Physiotherapy lecturer is first to provide ‘Gold standard’ ultrasound guided Botox treatments for patients at home

Gary Morris, a Physiotherapy Lecturer at Cardiff University and an Advanced Practitioner at Hywel Dda UHB, is first to provide ultrasound guided Botox injections in patient’s homes. The practice of doing Botox injection using Ultrasound guidance is considered the gold standard as it is more accurate, provides better results and minimises risk of bleeding.

Patients, predominantly adults, with conditions such as stroke, multiple sclerosis, spinal injury, and traumatic brain injury can require Botox injections to help with tight muscles. During the pandemic patients were unable to visit hospital outpatient clinics, so instead Gary and the team at Hywel Dda UHB used new technology and methods to deliver the same treatment but in the comfort patient’s homes.

Gary said: “The pandemic meant we had to re-evaluate how we were going to support our patients…The use of this low-cost portable technology means we can now effectively take the hospital to patients. This innovation has been particularly important for people who have higher levels of disability where travel can be very difficult.”

Using Hywel Dda Health Charities, the organisation purchased a new piece of technology, the handheld ultrasound from Orca Medical which connects to a tablet was purchased for the service with the help of charities. This novel technology now allows us to routinely provide ultrasound guided injections to people both in the hospital and out in the community in people's homes.
Hywel Dda University Health Board are the only health board in Wales and one of only a very small number in the UK who routinely provide ultrasound guided injections in people's homes. This now means the majority of work done in this health board can be completed in the home setting.

Two people to have benefitted are Kirsty and Katheryn Fields. The 27-year-old twins from Llanelli have a neurological condition so rare it has been named after them: ‘Fields condition’. The twins both suffer for painful spasms and were among the first to receive the treatment at home. Their mother and main carer Lyn Fields said:

“For both Kirsty and Kath to attend a hospital appointment there’s a huge amount of work involved, it can easily take 5 or 6 hours. The girls need 24/7 care at home so to do that while spending most of the day travelling and at the hospital means we need extra care to support them, it can be exhausting for all of us. Receiving the treatment in the comfort of their home and fitted around their care needs has been a massive benefit to us.”

Calum Higgins, Public Affairs and Policy Manager Wales for the Chartered Society of Physiotherapy commented: “As the professional body for physiotherapists we are keen to see the development of innovative community based service for patients and developing the workforce advanced practice skills…it’s great to see Hywel Dda developing a service that goes to the patient where they are and offering opportunities for the physio workforce to develop these advanced practice skills.”

Due to Hywel Dda University Health Board’s and Cardiff University’s reputation in this area, both organisations are currently working in collaboration with Kings College London to develop international standards on the use of ultrasound guided injection of Botox with a view to increase its use in clinical practice.