康复机器人对痉挛型脑性瘫痪患儿的康复效果

目的分析康复机器人训练对痉挛型脑性瘫痪患儿康复治疗的效果。方法选择2014-10—2016-10我院收治的痉挛型脑性瘫痪患儿94例,按随机数字表法分为对照组和观察组各47例,对照组采用常规康复训练,观察组在对照组基础上增加康复机器人辅助的减重步行训练,治疗前和治疗后3个月分别采用粗大运动功能测量表(GMFM)和日常生活能力评分(ADL)评定2组患儿的运动功能和生活能力。结果治疗后3个月,对照组E区GMFM评分及ADL评分均高于治疗前(P0.05),D区GMFM评分与治疗前比较差异无统计学意义(P0.05),观察组D区、E区GMFM评分及ADL评分均高于治疗前(P0.05),且观察组D区、E区GMFM评分及ADL评分均显著高于对照组(P0.05)。结论康复机器人训练能够有效改善痉挛型脑性瘫痪患儿的下肢运动功能,显著提高患儿的日常行动能力。     

自体骨髓间充质干细胞移植辅助高压氧治疗高血压脑出血临床观察

目的：观察自体骨髓间充质干细胞移植辅助高压氧治疗高血压脑出血的疗效。方法将102例高血压脑出血患者随机分为治疗组（自体骨髓间充质干细胞移植＋高压氧治疗组）和对照组（高压氧治疗组）,比较2组患者治疗前和治疗后6个月的神经功能缺损程度评分（NIHSS）和日常生活活动能力评分（Barthel指数）,治疗后6个月格拉斯哥预后评分（GOS）及远期生活质量评估量表评分（KPS）。结果治疗后6个月与对照组比较,NIHSS评分均有显著降低Barthel指数均有显著升高（P＜0·05）,治疗组GOS及KPS评分显著好于对照组（P＜0·05）。结论自体骨髓间充质干细胞移植辅助高压氧治疗能显著促进高血压脑出血患者神经功能恢复,提高患者生存率和生活质量。     

自体骨髓间充质干细胞移植治疗颅脑创伤后神经功能障碍的护理

目的：探索自体骨髓间充质干细胞移植治疗颅脑创伤后神经功能障碍的护理措施。方法选取颅脑创伤后神经功能障碍患者76例,分别实施常规治疗和自体骨髓间充质干细胞移植治疗,通过对比2组患者治疗前、治疗后6个月神经功能缺损程度（NIHSS）和日常生活能力评分（Barthel指数）,评价治疗和护理效果。结果所有患者均治疗成功出院,移植组较对照组术后6个月NIHSS评分显著降低（P＜0.001）,Barthel指数显著升高（P＜0.001）。结论自体骨髓间充质干细胞移植治疗能促进患者神经功能恢复,提高患者生活能力,治疗前心理护理,移植后严密观察病情变化、不良反应,持之以恒的功能康复计划是促进患者康复的重要保障。     

自体骨髓间充质干细胞治疗脑干出血41例临床分析

目的探讨自体骨髓间充质干细胞移植治疗脑干出血的疗效。方法 41例接受自体骨髓间充质干细胞移植患者(干细胞治疗组)和41例接受常规治疗患者(对照组),实施美国国立卫生研究院卒中量表(NIHSS)评分和日常生活能力指数(Barthel index)评分,并比较两种治疗方法的差异。结果干细胞治疗组在治疗后14d、3个月NIHSS评分显著低于对照组(P<0.05);干细胞治疗组在治疗后3个月Barthel index评分及Barthel index加分幅度显著高于对照组(P<0.05);干细胞治疗组治疗后3个月疗效优于对照组。结论自体骨髓干细胞治疗可有效改善脑干出血患者的预后。     

