Neurolysis of the musculocutaneous nerve with alcohol to treat poststroke elbow flexor spasticity.

OBJECTIVE: To evaluate the effectiveness of alcohol in neurolysis of the musculocutaneous nerve for the treatment of elbow flexor spasticity in individuals with a stroke. DESIGN: Case series. SETTING: Outpatient clinic of a tertiary rehabilitation facility. PARTICIPANTS: Twenty patients with a mean age of 62.8 years and poststroke duration of 12.3 months with elbow flexor spasticity. INTERVENTION: Musculocutaneous nerve block of the hemiplegic upper extremity with 50% ethyl alcohol. OUTCOME MEASURES: The severity of spasticity as assessed by the modified Ashworth scale (MAS) score and the elbow passive range of motion (PROM). RESULTS: The mean baseline MAS score was 3.7 +/- 0.6, and this improved to 1.7 +/- 1.0, 2.0 +/- 0.8, and 2.1 +/- 0.8 at 4 weeks, 3 months, and 6 months postneurolysis, respectively. The elbow PROM was 87.3 degrees +/- 20.2 degrees, 104.3 degrees +/- 20.1 degrees, 103.8 degrees +/- 18.9 degrees, and 101.6 degrees +/- 19.7 degrees, respectively. These improvements were statistically significant (p < .05). Four subjects had concomitant improvement of finger flexor spasticity and another four had relief of shoulder pain. Three subjects developed temporary dysesthetic pain over the lateral forearm. CONCLUSION: Neurolysis of the musculocutaneous nerve with alcohol provides good relief of elbow flexion spasticity in hemiplegic individuals.     

Alcohol neurolysis of tibial nerve motor branches to the gastrocnemius muscle to treat ankle spasticity in patients with hemiplegic stroke

OBJECTIVE: To evaluate the effectiveness of alcohol neurolysis of tibial nerve motor branches to the gastrocnemius muscle for the treatment of ankle plantarflexor spasticity in patients with hemiplegic stroke. DESIGN: Case series. SETTING: Inpatient and outpatient clinics in the rehabilitation department of a university hospital. PARTICIPANTS: Twenty-two patients with hemiplegic stroke (mean age, 48y). INTERVENTIONS: Motor branch block (MBB) of the tibial nerve to the gastrocnemius muscle with 50% ethyl alcohol in cases of spastic ankle. MAIN OUTCOME MEASURES: The severity of spasticity was assessed using the Modified Ashworth Scale (MAS) score of ankle plantarflexor, clonus score of the ankle, and the passive range of motion (PROM) of ankle dorsiflexion. RESULTS: The MAS score was reduced in 17 (77%) of 22 patients during the 6-month follow-up, and spasticity reappeared at the level of the pre-MBB state in 5 patients (23%). The mean values of all parameters were significantly improved. The changes of mean values from the pre-MBB to the 6-month post-MBB stage were as follows: MAS score, 3.3+/-0.7 versus 1.7+/-1.1; clonus score, 1.6+/-0.7 versus 0.4+/-0.8; and PROM, 17.1 degrees +/-13.0 degrees versus 28.6 degrees +/-4.7 degrees. No serious complications were observed during the 6-month follow-up period. CONCLUSIONS: MBB of the tibial nerve to the gastrocnemius muscle is an effective and safe procedure for relieving localized spasticity of the ankle plantarflexors.     

A randomized controlled study of botulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity

OBJECTIVES: To assess the effects of botulinum toxin A (BT-A) on hemiplegic shoulder pain associated with spasticity. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Outpatient clinic of a rehabilitation department. PARTICIPANTS: Patients, more than three months post stroke, with hemiplegic shoulder pain associated with shoulder adductor and elbow flexor spasticity, randomly assigned to BT-A or placebo. INTERVENTION: One-time injection of BT-A (500 units) into the pectoralis major and biceps brachii on the hemiplegic side. MAIN MEASURES: Visual analogue scale of shoulder pain (0 -10), shoulder adductor and elbow flexor tone using the Ashworth Scale and passive range of shoulder abduction. These were assessed at baseline, four weeks, eight weeks and 12 weeks post injection. RESULTS: Seventeen patients were enrolled, eight in the BT-A group and nine in the placebo group. At baseline, the median visual analogue scale score for shoulder pain was 6, the median Ashworth Scale shoulder adductor and elbow flexor spasticity score was 2 and the median range of shoulder abduction 76 degrees. Subjects who received BT-A showed significantly greater improvements in median shoulder adductor and elbow flexor Ashworth Scale scores than placebo at week 4 (P B / 0.01) but not at week 8 and 12. For shoulder pain and passive shoulder abduction range, all subjects showed postinjection improvements and no difference could be demonstrated between the two groups. DISCUSSION: Possible reasons for the negative finding in this study include the small sample size and the presence of causes of shoulder pain not related to spasticity which could have confounded outcome.     

