Spasticity state, translated as pulling. The spastic state is a common symptom of upper motor neuron syndrome (UMNS) and is caused by damage to the proximal anatomical structures of the anterior horn cells of the spinal cord such as the cerebral cortex, brainstem, and descending motor pathways at the level of the spinal cord.The definition of spasticity was described by Lance in 1980: “Spasticity is one of the manifestations of movement disorders belonging to the upper motor neuron syndrome and is characterized by muscle tone in response to muscle detraction reflexes, accompanied by hyperactivity of tendon reflexes due to overexcitation of the detrusor reflex.” Recent studies have concluded that spasticity is a disorder of sensorimotor control due to upper motor neuron injury, a motor dysfunction characterized by velocity-dependent hyperexcitability of the tonic detrusor reflex due to increased excitability of the detrusor reflex. The velocity-dependent spasticity refers to an increase in muscle spasm accompanied by an increase in the speed of muscle stretch. It is characterized by an increase in resistance to external forces that cause movement, an increase with the speed of retraction, and a decrease in the threshold of resistance to external forces that cause velocity and joint angle (direction of joint movement) with an increase in the speed of retraction. Spasticity is not only velocity-dependent but also muscle length-dependent and may be related to reflex arc hypersensitivity and centripetal sensory tracts. Spasticity is difficult to define, the pathophysiology is obscure, and the findings on examination are inconsistent. In terms of TCM understanding, spasticity, which is expressed as “hard” and “strong” in Chinese medicine, is a real evidence and is attributed to the liver meridian. Weakened muscle strength and low muscle tone, which are expressed as “impotence” and “softness” in TCM, are evidence of Qi deficiency and are attributed to the Spleen meridian. This is because the weakening of certain areas, such as the core muscles, can cause spasms to occur especially in the extremities. This association can be understood with reference to the TCM understanding of deficiency causing actuality, and the original deficiency being the symptom of actuality. I. Spasticity manifestations and pros and cons The manifestations of upper motor neuron syndrome (UMNS) include both positive and negative symptoms. Weakness, paralysis and easy fatigue are negative symptoms, while muscle hyperactivity such as spasticity, tardive dyskinesia, hyperreflexia, release of primitive reflexes and dystonia are positive symptoms. The presence of spasticity is a dynamic phenomenon, with hyperreflexia, spread of reflexes to muscles other than the stimulated muscle, coordination disorders, flexor and extensor spasms, increased muscle tone, co-contraction, clonus, and tonic dystonia, as well as slow, labored activity, uncoordinated activity, and increased detrusor reflexes. In addition, there may be inactivity: muscle contractures and stiffness, stiffness of other soft tissues (e.g., skin, blood vessels, etc.), loss of range of motion, and stiffness of joints and joint capsules. Spastic cerebral palsy also shows the characteristics of upper motor neuron syndrome: tendon reflex hyperactivity, clonus, pathological reflexes, synergistic patterns, muscle weakness, loss of selective motor control and loss of manual dexterity. The positive effect of spasticity is demonstrated by the fact that in patients with severe muscle weakness, the increase in muscle tone, especially in the anti-gravity muscles of the trunk and lower limbs, helps the patient to move, stand and walk, making a greater impact on the maintenance of muscle volume and bone density and on proper postural maintenance and motor function. However, the negative effects of spasticity cannot be ignored: increased muscle tone leads to loss of trunk balance and active motor difficulties; abnormal posture, decreased motor load and balance dysfunction due to suboptimal support surfaces triggered by spasticity, and the persistence of spasticity leads to pain, deformation, contracture and dislocation of joints. Spasticity accompanied by pain also affects the patient’s sleep, mood and mental state. The adverse effects of spasticity on children with cerebral palsy are motor difficulties, abnormal postures such as sitting and standing, deformities due to contractures, pressure sores and pain. The discomfort caused by increased muscle tone. The non-amputee child has difficulty maintaining a sitting position due to increased tone in the adductor and cord muscles. He is unable to complete bed-wheelchair transfers, wheelchair-bath transfers. The child requires more effort to complete perineal hygiene and dressing. The bedridden child is likely to encounter difficulty initiating movement, his inability to