自体骨髓间充质干细胞移植治疗脑梗死：6个月随访

目的：观察骨髓间充质干细胞移植治疗脑梗死的临床疗效和安全性。 方法：本院2003-06/2008-06收治的脑梗死患者120例，均符合1995年全国第四届脑血管病会议制定的诊断标准，随机分为4组：对照组、单纯干细胞动员组、单纯干细胞移植组、联合组，30例/组。对照组采用常规药物治疗与康复训练；单纯干细胞动员组在对照组治疗的基础上，给予重组人粒细胞集落刺激因子150 μg腹部皮下注射；单纯干细胞移植组在对照组治疗的基础上，经静脉移植自体骨髓间充质干细胞(16.2~51.3)×108；联合组综合上述3组方法进行治疗。 结果：①与对照组比较，治疗后4周、12周、6个月单纯干细胞动员组、单纯干细胞移植组、联合组Fugl-Meyer运动功能评分、功能独立性评定量表评分均显著好转(P < 0.05或P < 0.01)；且联合组治疗效果最佳，疗效明显优于单纯干细胞动员组、单纯干细胞移植组(P < 0.05)。②治疗后14 d内，单纯干细胞动员组未发现任何不良反应；单纯干细胞移植组发热4例，体温均在38 ℃以下，且24 h后体温恢复正常，轻微头痛3例，未行治疗24 h后缓解；联合组发热5例，体温均在38 ℃以下，且24 h后体温恢复正常，轻微头痛3例，未行治疗24 h后缓解。 结论：骨髓间充质干细胞移植治疗脑梗死近期疗效明显，不良反应较少。     

骨髓间充质干细胞移植脊髓全横断模型大鼠运动和体感诱发电位的评价

背景：临床常用皮质运动诱发电位和皮质体感诱发电位来分别评价脊髓损伤后运动传导路和感觉传导路的损伤或修复情况。 目的：以脊髓诱导电位监测骨髓间充质干细胞移植后急性脊髓完全性损伤大鼠下肢神经功能的变化。 方法：选取健康Wistar大鼠50只，分成5组，即生理盐水组、骨髓间充质干细胞移植组、脑源性神经营养因子修饰组、神经营养素3+骨髓间充质干细胞移植组和假手术组。除假手术组外，其余各组均制作Allen’s脊髓完全性损伤动物模型，造模后各组均行相应治疗。治疗后4，8和12周行大鼠后肢运动功能评分，并于造模后24 h，3，7，14 d行运动和体感诱发电位检测。 结果与结论：运动诱发电位检测结果提示，各治疗组的运动功能均有不同程度的恢复，与生理盐水组间差异均有显著性意义(P < 0.05)，大鼠后肢BBB评分也证实了各治疗组后肢运动功能明显优于生理盐水组(P < 0.05)。提示经脑源性神经营养因子修饰的骨髓间充质干细胞可移植到脊髓损伤处，可改善大鼠的后肢运动，神经营养素3蛋白有可能提高骨髓间充质干细胞在体内的生存率，促进受损脊髓的轴突再生。     

自体骨髓间充质干细胞移植治疗脑出血32例：是否安全、可行及有效？

背景：大量动物实验证实骨髓间充质干细胞在适宜条件下能够定向分化为神经细胞,但目前其应用于临床治疗神经系统损伤性疾病的报道较少。 目的：观察自体骨髓间充质干细胞移植治疗脑出血的近期疗效。 方法：以2007-11/2009-01聊城市脑科医院神经外科收治的32例脑出血患者作为治疗组,根据患者一般状况及血肿量大小,分别行钻孔引流或开颅血肿清除,均留置血肿腔引流管,退至血肿腔边缘,通过引流管注射自体骨髓间充质干细胞悬液3.5 mL。选择同期入院但未行干细胞移植的40例患者作为对照组。分别于移植前和移植后6个月进行神经功能缺损程度评定(NIHSS评分)和日常生活活动能力评定(Barthel指数),行颅脑MRI、血生化指标、肿瘤标记物检查,监测干细胞移植的安全性。 结果与结论：移植前两组患者NIHSS评分及Barthel指数基本相似。与对照组比较,移植后6个月治疗组NIHSS评分显著降低(P < 0.01),Barthel指数显著升高(P < 0.01)。与移植前比较,治疗组在移植后6个月NIHSS评分显著降低(P < 0.01),Barthel指数显著升高(P < 0.01)。治疗组2例患者在移植后出现一过性发热,予对症处理后症状缓解。移植后6个月随访,除1例患者因肺癌导致肿瘤标记物CA-153升高外,颅脑MRI及血生化指标均未出现明显异常,说明自体骨髓间充质干细胞移植治疗脑出血是安全可行的,且在近期内疗效确定,远期疗效尚待进一步观察。     