脑卒中偏瘫患者下肢痉挛与步行速度的关系

目的探讨脑卒中偏瘫患者下肢痉挛与步行速度之间的关系。方法对 3 5例脑卒中偏瘫痉挛患者用改良Ashworth法评定下肢膝伸肌和足跖屈肌的痉挛程度 ;测定步行速度、步距和步频 ;分析膝伸肌和足跖屈肌痉挛与步行速度、步长和步频之间的相关性 ,以及决定步行速度、步长和步频的下肢痉挛因素。结果患者在自由步行时的步行速度与膝伸肌和足跖屈肌痉挛呈中度负相关 (r =-0 .43 2 ,P <0 .0 5 ;r =-0 .44 8,P <0 .0 5 ) ,其中膝伸肌痉挛仅与步频呈中度负相关 (r =-0 .415 ,P <0 .0 5 ) ,而足跖屈肌痉挛与步距和步频呈中度负相关 (r =-0 .41,P <0 .0 5 ;r =-0 .3 3 5 ,P <0 .0 5 )。最大步行速度时的步长和步频与膝伸肌和足跖屈肌痉挛之间无相关性 (r =-0 .118— 0 .3 0 7,P >0 .0 5 )。决定自由步行速度、步长的下肢痉挛因素是足跖屈肌痉挛 (分别为R2 =0 .2 0 ,P <0 .0 1;R2 =0 .168,P <0 .0 5 ) ;决定步频的是膝伸肌痉挛 (R2 =0 .172 ,P <0 .0 5 )。结论脑卒中偏瘫患者下肢痉挛对步行速度的影响力较小 ,在以改善患者步行能力为目的的治疗中 ,应重点关注痉挛以外的其他更重要的临床因素。     

Interrater reliability of the Modified Modified Ashworth Scale (MMAS) for patients with wrist flexor muscle spasticity

The measurement of spasticity is part of the neurological examination of patients with disorders of the central nervous system. Recently, the Modified Modified Ashworth Scale (MMAS) was developed for the characterization of muscle spasticity. The purpose of this study was to determine the interrater reliability of the MMAS in the assessment of wrist flexor muscle spasticity in adult patients after upper motoneuron lesions resulted in hemiplegia. Thirty hemiplegic patients (17 males and 13 females) with a mean age of 55.6+/-7.8 years participated in this study. The wrist flexor spasticity was assessed according to MMAS by two female physiotherapists. The raters gave 23 patients the same spasticity score (weighted percentage agreement=97.4%). The most agreement occurred for scores 3 (46.7%) and 0 (16.7%), respectively. The agreement between raters was very good (weighted kappa=0.92, SE=0.03, p<0.0001). In conclusion, the MMAS has very good interrater reliability for the assessment of wrist flexor muscle spasticity.     

Functional outcomes after endoprosthetic knee reconstruction following resection of osteosarcoma near the knee

PURPOSE: The aims of this study were to evaluate outcomes of osteosarcoma patients who underwent wide resection and endoprosthetic knee reconstruction, to compare with their own sound sides and controls, and to assess the interrelationships among these parameters. METHOD: Twenty patients and 20 matched controls were recruited. Strength and range of motion (ROM) of the knee, gait and Enneking functional score were measured. RESULTS: The results revealed the operated knees were significantly weaker than sound knees and controls (p < 0.05). The ROM of operated knees, sound knees and controls were 106.2 degrees +/- 13.0 degrees, 134.1 degrees +/- 7.5 degrees, and 137.7 degrees +/- 7.0 degrees respectively (p < 0.05). Patients' and controls' walking velocity were 54 +/- 12 m/min, and 72 +/- 6 m/min (p < 0.05). Their Enneking score was 21.6 +/- 2.8 (72% of total score, 30). The ratio of extensor strength of operated/sound knee and isometric hamstring/quadriceps ratio of operated knee were significantly correlated to the difference of stance-phase duration of bilateral sides (p < 0.05). In addition, the ratio of isometric flexor strength was significantly correlated to Enneking score (p < 0.05). CONCLUSIONS: The patients achieved an acceptable recovery in strength and gait in spite of some functional limitation.     

