Ergonomic positioning is important in any medical procedure, but can be particularly challenging with ultrasound-guided injections, given that the practitioner is balancing multiple implements and will also need to direct assistance in their roles. Ergonomic positioning is important to avoid practitioner injury, optimize patient comfort, and obtain the best possible procedure outcome. Positioning may vary between practitioners and patients. In order to avoid practitioner injury, the practitioner should get close enough to the patient that it is not necessary to lean forward or to the side during the procedure, adjust the height of the bed, be sure that there is easy access to the transducer without straining the wrist, elbow, shoulder, or spine, and it is also important to ensure that the ultrasound display is in view. To avoid patient discomfort, position the patient so that they are comfortable, consider use of multiple pillows to accommodate for any contractures, deformities, or spasticity, and consider lateral decubitus positioning if the patient is unable to lie prone. We will demonstrate ultrasound-guided lower limb botulinum toxin injections in the prone position. We prefer the prone position because it allows easy access to the medial and lateral aspects of the posterior lower limb to accommodate multiple injection sites without repositioning the patient. This improves both patient comfort and procedural efficiency. If the prone position is not feasible due to limitations such as contracture or deformity, the lateral decubitus position may be used alternatively.

ergonomic positioning

ultrasound-guided injections

patient comfort

prone position

lateral decubitus position