Analysis of the influencing factors related to spasticity in patients with spinal cord injuries: a retrospective study

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SETTING: Individuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University. METHODS: Individuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University, were screened for spasticity by using the modified Ashworth spasm scale. A total of 183 individuals diagnosed with SCI were finally included in the study. We collected the individuals’ basic information, including gender, age, disease course, injury segment, American Spinal Injury Association (ASIA) grade, Cause of injury. Univariate and dichotomous logistic regression analysis analyses were used to examine the influencing factors of spasticity in the individuals with SCI. RESULTS: The chi-squared test revealed that the course of the disease ( p= 0.004), the injured segment ( p< 0.001) and the pressure ulcers of the individuals ( p= 0.002) with SCI had statistical significance. A dichotomous logistic regression analysis was performed to analyze the influencing factors of spasticity. the course of the disease, the injured segment and the pressure ulcers of the individuals with SCI were independent influencing factors of spasticity in individuals with SCI, among which the prolongation of the course of the disease (when the course of disease was 3 to 6 months and 6 months or more, the incidence of spasticity was 2.441 times (95% CI, 0.968~6.157) and 5.090 times (95% CI, 1.883~13.76), compared with a disease course of less than 3 months) and the presence of pressure ulcers were independent risk factors (the incidence of spasticity in patients with pressure ulcers was 2.481 times (95% CI, 0.961~6.406) higher than that without pressure ulcers). the low injury segment was a protective factor (the incidence of spasticity in thoracic and lumbar spinal cord injuries was 0.363 times (95% CI, 0.154~0.855) and 0.034 times (95% CI, 0.004~0.268) higher than that in cervical spinal cord injuries). CONCLUSION: In this study, we found that there was no significant correlation between spasticity after SCI and gender, ASIA grade, cause of injury and other factors. However, the prolongation of the course of the disease and the presence of Pressure ulcers were independent risk factors, and the low injury segment was a protective factor. Health sciences/Risk factors Health sciences/Diseases/Neurological disorders/Spinal cord diseases Spasticity correlative factors pressure ulcers Introduction Spasticity is a kind of limb motor dysfunction caused by intermittent or continuous muscle activation, An often used definition of spasticity is a motor disorder characterized by a velocity dependent increase in the tonic stretch reflex with exaggerated tendon jerks [ 1 ] . Spasticity is one of the common complications after spinal cord injury (SCI). Moderate spasticity can have a positive effect; for example, an extensor spasticity of the lower extremity can help individuals carry out posture transfer in their daily life. It can act as a venous muscle pump to promote the circulation of blood in the veins in the lower limbs and prevent the formation of deep vein thrombosis. However, severe spasticity can lead to joint contracture, pain, difficulty in walking and urinary tract infection, and increase the risk of joint dislocation, fracture and heterotopic ossification in SCI individuals, which has a negative impact on the daily life and prognosis of individuals with this type of injury [ 2 ] . At present, relevant literature has analysed the factors that impact SCI that is complicated by urinary tract infection [ 3 ] and neuropathic pain [ 4 ] ; however, no studies have conducted a relevant factor analysis of spasticity after SCI. According to previous studies, spasticity affect 65% of SCI individuals discharged from a community hospital [ 5 ] and create many challenges in their daily lives. The proportion of spasticity in different stages and segments of SCI varies. Thus, this study aimed to identify the epidemiological characteristics of spasticity, determine the protective or risk factors for spasticity after SCI, minimise the impact of spasticity and improve the quality of life of individuals with SCI. Methods Setting and data sources This retrospective study retrospectively analysed 183 individuals with SCI who were hospitalised in the Department of Rehabilitation Medicine of the Affiliated Hospital of Guizhou Medical University from January 2019 to December 2021. The inclusion criteria were in accordance with the diagnostic criteria of SCI based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). The ISNCSCI, also referred to as the ASIA Impairment Scale (AIS), was developed by the American Spinal Injury Association (ASIA). Which level or degree of SCI was confirmed by imaging examination. The following exclusion criteria were applied: the individual had spasticity caused by cervical and lumbar diseases, upper motor neuron