偏瘫患者运动疗法中肌痉挛的体位控制

目的：分析常见功能活动对偏瘫患者肌痉挛的影响，总结一套对抗这些肌痉挛的体位控制方法。方法：观察41例偏瘫患者在接受功能性活动，包括体位转换、移动活动、平衡活动及一些力量性训练过程中发生患侧上肢屈肌痉挛(不自主屈肘或握拳)和下肢伸肌痉挛(不自主膝过伸或踝趾屈)的阳性率，以及采取对抗痉挛体位1个月后，患者步行中患肢肌痉挛被抑制的效应。结果：容易导致上肢屈肌痉挛出现的活动，如仰卧位坐起(73％)、健侧翻身(68％)、上楼，下楼(66％／59％)、步行及坐位站起(59％)；容易引起下肢伸肌痉挛的活动，如患侧卧位坐起(54％)、健侧翻身及仰卧坐起(49％)、健侧抗阻屈膝(44％)。短暂体位控制对抗痉挛模式使上肢痉挛控制率达83％，下肢痉挛控制率达62％；长时间体位抑制使上肢痉挛的主动控制率达42％，下肢痉挛控制率达38％。结论：偏瘫康复早期一些功能活动可以诱发痉挛产生，抗痉挛抑制体位对此有一定效果。     

Comparing Electrical Stimulation With and Without Ultrasound Guidance for Phenol Neurolysis to the Musculocutaneous Nerve

Background

Ultrasound guidance is increasingly being used for neurolytic procedures that have traditionally been done with electrical stimulation (e-stim) guidance alone. Ultrasound visualization with e-stim?guided neurolysis can potentially allow adjustments in injection protocols that will reduce the volume of neurolytic agent needed to achieve clinical improvement.

Needle acupuncture in chronic poststroke leg spasticity

OBJECTIVE: To determine whether needle acupuncture may be useful in the reduction of leg spasticity in a chronic state. DESIGN: Single-blind, randomized, placebo-controlled trial. SETTING: Neurologic outpatient department of a medical school in Germany. PARTICIPANTS: Twenty-five patients (14 women) suffering from chronic poststroke leg spasticity with pes equinovarus deformity (Modified Ashworth Scale [MAS] score, >/=1), aged 38 to 77 years (mean +/- standard deviation, 58.5+/-10.4 y), were enrolled in the study. The mean time from stroke to inclusion in the study was approximately 5 years (mean, 65.4+/-48.3 mo; range, 7-180 mo). INTERVENTIONS: Participants were randomly assigned to placebo treatment (n=12) by using a specially designed placebo needling procedure, or verum treatment (n=13). MAIN OUTCOME MEASURES: MAS score of the affected ankle, pain (visual analog scale), and walking speed. RESULTS: There was no demonstrated beneficial clinical effects from verum acupuncture. After 4 weeks of treatment, mean MAS score was 3.3+/-0.9 in the placebo group versus 3.3+/-1.1 in the verum group. The neurophysiologic measure of H-reflex indicated a significant increase of spinal motoneuron excitability after verum acupuncture (H-response/M-response ratio: placebo,.39+/-.19; verum,.68+/-.41; P<.05). CONCLUSIONS: This effect might be explained by afferent input of A delta and C fibers to the spinal motoneuron. The results from our study indicate that needle acupuncture may not be helpful to patients with chronic poststroke spasticity. However, there was neurophysiologic evidence for specific acupuncture effects on a spinal (segmental) level involving nociceptive reflex mechanisms.     