wear his braces, as well as increased motor energy expenditure, lack of function, increased parental care difficulties, and other adverse factors. Second, the factors associated with the impact of spasticity Spasticity can occur after damage to the central nervous system, but clinically spasticity is most often seen in stroke, spinal cord injury, spinal cord lesions, cerebral palsy and multiple sclerosis. Many factors can cause or exacerbate spasticity, including the body’s own factors, such as fever, stones, urinary tract infections, stress ulcers, ingrown nails, contractures, pressure sores, pain, fatigue, deep vein thrombosis, ectopic ossification, constipation, sepsis, and certain drugs that aggravate spasticity; spasticity is usually significantly reduced when the trigger is removed. It also includes external physical environmental factors and social environmental factors spasm influence, etc. Therefore, it is essential to avoid the appearance and aggravation of spasticity in daily life for patients with central nervous system injury. Although the brain injury in children with spastic cerebral palsy is non-progressive, the peripheral nerve and muscle lesions accompany the growth and development of the child. It has been shown that the increased tension caused by central nerve injury is also associated with changes in the mechanical properties of the muscles, and that prolonged spasticity leads to changes in the properties of nerves, soft tissues and muscles. Experimental studies in animals have shown that loss of muscle tubercle occurs in flexion of the joint, resulting in a decrease in tendon and muscle fiber compliance, as well as a change in muscle tropism, a form of resistance to muscle tension that is dependent on the stiffness of the muscle fibers themselves due to cross-linking of myosin and actin during exercise. This is a form of resistance to stretching that is influenced by the state in which the movement was performed in the past, and can be exacerbated by tropic stiffness and can make spasticity hyperactive. Tactile degeneration changes the sensitivity of the muscles in the shuttle to stretching, and increased stretching of the muscles in the shuttle can contribute to spasticity, creating a vicious circle in which spasticity and muscle tension reinforce each other. Therefore, this vicious circle can be broken by dealing with the muscle tropism and improving the function of the muscle itself. Based on the International Classification of Functioning, Disability and Health (ICF), which is based on a “bio-psycho-social” theoretical model, it is also possible to consider spasticity not only as a result of disease, trauma, or health status, but also as a result of a medium-grade spasticity. The ICF is based on a “biopsychosocial” model, which allows us to consider spasticity not only as a result of disease, trauma, or health status, but also as a social problem caused by damage to the central nervous system, not only as an individual characteristic, but also as a compound state formed by the social environment. The manifestations of spasticity are clearly individualized, such as the patient’s own physiological and psychological state, and are related to environmental factors and the specific task or action performed. Patients with spasticity may experience difficulty in performing a task or action that is dysfunctional at the overall individual level. For these patients, committing to a social environment China may experience to a variety of problems, which is the patient’s social dysfunction, such as family life interpersonal interactions and contacts, access to education and work employment and other major areas of life, the ability to participate in social, community and civic life will be different participation limitations, so understanding the elements that may lead to the occurrence or exacerbation of spasticity in daily life and participation in a life situation is essential. There is also a growing interest in clinical rehabilitation of cerebral palsy in the important role of social-environmental factors in the rehabilitation of patients. Environmental factors include certain assistive tools and techniques, support and assistance from others, and accessibility. An environment with barriers or lack of enabling factors will limit an individual’s performance and worsen spasticity; an environment with facilitating factors will improve performance and reduce spasticity. Based on the theory of opposite innervation, the phenomenon that the antagonist muscle is inhibited once a muscle group is excited, i.e., the motor neurons innervating the muscle are excited by the centripetal fibers emanating from the muscle shuttle, and the motor neurons innervating the antagonist muscle of the muscle are inhibited. Conversely innervation is the ability to selectively make a certain motor pattern, while directing coordinated