diseases, other injuries or diseases. Individuals with serious diseases or tumours of the heart, lung, brain and other important organs were also excluded, as were individuals with incomplete clinical data. This study was approved by the ethics committee of the Affiliated Hospital of Guizhou Medical University (No. 2022 − 435). According to ISNCSCI, SCI is divided into five grades. Grade A refers to a complete injury and Grade B, Grade C, Grade D and Grade E refer to an incomplete injury [ 6 ] . According to the diagnostic criteria for spasticity [ 7 ] based on the modified Ashworth spasm scale, all individuals were divided into spasticity group and normal group. Research methods The gender, age, injury segment, ASIA grade and cause of damage were analysed for 183 individuals with SCI that were included in this study. The presence of complications, such as press ulcer, neuropathic pain and lower extremity deep venous thrombosis, was also analysed. Moreover, the occurrence of these characteristics and the factors influencing spasticity after SCI were evaluated. The collection of all the above data and related evaluations were completed by two senior rehabilitation physicians. Informed consent was obtained from all individuals during the investigation, and complete data were available for all subjects included in this study. Statistical methods All statistical analyses were performed using SPSS version 20.0 software (SPSS Inc., Chicago, IL, USA). All measurement data are expressed by (x̄ ± s). Count data are expressed by percentage (%). The chi-squared test was used for univariate analysis. The variables with statistical significance in the univariate analysis were subjected to dichotomous logistic regression analysis. A p value < 0.05 indicates that the difference was statistically significant. Results General information Of the 183 individuals with SCI included in this study, 141 (77.05%) were male and 42 (22.95%) were female. The average age was 43.51 ± 14.25 years (range: 9–75 years). The main cause of SCI was a fall from a high place (61 cases, 33.33%). Most of the injuries were ASIA Grade A (61 cases, 33.33%), followed by ASIA Grade C (36 cases, 19.68%), ASIA Grade D (30 cases, 16.39%) and ASIA Grade B (28 cases, 15.30%); 28 cases (15.30%) were assigned the cauda equina injury .The cervical segment was the main injury site in 81 cases (44.26%). The disease course was mainly concentrated in the range of 0–3 months (113 cases, 61.75%). In terms of comorbidities, 26 cases (14.21%) were complicated with press ulcer, 77 cases (42.08%) were complicated with neuropathic pain, 60 cases (32.79%) were complicated with venous thrombosis, 93 cases (50.82%) were complicated with anaemia, 95 cases (51.91%) were complicated with hypoalbuminemia, 88 cases (48.09%) were complicated with elevated D-dimer, 59 cases (32.24%) were complicated with urinary tract infection and 32 cases (17.49%) were complicated with hydronephrosis (Table 1 ). Table 1 General Information Variables Number(n) Constituent ratio(%) Variables Number(n) Constituent ratio (%) Gender Pressure ulcer Male 141 77.05 Yes 26 14.21 Female 42 22.95 No 157 85.79 Age(years) Neuropathic pain <30 34 18.58 Yes 77 42.08 [30,60) 125 68.31 No 106 57.92 ≥ 60 24 13.11 Lower extremity venous thrombosis Disease course (months) Yes 60 32.79 <3 113 61.75 No 117 63.93 [3,6) 39 21.31 Uncertain 6 3.28 ≥ 6 31 16.94 Anemia Injury segment Yes 93 50.82 C1-C7 81 44.26 No 90 49.18 T1-T12 52 28.42 D-Dimer L1-L5 50 27.32 Yes 88 48.09 ASIA Grade No 74 40.44 A 61 33.33 Uncertain 21 11.47 B 28 15.30 Hydronephrosis C 36 19.68 Yes 32 17.49 D 30 16.39 No 109 59.56 Cauda equina injury 28 15.30 Uncertain 42 22.95 Cause of injury Hypoproteinemia Traffic accident 32 17.49 Yes 95 51.91 Fall from a high place 61 33.33 No 87 47.54 Hit by heavy objects 33 18.03 Uncertain 1 0.55 Fall down 44 24.05 Urinary tract infection Other 13 7.10 Yes 59 32.24 No 122 66.67 Uncertain 2 1.09 Univariate analysis of spasticity in individuals with SCI In this study, the relevant factors influencing spasticity included: gender, age, course of the disease, injury segment and ASIA grade; the comorbidities and complications included press ulcer, neuropathic pain, deep venous thrombosis of the lower limbs, anaemia, hypoalbuminemia, the presence or absence of D-dimer elevation, urinary tract infection and hydronephrosis. The Chi-square test was performed by measuring the frequency number of each influence factor. The results show that the course of the disease, the injured segment and the press ulcer of the individuals with SCI were statistically significant ( p < 0.01) (Table 2 and Table 3 ). Table 2. Univariate analysis of s pasticity in patients with spinal cord injury Variables Spasticity group Normal group Z/χ 2 P Gender 2.322 0.128 Male 40 101 Female 7 35 Age(years) 0.544 0.762 ＜30 10 24 [30,60) 32 93 ≥60 5 19 Cause of injury 4.643 0.326 Traffic accident 9 23 Fall from a high place 12 49 Hit by heavy Objects 8 25 Fall down 16 28 Other 2 11 