自体骨髓间充质干细胞移植治疗颅脑损伤后痉挛性瘫痪

目的探讨应用自体骨髓间充质干细胞治疗颅脑损伤后痉挛性瘫痪的临床疗效。 方法回顾性分析第四军医大学西京医院神经外科自2009年5月至2014年4月治疗的33例颅脑损伤后痉挛性瘫痪患者,完成4次自体骨髓间充质干细胞移植,每周1次,每次经腰椎穿刺蛛网膜下腔注射,细胞数为2×10⁷,移植前、移植后1个月、3个月、6个月通过改良Ashworth分级、Brunnstrom分级评估患侧上下肢肌张力、运动功能,并行脑PET/CT、脑电图、偏瘫肢体肌电图检查。 结果移植后1个月开始Brunnstrom分级较移植前改善。移植后3个月开始Ashworth分级较移植前改善。5例移植后3个月头颅PET/CT见脑葡萄糖代谢减低较前改善。临床观察未发现明显不良反应,脑电图、偏瘫肢体肌电图检查未见明显变化。 结论自体骨髓间充质干细胞移植对颅脑损伤后痉挛性瘫痪的肢体肌张力增高和运动障碍均有改善,移植后6个月内通过临床观察及影像学检查未发现不良反应,为临床治疗颅脑损伤后遗症提供了新方法。     

高压氧联合骨髓间充质干细胞移植修复缺氧缺血性脑损伤

背景：单纯骨髓间充质干细胞移植对脑梗死组织的修复作用并不理想,需要结合药物及生物工程材料等手段进行综合治疗。 目的：验证高压氧结合骨髓间充质干细胞移植修复大鼠缺氧缺血性脑损伤的效果。 方法：体外培养大鼠骨髓间充质干细胞。应用线栓法建立大脑中动脉阻塞大鼠模型,按随机区组法分为3组,即对照组、骨髓间充质干细胞移植组及高压氧+骨髓间充质干细胞移植组。静脉移植后24 h,3 d及伤后1,2 周行Longa行为学评分,检测神经功能的损伤情况。移植2周后,应用RT-PCR法测定生长相关蛋白43 mRNA的表达,并以BrdU免疫组化和苏木精-伊红染色行梗死处组织学检查以证实恢复程度。 结果与结论：移植后1周,高压氧+骨髓间充质干细胞移植组大鼠神经功能障碍评分低于骨髓间充质干细胞移植组,骨髓间充质干细胞移植组低于对照组(P < 0.05)。2周后脑梗死周围组织生长相关蛋白43 mRNA的表达高压氧+骨髓间充质干细胞移植组高于骨髓间充质干细胞移植组,骨髓间充质干细胞移植组高于对照组(P < 0.05)。BrdU免疫组化和苏木精-伊红切片中的神经元数量高压氧+骨髓间充质干细胞移植组多于骨髓间充质干细胞移植组,骨髓间充质干细胞移植组多于对照组(P < 0.05)。提示高压氧联合骨髓间充质干细胞静脉移植治疗大鼠缺氧缺血性脑损伤可明显改善大鼠的神经功能,效果优于单纯骨髓间充质干细胞移植。     

自体骨髓间充质干细胞移植治疗脑出血的疗效观察

目的探讨自体骨髓间充质干细胞治疗脑出血近期有效性和安全性。方法 2009-01—2012-01我院神经外科收治的脑出血患者45例。移植组20例通过蛛网膜下腔注射方式行自体骨髓间充质干细胞移植,选择同期入院但未行干细胞移植的25例作为对照组。分别于移植前和移植后6个月进行神经功能缺损程度评定(NIHSS评分)和日常生活活动能力评定(Barthel指数)。同期随访血常规、生化全项、肿瘤标记物以观察其安全性。结果移植前2组NIHSS评分及Barthel指数基本相似。与对照组比较,移植后6个月治疗组NIHSS评分显著降低(P<0.05),Barthel指数显著升高(P<0.05)。与移植前比较,治疗组在移植后6个月NIHSS评分显著降低(P<0.05),BaRhel指数显著升高(P<0.05)。2例患者在移植后出现一过性发热,予对症处理后症状缓解。随访各项血液检查结果无明显异常。结论采用自体骨髓间充质干细胞治疗脑出血临床疗效安全有效,近期临床疗效明显,远期治疗效果有待观察。     