超声弹性成像在脑卒中后前臂屈肌痉挛定量评价中的应用

目的探讨应用超声弹性成像技术定量评价脑卒中后前臂屈肌痉挛的可行性及其特点。方法2019年1月至10月,脑卒中后屈腕和屈指肌痉挛的住院患者30例,采用超声弹性成像测量前臂屈肌群桡侧腕屈肌(FCR)、尺侧腕屈肌(FCU)、指浅屈肌(FDS)和指深屈肌(FDP)剪切波速度(SWV),采用改良Ashworth量表(MAS)评定屈腕和屈指肌张力。结果患侧和健侧各肌肉SWV在牵伸位时均显著高于放松位(|Z|>3.844,P<0.001);牵伸位时,患侧各肌肉SWV显著高于健侧(|Z|>3.593,P<0.001);牵伸位与放松位SWV差值比较,患侧各肌肉明显高于健侧(t>3.199,P<0.01);各肌肉牵伸位平均SWV与屈腕MAS评分显著相关(r=0.605,P<0.001);指浅屈肌和与指深屈肌牵伸位平均SWV与屈指MAS评分明显相关(r=0.540,P<0.01)。结论超声弹性成像可以定量评价脑卒中后前臂屈肌群内不同肌肉的痉挛程度。     

Interrater reliability of the Modified Modified Ashworth Scale (MMAS) for patients with wrist flexor muscle spasticity

The measurement of spasticity is part of the neurological examination of patients with disorders of the central nervous system. Recently, the Modified Modified Ashworth Scale (MMAS) was developed for the characterization of muscle spasticity. The purpose of this study was to determine the interrater reliability of the MMAS in the assessment of wrist flexor muscle spasticity in adult patients after upper motoneuron lesions resulted in hemiplegia. Thirty hemiplegic patients (17 males and 13 females) with a mean age of 55.6±7.8 years participated in this study. The wrist flexor spasticity was assessed according to MMAS by two female physiotherapists. The raters gave 23 patients the same spasticity score (weighted percentage agreement=97.4%). The most agreement occurred for scores 3 (46.7%) and 0 (16.7%), respectively. The agreement between raters was very good (weighted kappa=0.92, SE=0.03, p<0.0001). In conclusion, the MMAS has very good interrater reliability for the assessment of wrist flexor muscle spasticity.     

Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study

OBJECTIVE: To investigate the effectiveness of Bobath on stroke patients at different motor stages by comparing their treatment with orthopaedic treatment. DESIGN: A single-blind study, with random assignment to Bobath or orthopaedic group. SETTING: Physical therapy department of a medical centre. SUBJECTS: Twenty-one patients with stroke with spasticity and 23 patients with stroke at relative recovery stages participated. INTERVENTIONS: Twenty sessions of Bobath programme or orthopaedic treatment programme given in four weeks. MAIN OUTCOME MEASURES: Stroke Impairment Assessment Set (SIAS), Motor Assessment Scale (MAS), Berg Balance Scale (BBS) and Stroke Impact Scale (SIS) for impairment and functional limitation level. RESULTS: Participants with spasticity showed greater improvement in tone control (change score: 1.20 +/- 1.03 versus 0.08 +/- 0.67, p = 0.006), MAS (change score: 7.64 +/- 4.03 versus 4.00 +/- 1.95, p = 0.011), and SIS (change score: 7.30 +/- 6.24 versus 1.25 +/- 5.33, p = 0.023) after 20 sessions of Bobath treatment than with orthopaedic treatment. Participants with relative recovery receiving Bobath treatment showed greater improvement in MAS (change score: 6.14 +/- 5.55 versus 2.77 +/- 9.89, p = 0.007), BBS (change score: 19.18 +/- 15.94 versus 6.85 +/- 5.23, p = 0.015), and SIS scores (change score: 8.50 +/- 3.41 versus 3.62 +/- 4.07, p = 0.006) than those with orthopaedic treatment. CONCLUSION: Bobath or orthopaedic treatment paired with spontaneous recovery resulted in improvements in impairment and functional levels for patient with stroke. Patients benefit more from the Bobath treatment in MAS and SIS scores than from the orthopaedic treatment programme regardless of their motor recovery stages.     