ASIA Grade 5.023 0.285 A 17 44 B 4 24 C 13 23 D 8 22 Cauda equina injury 5 23 Injury segment 23.003 <0.001 * C1-C7 35 46 T1-T12 11 41 L1-L5 3 47 Disease course (months) 11.132 0.004 * ＜3 20 93 [3,6) 13 26 6~ 14 17 * p <0.01 Table 3 Effects of comorbidities or complications on spasticity in patients with spinal cord injury Variables Spasticity group(n) Normal group(n) Z/χ 2 P Pressure ulcer 9.389 0.002 * Yes 13 13 No 34 123 Neuropathic pain 2.096 0.148 Yes 24 53 No 23 83 Anemia 0.954 0.329 Yes 21 72 No 26 64 Hypoproteinemia 0.702 0.714 Yes 23 72 No 24 63 Uncertain 0 1 D-Dimer 1.698 0.428 Yes 19 69 No 21 53 Uncertain 7 14 Urinary tract infection 1.618 0.400 Yes 17 42 No 29 93 Uncertain 1 1 Hydronephrosis 0.134 0.935 Yes 8 24 No 29 80 Uncertain 10 32 Lower extremity venous thrombosis 2.780 0.217 Yes 11 49 No 34 83 Uncertain 2 4 * p < 0.01 Logistic regression analysis of the factors influencing spasticity The course of the disease, the injury segment and the press ulcer were screened using univariate analysis and analysed using binary logistic regression. The results show that all three were independent factors influencing spasticity in individuals SCI. the prolongation of the course of the disease and press ulcer were found to be independent risk factors (or > 1) and the low injury segments were found to be protective factors (or < 1) (Table 4 ). Table 4 Logistic regression analysis of the influencing factors of spasticity in patients with spinal cord injury Variables β S.E. Wald χ 2 P OR (95% CI ) Injury segment C1-C7 1.000 T1-T12 -1.014 0.437 5.376 0.020 0.363(0.154 ~ 0.855) L1-L5 -3.378 1.052 10.31 0.001 0.034(0.004 ~ 0.268) Disease course (months) <3 1.000 [3,6) 0.892 0.472 3.574 0.059 2.441(0.968 ~ 6.157) ≥ 6 1.627 0.507 10.287 0.001 5.090(1.883 ~ 13.76) Press ulcer No 1.000 Yes 0.909 0.484 3.527 0.060 2.481(0.961 ~ 6.406) * p < 0.01 Discussion Features of spasticity after SCI The prevalence of SCI is increasing every year. Spasticity caused by SCI seriously affect a individual’s mood, sleep, disease prognosis and quality of life. The mechanism of spasticity is unclear; currently, it is thought to be a complete γ-loop stretch reflex caused by abnormal muscle tone due to the cone system, extrapyramidal system, brainstem reticular formation and cerebellar participation. When the cone system or extrapyramidal system is damaged, excessive γ motor neuron activity occurs and can present as cramps. Studies have suggested that spasticity are caused by changes in the network excitability of interneurons after SCI and the adaptive changes of motor neurons below the injury plane, such as the decrease in the levels of inhibitory neurotransmitter γ-aminobutyric acid (GABA) [ 8 ] , the change in the number of 5-HT receptors [ 9 ] and the decrease in the presynaptic inhibitory activity of Class Ia proprioceptive afferent fibre terminals [ 10 ] . Analysis of the factors related to spasticity Relationship between the disease course and spasticity This study’s findings suggest that the duration of the SCI is one of the risk factors for spasticity(when the course of disease was 3 to 6 months and 6 months or more, the incidence of spasticity was 2.441 times (95% CI, 0.968 ~ 6.157) and 5.090 times (95% CI, 1.883 ~ 13.76), compared with a disease course of less than 3 months), and as the duration is prolonged, the incidence of spasticity increased. Previous studies have shown that the incidence of spasticity gradually increases with the prolongation of the course of SCI [ 11 , 12 ] . Those results are consistent with the present study’s findings. Moreover, relevant animal experiments have explored the relationship between spasticity and the course of disease or the formation of chronic spasticity in individuals with SCI. Kapitza et al. [ 13 ] reached the same conclusion. They performed complete sacral spinal cord transection in rats at the S2 level of the spinal cord, and the rats gradually showed signs of tail spasm one week after surgery; that study also found that the number of inhibitory GABA neurons was significantly reduced one week after injury. Therefore, one of the possible causes of spasticity after SCI could be the main structural changes in the interneuronal circuit connections in the spinal cord below the transection level. Emre et al. [ 14 ] reported that the denervation structure at the spinal cord level restructured and changed the upper and lower conduction fibre bundles, leading to the formation of chronic spasticity in individuals with SCI. At present, it is unclear which neural pathways or substances play a key role in the formation of chronic spasticity. Therefore, researchers should continue to conduct more studies on the relationship between various substances in the spasticity -related pathways and the disease course after SCI, and conduct early interventions of spasticity in high-risk individuals with SCI to prevent limb spasticity from seriously affecting their daily life. Relationship between injury segment and spasticity