muscle activity within the central nervous system of excitation and inhibition. One of the representatives is the opposite inhibition by Ia fibers from the muscle spindle, while the non-opposite innervation is represented by the self-inhibition via centripetal Ib fibers due to the stretch stimulation of the Golgi tendon organ at the tendon transition during relative rest. After central nerve injury, good limb position placement should be taken to reduce or keep spasticity from appearing even before myotonia increases, so correct posture position is an important part of treatment of spasticity state, wrong posture can lead to increased spasticity state, pain, and vicious cycle leading to more severe spasticity state. The antagonist muscle activity of the spastic muscles should be strengthened to inhibit spasticity and improve coordination and skill of the active muscles. Movements that hinder coordination and skill, such as excessive speed movements and strengthening of the opposite impedance movements, should be avoided. Use tensioning techniques to relax the spasm. With passive vibration method such as hand and joint, the spastic muscle and antagonist muscle repeatedly contract back and forth alternately, so that the contraction force of antagonist muscle is enhanced to inhibit the spastic impulse, also can be used to inhibit muscle tone by firing method, such as when the muscle tone of lower limb is increased, make toe dorsiflexion can reduce muscle tone, provide the basis for walking function recovery, prevent toe dragging, fall on uneven outdoor road caused by the decrease of foot contouring ability. There are many traditional treatment methods, mainly acupuncture and moxibustion, tui na therapy, in addition to acupuncture point injection, acupuncture point buried thread, cupping, warmth and Chinese herbal soup, etc., which are quite characteristic of Chinese medicine and have certain efficacy in the treatment of pediatric cerebral palsy. Some of them are used clinically, but most of them are applied in an integrated way. Especially, acupuncture and tuina treatment play an irreplaceable role in the rehabilitation of pediatric cerebral palsy in China. 3.1 Acupuncture Acupuncture mainly includes head acupuncture and body acupuncture. In particular, head acupuncture is one of the commonly used treatment methods, and there are different schools of clinical practice. Jiao’s head acupuncture uses the cortical functional localization theory as the main basis for acupuncture points, Tang’s head acupuncture uses the biological holographic theory as its basis for acupuncture points, Fang’s head acupuncture combines the cortical functional localization theory and the biological holographic theory for acupuncture points, and the head acupuncture points of the international standardized protocol are closely related to the meridian points of the head. Although each school has a different basis for acupuncture points, their scope of application is basically the same, especially for brain-derived diseases, which have their unique efficacy. In addition, body acupuncture is also selected on the basis of head acupuncture treatment based on TCM identification and the location and degree of limb disorders. Experimental studies have confirmed that head acupuncture has the effect of improving blood rheology. Cranial Doppler ultrasound testing also confirmed that head acupuncture improves cerebral blood flow in children with cerebral palsy. Acupuncture at Baihui increased the content of arginine pressor (memory-enhancing peptide) in the brain tissue of rats and improved their learning function. Acupuncture of body surface points improves peripheral circulation function, activates sensory function, improves cerebral cortex activity, improves muscle strength, relieves muscle tone, improves body immunity, and enhances physical fitness. 3.2 Tui Na Tui Na therapy has the effect of unblocking meridians and channels, managing tendons and repositioning muscles, soothing tendons and slowing down anxiety, slipping joints and loosening adhesions, which can directly and effectively regulate the functions of muscles and joints in the locomotor system, and is widely used in clinical practice to treat various locomotor system diseases. Due to its painlessness and comfort, it is more widely used in the rehabilitation of children with cerebral palsy. Wang Junying uses holistic tui-na massage treatment on the scalp, trunk and limbs for children with cerebral palsy. To reduce muscle tone and relieve spasticity, gentle and gentle techniques are used; to enhance muscle activity and strength, strong and heavy techniques are applied; spastic type is combined with stretching and joint activities, and strong stimulation is given to the flaccid type and tachycardia type, and massage is performed with gentle to heavy and fast techniques; for different local