Insulin growth factors may explain relationship between spasticity and skeletal muscle size in men with spinal cord injury

The major objectives of this cross-sectional study were to (1) measure insulin-like growth factor-1 (IGF-1) in individuals with complete spinal cord injury (SCI) and spasticity and (2) determine the relationships between IGF-1 and cross-sectional areas (CSAs) of thigh skeletal muscle groups. Eight individuals with motor complete SCI underwent magnetic resonance imaging to measure the CSA of the whole thigh, knee extensor, and knee flexor skeletal muscle groups and dual-emission X-ray absorptiometry to measure fat-free mass. After participants fasted for 12 h, we measured their IGF-1 levels and determined spasticity using the Modified Ashworth Scale (MAS). Spearman rho correlations were used to test for the relationships among the tested variables, and independent t-tests were used to determine the difference in plasma IGF-1. Plasma IGF-1 was 44% greater in those with MAS scores of 2 or higher (p < 0.05). Plasma IGF-1 was positively related to knee extensor skeletal muscle CSA (r = 0. 83, p < 0.01). IGF-1 was strongly related to knee extensor and flexor spasticity (r = 0.88, p < 0.004). The findings suggest that IGF-1 is greater in SCI individuals with increased spasticity, and this may explain the strong positive relationships that were noted between spasticity and skeletal muscle CSA.     

胫神经腓肠肌运动分支乙醇溶解术治疗脑卒中后痉挛性垂足的初步研究

目的观察胫神经运动神经分支乙醇溶解术对脑卒中患者腓肠肌痉挛和步行功能的影响。方法符合条件的18例患者被收入本研究，应用BTL公司的5000e型电诊断仪在体表探测定位，然后应用无水乙醇进行运动分支神经溶解术。每一点的最大剂量不能超过1ml。结果注射后腓肠肌痉挛的各项指标均立即好转，疗效至少维持6个月；10m步行速度观察，在治疗后1个月有所改善，但没有达到统计学意义，治疗后3个月步行速度显著好于治疗前，疗效至少维持到治疗后6个月。不良反应的发生率很低，且多数为可恢复的。结论腓肠肌胫神经运动分支乙醇溶解术治疗脑卒中后腓肠肌痉挛安全有效，能显著缓解痉挛，改善患者步行功能。     

Effectiveness of Botulinum Toxin A in Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-analysis

ObjectiveTo evaluate the effectiveness of botulinum toxin A (BTX-A) in the treatment of hemiplegic shoulder pain.Data SourcesPubMed, EMBASE, Elsevier, Springer, Cochrane Library, Physiotherapy Evidence Database, CNKI, and VIP were researched from the earliest records to September 1, 2020.Study SelectionRandomized controlled trials that compared shoulder BTX-A injections vs a control intervention in patients with a history of hemiplegic shoulder pain after stroke were selected. Among the 620 records screened, 9 trials with 301 eligible patients were included.Data ExtractionOutcome data were pooled according to follow-up intervals (1, 2, 4, and 12 wk). The primary evaluation indices were pain reduction (visual analog scale [VAS] score) and range of motion (ROM) improvement. The second evaluation indices were upper limb functional improvement, spasticity improvement, and incidence of adverse events. Cochrane risk-of-bias was used to assess the methodological quality of studies independently by 2 evaluators.Data SynthesisMeta-analysis revealed a statistically significant decrease in the VAS score in the BTX group vs the control group at 1, 4, and 12 weeks postinjection (wk 1: standardized mean difference [SMD], 0.91; 95% confidence interval [CI], 0.27 to 1.54; wk 4: SMD, 1.63; 95% CI, 0.76 to 2.51; wk 12: SMD, 1.96; 95% CI, 1.44 to 2.47). Furthermore, the meta-analysis demonstrated a statistically significant increase in abduction at 1, 4, and 12 weeks postinjection (wk 1: SMD, 3.71; 95% CI, 0 to 7.41; wk 4: SMD, 8.8; 95% CI, 2.22 to 15.37; wk 12: SMD, 19.59; 95% CI, 9.05 to 30.13) and external rotation at 1, 2, 4 weeks postinjection (wk 1: SMD, 5.67; 95% CI, 0.88 to 10.47; wk 2: SMD, 9.62; 95% CI, 5.57 to 13; wk 4: SMD, 6.89; 95% CI, 2.45 to 11.33) in the BTX group.ConclusionsBTX-A injection provided greater analgesic effects and increased shoulder abduction and external rotation ROM compared with steroid or placebo injection for the treatment of HSP.     

