The study of the effectiveness of botulinum toxin therapy in combination with other methods of rehabilitation of cerebral palsy (CP) remains relevant, as it allows clinicians to significantly expand the scope of rehabilitation opportunities. Our aim was to study the effect of the combined application of botulinum therapy and robotic kinesiotherapy in the complex rehabilitation of children with spastic diplegia on improvement of general motor function. The study involved 162 children with CP (spastic diplegia). The study group (n=82) in complex rehabilitation received robotic kinesiotherapy (with the help of the Lokomat® complex) and intramuscular injection of botulinum toxin type A. In the control group (n=80), children underwent rehabilitative treatment with traditional methods. Motor rehabilitation was evaluated using the Ashworth spasticity scale and Gross Motor Function Measure-88 (GMFM). The inclusion criteria were: CP diagnosis, spastic diplegia; the patients` age should be 4 years and older, the motor development level according to Gross Motor Function Classification System (GMFCS) II and III. The exclusion criteria were: severe concomitant somatic pathology; uncontrolled epileptic seizure; orthopedic surgery; hip joint instability; concomitant diseases with clinical signs of motor damage. BTA injection exclusion criteria were: acute inflammatory conditions, hyperthermia, pathological characteristics of the general analysis of blood and urine, persistent contracture. Statistical analysis of this study results was carried by using IBM SPSS Statistics Professional 21.0. The present study showed a significant improvement in the parameters of general motor development with the combined use of botulinum and robotic walking in the complex rehabilitation of children with spastic diplegia. Thus, the combined use of botulinum therapy and robotic kinesiotherapy in complex rehabilitation can be considered as one of the effective methods of motor rehabilitation with CP. Distribution of patients by age, gender and motor development level according to GMFCS is given in Table 1. In comparing the baseline indicators of the study parameters, no differences between groups were observed (P>0.05). Improvement of spasticity with a transition to an easier form was observed in 30 patients of the study group vs 7 patients in the control group. Here, the number of children with the highest spasticity in the study group decreased from 12 (14.63%) to 1 (1.22%) (P=0.001), and in the control group from 9 (11.25%) to 4 (5.0%) (P=0.146) (Figure 1). In the analysis of GMFM data, the highest results were obtained in the study group, where the average motor development index increased with a difference of 6.42 points (Table 2). In the control group , this indicator increased with a difference of 2.40 points. The most significant progress was noted in patients of the III development level according to Gross Motor Function Classification System (study group, 7.86; control group, 2.42). Table 1. Characteristics of groups Age, years, M±SD 4.84±0.56 4.78±0.61 0.570 Gender: males/ females, n (%) 48/34 (58.54/41.6) 45/35 (56.25/43.75) 0.772 GMFCS II, n (%) 45 (54.88) 39 (48.75) 0.436 GMFCS III, n (%) 37 (45.12) 41 (51.25) MAS, M±SD 2.84 (0.72) 2.66 (0.50) 0.156 GMFCS: Gross Motor Function Classification System; MAS - Modified Ashworth Scale for Grading Spasticity; M - mean; SD - standard deviation. 2,44 3,66 21,95 2,50 3,75 35,37 51,22 35,00 42,5 46,34 23,17 51,25 48,75 14,63 1,22 11,25 5,00 0% 20% 40% 60% 80% 100% pre post pre post study group control group 0 1 2 3 4 Modified Ashworth Score: Levels Before p- value After p- value Difference p- value Study group Control group Study group Control group Study group Control group Mean±SD Mean±SD Mean±SD GMFCS II 81.95±5.68 79.68±7.20 0.183 87.19±5.55 82.07±7.48 0.002 5.24±2.41 2.39±1.26 0.0001 GMFCS III 55.44±7.40 54.95±7.24 0.589 63.31±7.48 57.38±7.38 0.001 7.86±4.01 2.42±1.78 0.0001 GMFCS II & III 69.99±14.76 67.01±14.35 0.171 76.41±13.59 69.41±14.45 0.002 6.42±3.47 2.40±1.54 0.0001 GMFCS: Gross Motor Function Classification System; SD - standard deviation; probability (p) was calculated using the Mann-Whitney U test Table 2. The dynamics of general motor development indicators by GMFM-88 Figure 1. The distribution of spasticity on a Modified Ashworth scale 5,24 7,87 6,42 81,95 55,44 69,99 87,19 63,31 76,41 GMFCS II GMFCS III GMFCS II-III pre post 2,39 2,43 2,4 79,68 54,95 67,01 82,07 57,38 69,41 GMFCS II GMFCS III GMFCS II-III pre post Figure 2. The dynamics of general motor development indicators by GMFM-88 Study group Control group