目的：情境理論認為環境的改變會影響動作行為，而肉毒桿菌治療對於控制過高的肌肉張力已成為傳統復健治療以外的新選擇。本研究的目的在探討情境與肉毒桿菌治療對腦性麻痺兒童的動作影響。方法：共有17位診斷為腦性麻痺兒童參與本研究。依照顧者意願分兩組，一組為傳統治療組，其個案持續接受復健治療，另一組為肉毒桿菌組，其個案同時接受肉毒桿菌治療以及復健治療。在治療前後，兩組均接受兩種情境（實物與想像兩種情境）的上肢運動學與下肢動力學評估。治療前後施行運動學、動力學與臨床評估。結果：情境效應上，不論哪一組，個案在想像情境下，上肢動作流暢度較高，及有較大的最大瞬時速度。肉毒桿菌效應上，不論哪一種情境，後測時肉毒桿菌組在動作過程中，功能較差的下肢承重百分比明顯增加；在臨床評估粗動作功能中的走路、跑步與跳躍分項中，肉毒桿菌組相較於前測，後測分數有明顯退步的情形。討論：本研究在情境效應的動作表現與先前研究的結果不符合，原因可能與實物情境下活動的限制特性有關；肉毒桿菌效應上，肉毒桿菌組功能較差的下肢承重比例顯著增加，但未能反映在上肢伸臂動作表現上。此結果的臨床意涵為情境與肉毒桿菌注射可改變動作的某些向度，因此可視個案治療的需要給予不同方式的治療，或者合併兩種治療方式。

Context theory posited contextual influences on motor behavior, and Botulinum Toxin (Botox) injection has been applied to treat muscle spasticity for children with cerebral palsy (CP) in rehabilitation. The interplay between Botox injection and contextual influences has not been studied. The purpose of this study was to investigate the influences of context and Botox injection on motor performance for children with CP in forward reaching tasks. Methods: Seventeen children with CP participated in this study and were allocated to different groups by the caregiver's will. The traditional rehabilitation group only received the regular rehabilitation sessions, while the Botox treatment group received the lower limb injection and rehabilitation session. We used clinical measures to evaluate their muscle tone and gross motor function. All participants received two contextual conditions (reality and image) pre- and post-treatment evaluation. Contextual effects were evaluated by kinematic and kinetic analyses, and Botox effects were manifested not only by kinematic and kinetic analyses, but also by clinical assessments. Results: A smoother movement trajectory and a larger peak velocity were found in the imagery-based condition than in the real condition, regardless of groups. There was the enhanced ability of weight bearing at the affected side for the Botox treatment group than for the traditional group, regardless of contextual conditions. Discussion: The findings of this study regarding contextual effects were not consistent with those of previous studies. The reason could be that the task constraints were different from those used in the previous studies. The Botox treatment group improved only in the ability of weight bearing, not in the reaching performance. The treatment program planning may depend on individual needs.