contribution of different rehabilitation strategies post Botulinum Toxin injection and ensure critical monitoring of responses to Botulinum Toxin for different conditions, and apply knowledge of Botulinum Toxin actions and interactions in order to modify treatment or refer the patient, as appropriate.
  5. Evaluate and challenge practice within a framework of professional, legal accountability and ethical issues underpinning injection therapy for Botulinum Toxin within the health professions.

Who is the module for? Suitable for physiotherapists and other relevant healthcare professionals.

Module code: ER718X


  • Ability to carry out basic arithmetic which will allow accurate calculation of medication dosages
  • Evidence of a sound understanding of human anatomy and muscle physiology
  • Registration with the appropriate professional body
  • At least two years of experience in neurosciences
  • To hold a current position that will allow completion of supervised injections in a clinical setting
  • Evidence of physical assessment and history taking skills
  • Evidence of ability to study at minimum academic level 7
  • In addition, written confirmation will be needed from:
    • The employer/Trust showing their support for the participant to undertake the module.
    • Designated medical practitioners (DMP) who meets eligibility criteria for medical supervision and who has agreed to provide the required term of supervised practice.

Entry criteria:
Applicants should normally have, or be expected to achieve, a first degree in a relevant professional area (or an equivalent overseas qualification). Recent Level 6 or 7 study will also be considered.

Non-standard applicants

  • Qualified Health and Social Care practitioners (without first degrees) that can demonstrate evidence of either a contribution to the development of practice, or appropriate other study, are also encouraged to apply. Alternative qualifications may be considered and applicants holding these qualifications are encouraged to submit an application form. Candidates may be required to submit supplementary details (e.g. transcripts) and asked to complete a short qualifying essay.
  • If you are an international student, you will also need an English Language Qualification i.e. IELTS 6.5 (no less than 6.0 in each section) or other equivalent recognised language qualification.

Number of credits and level of study: 15 credits at level 7

Assessment:Objective structured clinical examination (OSCE) and portfolio

Location: St George’s, University of London

Pattern of Delivery: 5 days

Module dates:

  • 26, 27, 28 February, 20, 21 March 2018 + OSCE on 5 September 2018

Fee: £950 (including injection consumables)

Programme: This module is part of Applied Exercise for Health PgCert/PgDip/MSc and Rehabilitation PgDip/MSc