束带强化核心稳定性训练结合感觉统合训练 对痉挛型脑性瘫痪患儿体位控制的影响

目的 探讨束带强化核心稳定性训练结合感觉统合训练对痉挛型脑性瘫痪(SCP)患儿体位控制的影响。方法 选取2014年6月-2017年6月本院收治的SCP患儿100例,依据随机数字表法分为束感组和常规组,每组各50例,常规组给予常规康复及感觉统合训练,束感组在此基础上给予束带强化核心稳定性训练,比较2组痉挛状态、粗大运动功能、体位控制。结果 束感组痉挛改善有效率明显高于常规组(P<0.05); 束感组和常规组治疗3、6个月后粗大运动功能量表(GMFM)、Berg平衡量表(BBS)得分明显高于治疗前,束感组治疗3、6个月后GMFM、BBS得分明显高于常规组(P<0.05)。结论 束带强化核心稳定性训练结合感觉统合训练可有效缓解SCP患儿的痉挛症状,有利于改善患儿粗大运动功能、体位控制能力。     

Association of therapeutic occasion, gross motor function grading and developmental level with gross motor functional recovery in children with cerebral palsy

BACKGROUND: The abnormal posture and motor pattern have not stabilized in children with cerebral palsy at early period, thus timely treatment can establish normal postural reflex and motor pattern, and prevent complications of muscle contracture, ankylosis, skeletal deformity, etc. The clinical factors affecting the rehabilitative efficacy of gross motor function in children with cerebral palsy should be observed. OBJECTIVE: To observe the effects of therapeutic occasion, grading of gross motor function and developmental level on the rehabilitative efficacy in children with cerebral palsy. DESIGN: A case-controlled analysis. SETTING: Qilu Children's Hospital of Shandong University. PARTICIPANTS: Totally 138 children with cerebral palsy, who were hospitalized for 12 months in the Rehabilitation Center of Qilu Children's Hospital, Shandong University, were selected from April 2004 to September 2006, and all the children were diagnosed to be accorded with the standard set by the national seminar on cerebral palsy in 2004. There were 97 males and 41 females, including 55 cases of 0–2 years old, 47 cases of 2–4 years and 36 cases of 4–6 years. Informed contents were obtained from relatives of all the children. METHODS: ① Comprehensive rehabilitation treatment: Vojta method was to induce the children to turn over the body and crawl by stimulating reflective turn over and crawling on belly. Bobath method including trainings of head control, turning over body, keeping sitting position, keeping balance, crawling, keeping standing position, and walking, etc.; The children were massaged by using the maneuvers of push, press, rub, pull, wave, etc. according to the sites and types of palsy. Acupuncture was performed mainly at bilateral motor areas, the needle was retained for 1 hour per time, 6 days continuously every week, and followed by a 1-day interval. ② Prognosis assessment: The gross motor functional grading of the children with cerebral palsy at admission was assessed using the Chinese version of gross motor function classification system (GMFCS). The gross motor functions of the children with cerebral palsy were assessed before rehabilitation treatment and 12 months after rehabilitation treatment by using gross motor function measure (GMFM). The improved GMFM total score was calculated. Developmental quotient was evaluated using Gesell developmental schedules (GDS) after 12-month rehabilitation treatment. Univariate analysis of variance was performed using the improved GMFM total score with age, GMFCS grade and developmental level (developmental quotient). MAIN OUTCOME MEASURES: Effects of age started to accept rehabilitation treatment, GMFCS grade and developmental level on the recovery of gross motor function in children with cerebral palsy. RESULTS: All the 138 children with cerebral palsy were involved in the analysis of results. The improved GMFM total scores were significantly different among the children with cerebral palsy of different ages started to accept treatment, GMFCS grades and developmental levels (F=13.464, 37.283, 30.814, P < 0.01). The younger the children started to accept treatment, the lower the their GMFCS grades and the higher their developmental levels, then the higher their improved GMFM total scores. CONCLUSION: The recovery of gross motor function is better in younger children started to accepted treatment with cerebral palsy with lower GMFCS grades and higher developmental levels.     

MOTO-med训练对脑瘫患儿肢体运动功能障碍的影响

目的观察MOTO-med训练对脑瘫患儿肢体运动功能障碍的影响。方法收集2013-01—2015-10我院收治的86例脑瘫患儿为研究对象,随机数字表法分为研究组和对照组各43例,对照组实施基础治疗,研究组在对照组基础上联合MOTO-med训练,对2组治疗后运动功能障碍[腘绳肌张力(Ashworth评分)、粗大运动评估量表(GMFM88量表)中的D、E两功能区得分、步态参数]的改善作用进行比较。结果 2组治疗后Ashworth评分均较治疗前显著减小,且治疗后研究组Ashworth评分较对照组显著减小,差异均有统计学意义(P0.05);2组治疗后粗大运动的D、E能区得分分别均较治疗前显著升高,且研究组粗大运动的D、E能区得分分别均较对照组显著升高,差异有统计学意义(P0.05);2组治疗后健侧步长、患侧步长、步速均较治疗前显著增大,且研究组健侧步长、患侧步长、步速均较对照组显著增大(P0.05)。结论 MOTO-med训练对脑瘫患儿肢体运动功能障碍临床疗效显著,有较广泛的推广应用价值。     

