目的：探究力量训练对脑瘫儿童下肢骨骼肌肉形态和功能的影响,为脑瘫儿童运动功能障碍的防治提供更高阶和切实可行的实践参考。方法：采用系统综述方法在Ovid Medline、Embase和The Cochrane Library3个英文数据库进行文献检索,经过2轮的筛选最终纳入4篇方法学质量评估得分为16-18分的高质量文献进行综述分析。结果：以平均年龄在8-13岁且粗大运动功能分类为I-Ⅲ级的49名脑瘫儿童为干预对象,经过8-12周的力量训练发现,脑瘫儿童下肢骨骼肌肉的力量和形态均存在不同程度的改变,但是因为具体的干预措施和负荷不同,最后呈现的实际干预效果也存在差异。结论：力量训练对脑瘫儿童下肢骨骼肌肉的形态和功能均存在积极性的影响。
[1] BAX M, TYDEMAN C, FLODMARK O .Clinical and MRI Correlates of Cerebral Palsy: the European Cerebral Palsy Study[J]. JAMA, 2006, 296(13):1602-8.
[2] BMJMA, CSJB, DMDK, et al. Prevalence of Cerebral Palsy and Intellectual Disability Among Children Identified in Two U.S. National Surveys, 2011-2013[J]. Annals of Epidemiology, 2016, 26( 3):222-226.
[3] 李晓捷,邱洪斌,姜志梅,等.中国十二省市小儿脑性瘫痪流行病学特征[J].中华实用儿科临床杂志,2018,33(5):378-383.
[4] KORZENIEWSKI SJ,SLAUGHTER J,LENSKI M, et al.The Complex Aetiology of Cerebral Palsy[J]. Nature Reviews Neurology 2018,14(9):528-43.
[5] JAN MM.Cerebral Palsy:Comprehensive Review and Update[J]. Annals of Saudi Medicine 2006,26(2):123-32.
[6] DZIENKOWSKI R C, Smith K K, DILLOW K A, et al.CEREBRAL PALSY: A Comprehensive Review[J]. Nurse Practitioner, 1996, 21(2):45-48.
[7] FORAN JR,STEINMAN S,BARASH I, et al.Structural and Mechanical Alterations in Spastic Skeletal Muscle[J].Developmental Medicine&Child Neurology 2005,47(10):713-17.
[8] LEE, BARBER, TANDY, et al. Medial Gastrocnemius Muscle Volume and Fascicle Length in Children Aged 2 to 5 Years with Cerebral Palsy[J]. Developmental Medicine & Child Neurology, 2011,53(6):543-548.
[9] GRAHAM H .Musculoskeletal Aspects of Cerebral Palsy[J]. J Bone Joint Surg Br, 2003, 85(2):157-166.
[10] Moreau N G, TEEFEY S A, DAMIANO D L .In Vivo Muscle Architecture and Size of The Rectus Femoris and Vastus Lateralis in Children and Adolescents with Cerebral Palsy[J]. Developmental Medicine & Child Neurology, 2009, 51(10):800-806.
[11] FINDLAY B,SWITZER L,NARAYANAN U, et al.Investigating the Impact of Pain,Age,Gross Motor Function Classification System and Sex on Health-related Quality of Life in Children with Cerebral Palsy[J]. Developmental Medicine&Child Neurology 2016,58(3):292-97.
[12] HE P, CHEN G, WANG Z, et al.Children with Motor Impairment Related to Cerebral Palsy: Prevalence, Severity and Concurrent Impairments in China[J]. Journal of Paediatrics and Child Health, 2017, 53(5):480-484.
[13] ALEGRE LM,Jiménez F,GONZALO-orden JM, et al. Effects of Dynamic Resistance Training on Fascicle Lengthand Isometric Strength[J]. Journal of Sports Sciences, 2006,24(5):501-08.
[14] BEHRINGER M,VOM HEEDE A,YUE Z, et al.Effects of Resistance Training in Children and Adolescents: a meta-analysis[J]. Pediatrics, 2010,126(5):e1199-e210.
[15] TAYLOR NF,DODD KJ,BAKER RJ, et al.Progressive Resistance Training and Mobility-related Function in Young People with Cerebral Palsy: a Randomized Controlled Trial[J].Developmental Medicine&Child Neurology, 2013,55(9):806-12.
[16] Moreau NG,MARLOW NM,KHOLTHAUS. Differential Adaptations of Muscle Architecture in Response-high Velocity Versus Traditional Strength Training in Cerebral Palsy[J]. Developmental Medicine and Child Neurology, 2011(53):15.
[17] STACKHOUSE SK,INDERB-MACLEOD SA,STACKHOUSE CA, et al.Neuromuscular Electrical Stimulation Versus Volitional Isometric Strength Training in Children with Spastic Diplegic Cerebral Palsy:Va Preliminary Study[J].Neurorehabilitation&Neural Repair, 2007,21(6):475-85.
[18] MCNEE AE,GOUGH M,MORRISSEY MC, et al.Increases in Muscle Volume after Plantarflexor Strength Training in Children with Spastic Cerebral Palsy[J]. Developmental Medicine&Child Neurology, 2009,51(6):429-35.
[19] WILLIAMS S,ELLIOTT CM,VALENTINE J, et al.Combining Strength Training and Botulinum Neurotoxin Intervention in Children with CP: The Impact on Muscle Morphology and Strength[J]. Developmental Medicine and Child Neurology, 2012(54):75-76.
[20] Çağlar OKRR S,Uğur M,ŞENEL K. Effects of Botulinum Toxin A Injection on Ambulation Capacity in Patients with Cerebral Palsy[J]. Developmental Neurorehabilitation, 2019,22(4):288-91.
[21] DAMIANO D,QUINLIVAN J,OWEN B, et al.Spasticity Versus Strength in Cerebral palsy: Relationships Among Involuntary Resistance,Voluntary Torque and Motor Function[J].European Journal of Neurology, 2001(8):40-49.
[22] WILEY ME,DAMIANO DL.Lower-extremity Strength Profiles in Spastic Cerebral Palsy[J]. Developmental Medicine& Child Neurology, 1998,40(2):100-07.
[23] ROSE J,MCGILL KC.The Motor Unit in Cerebral Palsy[J].Developmental Medicine and Child Neurology, 1998,40(4):270-77.
[24] Gastrocnemius muscle-tendon interaction during walking in typically-developing adults and children and in children with spastic cerebral palsy[J]. Journal of biomechanics, 2016,49(14):3194-99.
[25] Gibson J,SMITH K,RENNIE M.Prevention of Disuse Muscle Atrophy by Means of Electrical Stimulation: Maintenance of Protein Synthesis[J]. The Lancet, 1988,332(8614):767-70.
[26] ABRESCH RT,HAN JJ,CARTER GT.Rehabilitation Management of Neuromuscular Disease: the Role of Exercise Training[J].Journal of Clinical Neuromuscular Disease, 2009,11(1):7-21.
