痙攣型腦性麻痺兒童的步態異常一直是臨床評估與治療的重點。近年來，許多研究報告提出，注射A型肉毒桿菌可有效減低腦性麻痺兒童痙攣情形，並增進其功能。然而，這些研究大多數是使用臨床評估方式，缺乏客觀性、科學化的評估研究，且目前並無注射前後足底壓力變化的文獻。
本研究目的是針對痙攣型腦性麻痺兒童下肢痙攣部位注射兩次肉毒桿菌，注射位置依痙攣程度選擇腓腸肌或股後肌，利用步態分析量化探討重複兩次注射前後之步態變化。本研究使用動態分析系統及鞋墊式足底壓力量測系統，收集包括時間-空間參數、關節角度與足底接觸面積和壓力的資料進行分析。
受測者共有八位，六位為雙邊痙攣型，二位為右側痙攣型。結果發現，受測者注射之後在步行平均速度、步頻、步伐長增加，尤其是第二次注射後達顯著差異。踝關節剛著地時過度蹠側彎曲明顯減少，而站立期最大彎曲角度有顯著增加，表示腓腸肌過度強勢情形減少。膝關節站立期過度伸直情形改善，然而擺盪期最大彎曲角度減少，可能是注射後肌力減少或股四頭肌相對強勢所造成，並使膝關節活動度減少。從足底壓力量測發現，注射後蹠骨區與趾區過大的壓力減少，而足跟區之接觸面積、最大壓力和壓力-時間積分皆增加。
多數步態參數在注射後兩個月有較大的進步，四個月出現回復現象但仍比未注射前改善，表示肉毒桿菌作用可能持續四個月，或者在作用期間結合復健計畫所得的進步。另外，第二次注射後步態參數比第一次注射較接近正常兒童，代表重複注射肉毒桿菌較只接受一次注射的效果為佳。

Gait abnormalities of spastic cerebral palsy (CP) children have been the focus of evaluation and treatment. Recently, a number of studies have demonstrated that injections of botulinum toxin-A (BTX-A) are effective in reducing spasticity and improving function in CP. However, most of researches used clinical evaluation form.
The purpose of the study is to quantify the influences of receiving two BTX-A injections on gastrocnemius or hamstring of spastic CP children. We employed the three-dimensional motion analysis systems and the Pedar pressure system to acquire the information of temporal-spatial parameters, joint angles and plantar pressure of the lower extremity during ambulation.
Eight spastic CP children were investigated in this research. The results showed significant increase in velocity and step length after second injection. Ankle dorsiflexion at initial contact and in stance improved significantly. Knee excessive extension in stance also improved, but knee flexion in swing and range of motion decreased. Contact area, peak pressure and pressure-time integral of hindfoot increased after injections.
The benefit reached to the peak in the second month after injections. At the fourth month, certain benefit still maintained in gait were due to the rehabilitation performed during the period with BTX-A benefit. The residual effects after second injection were more than those after first injection. This showed the tendency that repeated injections have more benefit than a single injection.

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