A型肉毒毒素注射配合综合康复训练治疗痉挛型偏瘫型脑瘫患儿临床分析

目的探讨A型肉毒毒素治疗痉挛型偏瘫型脑瘫患儿的临床疗效。方法选择痉挛型偏瘫型脑瘫儿童40例,随机分为A型肉毒毒素治疗组20例和单纯康复治疗组（对照组）20例。治疗组将A型肉毒毒素注射到患儿腘伸肌群和小腿三头肌群,注射后第2天开始进行康复训练（共6个月）。所有患者治疗前及治疗后2周、1个月、3个月、6个月进行腘窝角和足背屈角角度的测量、改良的Ashworth量表、粗大运动功能分级量表进行评价。结果治疗组的腘伸肌群和小腿三头肌群肌张力和粗大运动功能评分均比注射前改善明显（P〈0.05）,治疗效果明显优于对照组（P〈0.01）。结论 A型肉毒素配合康复治疗可以有效降低患儿患侧的肌张力,有助于提高运动功能,缩短治疗时间。     

80例头部立体定向间充质细胞移植治疗脑瘫疗效分析

目的 头部立体定向间充质细胞移植治疗脑瘫临床疗效分析.方法 对80例脑瘫患儿行头部立体定向间充质细胞移植治疗,并进行术前、术后半年、术后1年粗大运动功能评定（GMFM）、儿童精细运动功能评估量表（FMMF）、日常生活能力评定（ADL）Barthel指数、Ashworth痉挛分级评估运动功能改善情况评分.结果 患儿感觉功能、运动功能、日常生活能力明显改善,P＜0.01.结论 头部立体定向间充质细胞移植治疗可以显著改善脑瘫换患儿症状,改善运动、言语、智力等症状,促进脑功能恢复.     

不同定位方式下不同剂量肉毒毒素治疗痉挛性脑瘫的疗效观察

目的 观察不同定位方式下靶肌肉注射不同剂量A型肉毒毒素(BTX-A)治疗儿童痉挛性脑瘫的疗效.方法 选择厦门市妇幼保健院儿童神经康复科收治的痉挛性脑瘫患儿120例,分别应用肌电图定位及反向徒手牵拉定位(各60例),再分别按痉挛肌肉局部注射BTX-A剂量(3 U/kg、4 U/kg及5 U/kg)各分为3组(各20例),注射后配合康复训练.随访3个月时患儿疗效,采用粗大运动评价最表(GMFM)评定患儿功能区的运动功能,改良Ashworth痉挛量表评定肌痉挛程度.结果 肌电图定位组较反向徒手牵拉定位组治疗后GMFM评分增加和Ashworth分级减轻,差异有统计学意义(P<0.05),但此两种定位方式下各不同剂量BTX-A组间治疗后GMFM评分和Ashworth分级差异无统计学意义(P>0.05).结论 在相同有效剂量BTX-A注射情况下,肌电图定位较反向徒手牵拉定位疗效更好.

Abstract：

Objective To observe the clinical effects of different doses of botulinum toxin A (BTX-A) and different lacation ways on children with spastic cerebral palsy. Methods One hundred and twenty patients with BTX-A were employed in our study;these patients were performed locations of electromyography (n=60) and reverse stretching hand (n=60), and then, they were equally sub-divided into 6 groups, respectively: receiving injection of BTX-A at doses of 3, 4 and 5 U/kg, respectively (n=20).After injection, they were commenced functional training for 3 months. The gross motor assessment scale (GMFM) was used to assess the motor function of functional areas in these children 3 months after the training. The modified Ashworth scale was used to assess the degree of muscle spasticity. Results The scores of GMFM in patients received treatment with location of electromyography increased as compared with those with reverse stretching hand (P< 0.05), but the scores had no statistically significances among different doses of BTX-A treatment groups (P> 0.05). The Ashwort grade in patients received treatment with location of electromyography alleviated as compared with those with reverse stretching hand (P<0.05), but no statistically significance of grading was noted among different doses of BTX-A treatment groups (P>0.05). Conclusion All parameters in patients received treatment with location of electromyography improve better than those with reverse stretching hand after injection of same dose of BTX-A.     

