A survey of clinicians' understanding of paratonia, and current treatments, with a focus on botulinum toxin (BoNt-A).

van den Broek, Joanna; Buono, Alessandro; Robertson, Adrian · Disabil Rehabil · 2026

cross_sectional · Level IV

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Abstract

Paratonia is a form of hypertonia seen in individuals with dementia. It lacks clear recognition and standardised treatment guidelines. This survey aimed to assess awareness, understanding and treatment of paratonia among healthcare professionals in the UK, including the use of BoNt-A as a treatment. An anonymous survey, created <i>via</i> Qualtrics and distributed electronically across the UK, targeted to healthcare professionals involved in providing care to patients with dementia. Data was collected between May 2, 2023, to June 5, 2023, and interpreted <i>via</i> Excel. The study gathered responses from 75 participants primarily comprising of physiotherapists. Findings revealed variable recognition of paratonia and low awareness of evidence-based treatments. Treatment using passive stretches was widely used, contradicting established evidence. BoNt-A use by respondents was relatively low, potentially influenced by lack of BoNt-A licencing for paratonia treatment. This study highlights the need for increased awareness of paratonia and its potential treatments, emphasising the importance of evidence-based practices. There is a need for the development of guidelines for the optimal treatment of paratonia. These guidelines would be a starting point for more standardised and more evidence-based practices.