徒手感觉刺激对脑卒中偏瘫患者手指痉挛效果的表面肌电图观察北大核心CSCD

目的观察脑卒中患者偏瘫侧指部接受徒手感觉刺激前后,手指屈、伸肌表面肌电图(sEMG)的变化规律。方法2020年4月至8月,安徽医科大学第二附属医院康复医学科收治的脑卒中偏瘫患者50例,徒手对患侧各指甲床和末节两侧依次实施感觉刺激,至患侧手指主动伸展。刺激前后,采用改良Ashworth量表(MAS)评估患侧拇短屈肌、指浅屈肌、指伸肌张力;采集双侧拇短屈肌、指浅屈肌、指伸肌sEMG信号,计算均方根值(RMS)。结果刺激后,所有被测肌群MAS等级均明显降低(|Z|>2.699,P<0.01);患侧指伸肌RMS增加(t=-2.069,P<0.05)。患侧拇短屈肌和指伸肌RMS刺激前、后均小于健侧(t>2.450,P<0.05)。结论指部徒手感觉刺激能即时缓解脑卒中患者屈指肌痉挛,可能与促进伸指肌肌力有关。     

髌骨骨折后影响屈膝功能恢复的相关因素分析

目的探讨髌骨骨折后影响屈膝功能恢复的相关因素,预测中、短期康复疗效.方法髌骨骨折后膝关节屈曲功能受限者23例,接受门诊常规康复治疗,其中部分患者配合局部热疗.结果康复前屈膝度数(X1)、髌骨后缘不平整(X2)、关节制动时间(X3)是影响康复后1个月膝关节屈曲度数(Y1)和康复后3个月膝关节屈曲度数(Y2)的相关因素,Y1亦受到手术治疗(X4)的影响(部分回归系数P<0.05).屈膝功能恢复的回归方程Y1=49.327+0.736X1-11.977X2-0.137X3-10.826X4;Y2=78,037+0.535X1-25.779X2-0.158X3.23例Y1和Y2的平均理论值和实测值相差分别是5.6%和4.2%.结论康复前屈膝度数、髌骨后缘是否平整、关节制动时间长短是影响髌骨骨折后中、短期屈膝功能恢复的相关因素,其中短期恢复亦受到是否手术治疗的影响,回归方程可作为对中、短期康复效果的初步预测.     

全身低频渐进振动联合运动治疗对卒中患者下肢肌张力与步行能力的作用

目的:探究全身低频渐进振动联合运动治疗对卒中患者下肢肌张力与步行能力的作用。方法:选取符合入选标准的脑卒中患者67例,编号后随机分为对照组34例和观察组33例。2组均给予常规康复治疗,观察组在此基础上给予全身低频渐进振动联合运动治疗。治疗前后采用改良Ashworth分级(MAS)、表面肌电信号(sEMG)、10m步行试验和功能性步行量表(FAC)进行评定。结果:治疗6周后,2组股四头肌、小腿三头肌MAS评级、RMS均值、10m步行时间均较治疗前明显降低(P0.01,0.05),且观察组更低于对照组(P0.05,0.01)。治疗后,2组FAC评级均较治疗前明显提高(均P0.01),且观察组更高于对照组(P0.05)。结论:全身低频渐进振动联合运动治疗能改善卒中患者下肢肌张力,提升步行能力。     

MOTOmed训练系统用于痉挛型偏瘫患儿下肢运动功能恢复的研究

目的:研究常规康复治疗联合MOTOmed训练系统对痉挛型偏瘫患儿下肢功能的影响。方法:将40例痉挛型偏瘫患儿随机分为MOTOmed训练组(给予常规康复治疗及MOTOmed训练)及常规治疗组(给予常规康复治疗)。于治疗前及治疗12周时,同时对两组患儿改良的Ashworth分值(腘绳肌)综合痉挛量表(CSS)、粗大运动功能88项量表(GMFM)中的D、E两功能区及步态参数(健侧及患侧步长、步速)。所有患儿共接受为期12周的康复治疗。结果:两组患儿治疗前指数评分组间差异均无显著性意义(均P>0.05),治疗12周时上述各项指标均较治疗前明显改善(P<0.05),且以MOTOmed训练组的改善幅度较显著,与对照组比较,组间差异具有显著性意义(P<0.05)。结论:MOTOmed训练结合常规康复治疗能进一步提高痉挛型偏瘫患儿下肢运动功能。