Investigation Of Motor Function Recovery And Walking Ability In Children With Spinal Cord Injury

Background:The recovery of motor function and walking ability in children with spinal cord injury was investigated retrospectively.The objective is to provide better suggestions and directions for the formulation of locomotor training program and rehabilitation treatment after discharge of spinal cord injury in children.Objective:1.Subjects:Data of spinal cord injury cases in children under 15 years old from January 2017 to June 2022 were collected.92 patients met the inclusion criteria and 67 were followed up.2.Research contents:(1)The locomotor training project was divided into conventional locomotor training group and conventional locomotor training combined with robot-assisted walking training group.To compare the effect of two locomotor training programs on motor function and walking ability of children with spinal cord injury.(2)Grouping according to whether there is regular locomotor training after discharge.To compare the effect of two locomotor training programs on motor function and walking ability of children with spinal cord injury.(3)To explore the correlation between basic information of spinal cord injury and motor function and walking ability in children.3.Statistical methods:All data were analyzed by SPSS 26.0 software.Count data were statistically described by case number and/or component ratio(n,%),and qualitative data were statistically described by mean ±standard deviation(X±SD).The paired sample t test was used for self before and after comparison.The normal distribution between the two groups was consistent,and independent sample t test was used.For correlation analysis,Pearson analysis was used if the two variables were quantitative data.If there are hierarchical data in the two variables,Kendall analysis method is adopted.Results:1.Conventional locomotor training group and conventional locomotor training combined robot-assisted walking training group:48 cases of conventional locomotor training group,44 cases of conventional locomotor training combined robot-assisted walking training group.There was no significant difference in baseline data between the two groups(p>0.05).(1)Before and after comparison:There were significant differences in total score of UEMS and LEMS,WISCI-Ⅱ Index,10MWT,6MWD,Barthel Index and SCIM-Ⅲ among 92 cases(p<0.001).(2)Comparison between the two groups:There was no significant difference in total score of UEMS and LEMS(p=0.59),WISCI-Ⅱ Index(p=0.21),10MWT had significant difference(p=0.002),6MWD had statistical difference(p<0.001),There was no significant difference Barthel index(p=0.15).There were significant differences in SCIM-Ⅲ(p<0.001).2.Groups with or without conventional locomotor training after discharge:39 cases in the conventional locomotor training group and 28 cases in the non-formal conventional locomotor training after discharge.There was no significant difference in baseline data between the two groups(p>0.05).(1)Before and after comparison:The WISCI-Ⅱ Index had no significant difference(p>0.05),the total score of UEMS and LEMS,10MWT,6MWD,Barthel Index and SCIM-Ⅲ were significant difference(p<0.001).(2)Comparison between the two groups:There were no significant differences in WISCI-Ⅱ Index(p=0.24)and Barthel Index(p=0.15).There were significant differences total score of UEMS and LEMS(p<0.001),10MWT(p<0.001),6MWD(p<0.001)and in SCIM-Ⅲ(p<0.001).3.Correlation analysis between basic data and motor function and walking ability in children with spinal cord injury:(1)There was no significant differences correlation between sex,age,height,weight and ASIA classification,total score of UEMS and LEMS,WISCI-ⅡIndex,10MWT,6MWD,Barthel Index and SCIM-Ⅲ(p>0.05).(2)The cause of injury were significant differences from that of 10MWT(r=0.206,p=0.048)and that of 6MWD(r=0.217,p=0.037).There was no significant difference in association with ASIA classification,UEMS and LEMS total scores,WISCI-Ⅱ Index,Barthel Index and SCIM-Ⅲ(p>0.05).(3)There were significant differences in the correlation between the damaged segment and the total score of UEMS and LEMS,WISCI-Ⅱ Index,10MWT,6MWD and Barthel Index(p<0.05),no significant difference in the correlation with ASIA classification(p>0.05).(4)There were significant differences between ASIA grade and the total score of UEMS and LEMS,WISCIⅡ Index,10MWT,6MWD,Barthel Index and SCIM-Ⅲ(p<0.05).Conclusion:(1)The motor function and walking ability of children with spinal cord injury were significantly improved after locomotor training for 1 to 3 months.(2)The motor function and walking ability of children with spinal cord injury still improved from 3 months of locomotor training to 6 months after discharge.(3)The effect of routine locomotor training combined with assisted robot walking training group on the walking ability of children with spinal cord injury was better than that of routine exercise training group.(4)The walking ability and daily living ability of children with spinal cord injury recovered better after receiving regular sports training after discharge.(5)The cause of injury is correlated with the recovery of walking ability in children with spinal cord injury;The injured segment is correlated with the recovery of motor function and walking ability in children with spinal cord injury.ASIA grading is associated with recovery of motor function and walking ability in children with spinal cord injury.