Zhao Hong-Bo, Rong Xiang-Jiang, Zhang Qi, Ma Ting-Ting, Yan He, Zhou Tian-Tian, Zhang Yan-Qing
Department of Pediatric Physical Therapy, China Rehabilitation Research Center(Beijing Bo-ai Hospital), Beijing, China.
Department of Capital, University of Physical Education and Sports, Beijing, China.
BMC Pediatr. 2025 Mar 31;25(1):261. doi: 10.1186/s12887-025-05602-y.
This study is to investigate the factors that influence functional autonomy outcomes in children who have undergone rehabilitation for spinal cord injury. The aim is to enhance the clinical guidance provided to inpatients at the China Rehabilitation Research Center, Beijing Bo-ai Hospital. Furthermore, the objective is to optimize rehabilitation interventions and establish a scientific basis.
This study employed a retrospective survey method for data collection and analysis. Descriptive analysis, one-way ANOVA analysis, and Multiple logistic regression analysis were utilized to examine the influencing factors associated with the prognosis of functional independence outcomes in children with SCI. The degree of influence of each independent variable on functional independence outcomes was ultimately determined.
The total score of SCIM-III at admission was 41.48 ± 4.089, and the total score of SCIM-III at discharge was 50.05 ± 25.028, resulting in a significant difference in the total score of SCIM-III was (8.57 ± 7.000, p < 0.001).In one-way ANOVA analysis, Self-care: injury segments, damage plane, ASIA, assistive devices, complications, rehabilitation duration treatment, WISCI-II, UEMS and LEMS, BI, and 6WMD groups were statistically significant (p < 0.001). Respiratory and sphincter management: injury segments, ASIA, complications, injury to recovery time interval, rehabilitation duration treatment, WISCI-II, UEMS and LEMS, BI, and 6WMD groups were statistically significant (p < 0.05). Move: age, injury segments, damage plane, rehabilitation duration treatment, WISCI-II, UEMS and LEMS groups were statistically significant (p < 0.05). SCIM-III total score: age, AISA, assistive devices, injury to recovery time interval, rehabilitation duration treatment were statistically significant (p < 0.05). Multiple logistic regression analysis, revealed that the injury to recovery time interval had a negative correlation with the total difference in SCIM-III scale (t = -9.893, p < 0.001; 95%CI-12.006~-7.780), while the duration of rehabilitation treatment (t = 4.245, p < 0.001, 95%CI 2.636 ~ 5.854) had a positive correlation with different age groups (t = 4.002, p < 0.001, 95%CI 2.421 ~ 5.583).
The shorter the interval between the time of spinal cord injury and the time of intervention for rehabilitation, the more favorable the functional recovery of the children. Children with SCI who were hospitalized for rehabilitation and achieved 3-month daily functional independence scores were more successful. It is recommended that rehabilitation interventions for children with SCI in this institution should be initiated as early as possible and maintained over time. Among the subjects, the prognosis of functional independence was more favorable in the school-age group (6-18y) than in the preschool group (3-6 y).
本研究旨在调查影响脊髓损伤儿童康复后功能自主性结果的因素。目的是加强对北京博爱医院中国康复研究中心住院患者的临床指导。此外,目标是优化康复干预措施并建立科学依据。
本研究采用回顾性调查方法进行数据收集和分析。采用描述性分析、单因素方差分析和多元逻辑回归分析来检查与脊髓损伤儿童功能独立结果预后相关的影响因素。最终确定每个自变量对功能独立结果的影响程度。
入院时SCIM-III总分41.48±4.089,出院时SCIM-III总分50.05±25.028,SCIM-III总分差异有统计学意义(8.57±7.000,p<0.001)。在单因素方差分析中,自我护理方面:损伤节段、损伤平面、ASIA、辅助器具、并发症、康复治疗时长、WISCI-II、UEMS和LEMS、BI以及6WMD组差异有统计学意义(p<0.001)。呼吸和括约肌管理方面:损伤节段、ASIA、并发症、损伤至恢复时间间隔、康复治疗时长、WISCI-II、UEMS和LEMS、BI以及6WMD组差异有统计学意义(p<0.05)。移动方面:年龄、损伤节段、损伤平面、康复治疗时长、WISCI-II、UEMS和LEMS组差异有统计学意义(p<0.05)。SCIM-III总分方面:年龄、AISA、辅助器具、损伤至恢复时间间隔、康复治疗时长差异有统计学意义(p<0.05)。多元逻辑回归分析显示,损伤至恢复时间间隔与SCIM-III量表总分差异呈负相关(t=-9.893,p<0.001;95%CI-12.006-7.780),而康复治疗时长(t=4.245,p<0.001,95%CI 2.6365.854)与不同年龄组呈正相关(t=4.002,p<0.001,95%CI 2.421~5.583)。
脊髓损伤时间与康复干预时间间隔越短,儿童功能恢复越有利。因脊髓损伤住院康复且3个月日常功能独立评分达标的儿童更成功。建议该机构对脊髓损伤儿童的康复干预应尽早开始并持续进行。在研究对象中,学龄组(6 - 18岁)功能独立预后比学龄前组(3 - 6岁)更有利。