manifestations, massage techniques such as kneading, holding, rubbing and lifting are used to unblock meridians, activate qi and blood, improve local blood circulation, and moisten tendons and muscles. The treatment was carried out in 159 cases. Among 159 children treated, 21 cases (13.21%) were basically cured, 78 cases (49.06%) were effective, 56 cases (35.22%) were effective, 4 cases (25.2%) were ineffective, and 155 cases were effective, with a total effective rate of 97.48%. Liang Zhu used chiropractic treatment, massage of upper and lower limbs and trunk for children with cerebral palsy. Upper extremity: using the hand to press and knead the shoulder, biceps, triceps and anterior muscle groups, then pinching, holding and kneading the biceps and triceps tendon pieces to rotate the wrist joint. Lower limbs: press and rub the biceps and quadriceps and calf gastrocnemius muscles with hands, then knead, hold and rub the biceps and quadriceps tendons and rotate the ankle joint. Neck weakness: press and knead the great lyric and Fengchi points and the sternocleidomastoid muscle. Lumbar weakness: pressing and rubbing the lumbar region with the small fissure of the hand once a day for 3 months as a course of treatment, and observing 1 to 2 courses of treatment. 7 cases (21,2%) were significantly effective and 19 cases (57,5%) were effective in the 2 courses combined, with a total effective rate of 78,8%. Guo Dongbiao and Liu Maolan used different acupoints for massage treatment on the head and face, upper and lower limbs and trunk of the children, such as cerebral hollow, Fengchi, Tianzhu and Dazhi points on the head and neck; for upper limb paralysis, they could massage the arm, Quchi, Hand Sanli, Neiguan, Waiguan and Hegu points; for lower limb paralysis, they could massage the Huanjiao, Thigh Guan, Chengfu, Yinmen, Yanglingquan, Xiexi and Kunlun points. The results showed that 14 cases were cured, 162 cases were effective, 103 cases were effective, and 71 cases were ineffective, with an overall efficiency of 79,71%. According to Chinese medicine, spasticity belongs to the category of “meridian disease”. Children with spastic cerebral palsy often have movement disorders with limited joint movement, which is very similar to the flexion and extension dysfunction of the meridian tendons. This is very similar to the dysfunction of flexion and extension of the meridian tendon. Many people use the theory of meridian tendon and the meridian tendon stabbing method to deal with spasticity. According to modern neurophysiological research, the combination of TCM massage techniques and modern anatomy makes the manipulation more targeted. The main problem of the upper extremity in children with spastic hemiplegia: the affected hand disorder leads to hating the affected hand or even completely ignoring the existence of the affected limb, resulting in asymmetry of the body in terms of sensation and movement. The child uses only the healthy side, causing a joint reaction leading to increased muscle tension on the affected side and more difficult application. Moreover, this can cause emotional problems and attention deficits. Treatment: Establish movement on both sides, support function of the upper limb on the affected side, grasping ability of the affected hand. Inhibit the posterior gyration of the scapular girdle on the affected side and promote its protrusion to the front. Inhibit flexion inversion of the affected upper extremity, flexion of the elbow joint, inversion of the thumb and flexion of all fingers. Promote extension of the affected limb in all directions. Promotes median pointing of both hands and sensitivity of the palms to tactile stimuli. The neurophysiological basis for the development of tui na techniques is as follows. ①Drawing reflex and tendon reflex: Spasticity is a movement disorder characterized by a speed-dependent increase in muscle tone, accompanied by a hyperactive tendon reflex due to increased excitability of the drawer reflex. It is considered to be part of the upper motor neuron syndrome. Clinical neurophysiological studies have shown that muscle spasm is caused by imbalance in γ-loop control due to pyramidal and extrapyramidal dysfunction, resulting in enhanced muscle detrusor reflexes. Neuroelectromyographic studies tell us that muscle spasms are the result of hyperexcitation of the alpha loop. According to the neurophysiological understanding of the detrusor and tendon reflexes, when the tendon organ is excited, Ib-like fibers are transmitted to the spinal cord, which excite the interneurons and produce an inhibitory effect on the alpha motor neurons, thus allowing the strongly contracted muscles to be diastolic. At the same time, the lateral branches of class Ib fibers can also excite the corresponding antagonist muscles through the interneurons to counteract the over-contracted spastic muscle groups. Opposite