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5-1 1 General guidelines for lower extremity spasticity D Muscles injected Dose range (unitskg of bw) Number of sites per muscle Iliopsoas 2 2 Quadriceps 3-6 4 Medial hamstrings 3-6 3-4 Lateral hamstrings 2-3 2 Adductors 3-6 2 Gastrocnemius 3-6 1-2 Soleus 2-3 1 Tibialis posterior 1-3 1 In general maximum of 50 Usite F Botox® dose modifiers Decrease dose if Increase dose if Patient weight Low High Duration of therapy Chronic Acute Muscle bulk Very small Very large Number of muscles inject- ed simultaneously Many Few Ashworth score Low Very high Concern about weakness High Low Results of previous therapy Too much weakness Inadequate response Table reproduced with permission from WE MOVE New York www.
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