We usually have to take such procedures in conjunction with a physical medicine and rehabilitation doctor. Somebody who's undertaken the rehab of the patient may have undergone some trials of Botox, is determined that the patient would benefit from a more significant intervention. We will see the patient assess them. Sometimes EMG or nerve testing studies can be used to help us determine which muscles are the biggest problem and then we can do a very focused intervention. Typically the procedures lasts less than an hour. They are soft tissue incision followed by cutting of the nerve branches and the patient could go home on an outpatient basis. And the recovery of function is almost immediately realized this should be done in conjunction with physical therapy. The patient to after the relaxation of the muscles will need to be trained on how to use the arm and how to get the most function out of what has been performed. So if it's the upper extremity an occupational therapists will work with us on recovering that function. If it's a lower extremity, the physical therapist and a gait training program will be involved teaching the patient how to land the foot on the heel and had a swing through more appropriately to get a better date.
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