innervation: Under normal conditions, when the body performs a movement, the active muscle contracts and sends inhibitory impulses to the antagonist muscles, causing the antagonist muscles to be retarded, and the more the active muscle contracts, the more the antagonist muscles are retarded. According to the principle of opposite innervation, when a muscle is excited, its antagonist muscle will be inhibited. This principle can be applied to excite a muscle to achieve the purpose of relaxing its antagonist muscle. To summarize, we combine the results of modern research on the regulation of muscle tone: using plucking and pointing to act on the tendon of the dominant muscle in spasm to excite the tendon organ, which sends inhibitory impulses through class Ib fibers, thus inhibiting the action of alpha motor neurons in that muscle, so that alpha loop excitation is inhibited and muscle tone is reduced, relieving the dominant spasm. The use of percussion, point pressure and other techniques on the inferior side of the spasm, on the one hand, excite the muscle shuttle, increase the excitability of the alpha circuit, increasing the muscle tone of the inferior side, on the other hand, can also use the opposite innervation, by increasing the excitability of the antagonist muscle, to relax the dominant muscle of the spasm. At the same time, joint squeezing type manipulation and acupuncture point spot pressing are used to unblock the meridians and increase the stimulation of proprioception. The therapist can take the following methods according to the patient’s condition. The first step is to perform gentle kneading and pressing on the dominant side of the spasm, and then increase the strength of flicking and pointing at the joint of the muscle and tendon to relieve the spasm. The second step is to apply percussion, point pressing and flicking techniques on the inferior side of the spasticity to improve the muscle tone as the patient can tolerate. The third step of joint squeezing method and point pressing: the affected side sits with the shoulder joint abducted 45 degrees, the elbow joint extended, the wrist joint flexed, and the fingers straightened, so that the weight load is on the affected upper limb, and the squeezing method of the shoulder, elbow, and wrist joints is carried out one after another, together with point pressing on the shoulder, Quchi, Yangchi, and Hegu points, each point point pressing for about 15s. Shi Wei et al. combined traditional pediatric massage techniques in Chinese medicine with foreign neurodevelopmental therapies to design Based on the theory of motor development, this method uses the pushing, pressing, kneading, pressing, wrenching and shaking techniques in TCM pediatric massage to stimulate the child according to the site and type of paralysis, regulate the state of the child’s muscles and the alignment of the skeletal joints, use the techniques to achieve sensory input such as tactile, motor and vestibular sensations, and increase the child’s sensory experience in these areas, and at the same time draw on foreign The main methods in neurodevelopmental therapy for cerebral palsy are to continuously change the position and posture of the child during the operation, correct abnormal postures, prevent the creation and aggravation of deformities, and promote the creation of normal postures that conform to the laws of motor development, thus improving the level of gross motor development of the child. The results show that the motor development massage method has significant efficacy in treating pediatric cerebral palsy. Throughout the above, the rehabilitation effect of traditional rehabilitation treatment for children with spastic cerebral palsy is better than that of modern medical rehabilitation alone. Traditional medical rehabilitation complements the deficiencies of modern rehabilitation, plays an important role in enhancing the physical fitness of the children, promoting growth and development, reducing the occurrence of other comorbidities, and provides new ideas and references for the treatment of cerebral palsy. By stimulating the nervous system through acupuncture, the nerve conduction pathway is facilitated through a large number of times of information stimulation, which not only accelerates the repair and development of brain cells, but also inhibits abnormal postural reflexes and promotes the development of normal movement. Chinese medicine’s evidence-based treatment nourishes liver yin to soften the meridians and channels, tonifies the kidneys and strengthens the spleen to strengthen the muscles and bones, and achieves a balance of yin and yang by adjusting the body’s qi and blood functions. Tui-na massage techniques in TCM, unlike rehabilitation training, complement the training and play a good synergistic role, playing a very important role in the recovery of motor balance function.