The functional effect of segmental trunk and head control training in moderate-to-severe cerebral palsy: A randomized controlled trial

Purpose: To determine whether segmental training is more effective in improving gross motor function in children and young people with moderate-to-severe cerebral palsy than conventional physiotherapy. Methods: Twenty-eight participants were randomized to a segmental training or control group. Outcomes were Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), Segmental Assessment of Trunk Control (SATCo), and postural sway at baseline, at primary endpoint (6 months), and at follow-up (12 months). Results: There were no significant differences in either GMFM, PEDI, or SATCo scores at primary endpoint or follow-up. There were significant reductions in anterior–posterior head angular sway and trunk sway in the segmental training group at primary endpoint but not at follow-up. Conclusion: Segmental training was not superior to usual care in improving GMFM. Improvements in head and trunk sway were greater in the segmental training group at primary endpoint but not at follow-up.     

Functional improvement in cerebral palsy patients treated with botulinum toxin A injections – preliminary results

Authors report the preliminary results of an open-label, prospective study to evaluate a functional benefit of botulinum toxin type A injections in diparetic cerebral palsy patients, using gross motor function measure (GMFM) score. In a group of 14 children (mean age 3.9 years, range 2-6) treated with Dysport 30 IU/kg, a statistically significant improvement (P < 0.05) was noticed in both simple measurements (Modified Ashworth Scale, Selective Motor Control, Passive Range of Movements, Physician Rating Scale and parental Clinical Global Impression) and complex functions (GMFM dimensions D and E) after 1 and 3 months. However, the simple measurement scores decreased (but not to the baseline) after 3 months; surprisingly, GMFM scores were still increasing (7.7% change after 3 months and 11.3% change after 6 months in nine patients). These results are in concordance with a few other data published to date. The study may support the concept of persistent functional gain in long-term treatment of spasticity caused by cerebral palsy with botulinum toxin type A.     

Children with moderate to severe cerebral palsy may not benefit from stochastic vibration when developing independent sitting

Purpose: Determine sitting postural control changes for children with cerebral palsy (CP), using a perceptual-motor intervention and the same intervention plus stochastic vibration through the sitting surface. Methods: Two groups of children with moderate or severe CP participated in the 12 week interventions. The primary outcome measure was center of pressure data from which linear and nonlinear variables were extracted and the gross motor function measure (GMFM). Results: There were no significant main effects of intervention or time or an interaction. Both treatment groups increased the Lyapunov exponent values in the medial–lateral direction three months after the start of treatment as well as their GMFM scores in comparison with baseline. Conclusions: The stochastic vibration did not seem to advance the development of sitting postural control in children between the ages of 2 and 6 years. However, perceptual-motor intervention was found beneficial in advancing sitting behavior.     

Medium-term functional benefits in children with cerebral palsy treated with botulinum toxin type A: 1-year follow-up using gross motor function measure

One of the main goals when treating spasticity is to relieve pain and improve function. Intramuscular injection of botulinum toxin type A (BTX-A) has gained widespread acceptance in the treatment of spastic cerebral palsy. Several studies have clearly shown the short-term functional benefit of BTX-A treatment. Information is limited, however, on the efficacy of medium and long-term regimens, using repeated injection of BTX-A. The aim of the present open-label, prospective study was to evaluate functional outcome in children with spastic cerebral palsy after 1 year of treatment with BTX-A, using the Gross Motor Function Measure (GMFM) as a validated outcome measure. Patients ( n =25, age 1.5–15.5 years) were treated with BTX-A for adductor spasm ( n =12) or pes equinus ( n =13). The local effect was evaluated using passive range of motion and modified Ashworth Scale. Apart from a significant improvement in joint mobility and reduction of spasticity compared to pretreatment values ( P  < 0.01), we demonstrated a significant improvement of gross motor function after 12 months of treatment, with a median gain of 6% in total and goal scores ( P  < 0.001). An increase in GMFM scores was particularly evident in younger and moderately impaired children (Gross Motor Function Classification System level III). Whether the observed improvement in gross motor function in children with cerebral palsy is specifically related to therapy with BTX-A or represents at least in part the natural course of motor development still needs clarification.