The protective factor for spasticity increases when the SCI occurs at lower the level of the spinal cord (the incidence of spasticity in thoracic and lumbar spinal cord injuries was 0.363 times (95% CI, 0.154 ~ 0.855) and 0.034 times (95% CI, 0.004 ~ 0.268) higher than that in cervical spinal cord injuries). In the present study, the incidence of spasticity was significantly lower in individuals with a lumbosacral SCI in comparison to individuals with thoracic and cervical SCIs. This conclusion is consistent with the research results of Holtz et al. [ 5 ] . At present, there are few reports on the mechanism between spasticity and injured spinal cord segments after SCI. We hypothesised that the possible reason for spasticity was that the upper motor nerve damage weakened the inhibitory effect on the lower motor neurons. The incidence of spasticity was higher in individuals with a cervical SCI segment than those with a thoracolumbral SCI segment. Thus, the inhibitory effect was more obvious in the cervical SCI individuals, resulting in a higher proportion of spasticity. Some individuals with a high SCI (above C4), especially those with complete SCI, may die due to severe respiratory complications in the process of clinical diagnosis and treatment and may fail to be transferred to a rehabilitation department of a hospital; however, that does not affect the final statistical results of our study. It is worth noting that our study also found that individuals with cervical SCI with the same degree of injury had a higher probability of organ and limb dysfunction due to the higher injury segment, so the prognosis and the ability to function in their daily lives were worse for individuals with cervical SCI than those with an SCI in another segment of the spine. Some individuals with cervical SCI have diaphragmatic and upper limb spasticity, which significantly affects their airway clearance, respiratory function. Therefore, we should pay more attention to the spasticity of individuals with cervical SCI and actively address it to prevent more serious complications from affecting the quality of their daily life. Relationship between pressure ulcers and spasticity Pressure ulcers are one of the common complications in individuals with SCI, especially in individuals with high SCI who are in bed for a prolonged period. In this study, pressure ulcers were an important risk factor for spasticity in individuals with SCIs (the incidence of spasticity in patients with pressure ulcers was 2.481 times (95% CI, 0.961 ~ 6.406) higher than that without pressure ulcers. Previous studies have also shown that the presence of spasticity in the chronic stage of SCI is associated with an increased prevalence of pressure ulcers [ 15 ] . In individuals with SCI, pressure ulcers and spasticity also affect each other. Jaul et al. [ 16 ] found that the damage to skin and muscle soft tissues caused by pressure ulcers results in a series of changes in the neurons innervated by pressure ulcers and promote the occurrence of spasticity. After spasticity occurs, the muscle tension increases in the limbs and the soft tissue of the spasm muscle group and skin cells are damaged, which can promote the reoccurrence of pressure ulcers. Both are common and serious complications after SCI; this not only significantly interferes with the rehabilitation process of individuals with SCI, but also increases the economic burden of the individuals’ families. Therefore, in the early stage of SCI, it is important to pay attention to pressure ulcers that may develop in individuals, increase the nursing care for of individuals with pressure ulcers and, as much as possible, reduce the risk of spasticity caused by those sores in the later stage of SCI. Relationship between age of onset and spasticity Previous studies have shown that in the analysis of related factors of spasticity in individuals with SCI, there is a significant correlation between the age of onset and spasticity; the incidence of spasticity is relatively low in elderly individuals. In the study by Mills et al. [ 17 ] , For every 10 years increase in onset age, the probability of spasticity limiting function at community follow-up decreased by 4%; Field-Fote [ 18 ] and DiPiro [ 12 ] also reached the same conclusion. In their study on post-stroke muscle spasm, Béseler et al. [ 19 ] found that the incidence of spasticity was lower in elderly individuals than younger individuals; the possible reason for this was that the muscle stretch reflex and tension related to spasticity in the elderly were weak, so the incidence of spasticity was lower. It is worth noting that, in the univariate analysis of SCI individuals with spasticity in this study, although there was no statistical difference between the age factor and the occurrence of spasticity(p = 0.762), the probability of spasticity is higher in young individuals with SCI than in elderly individuals. The reason may be that the sample size is too small, which leads to the bias of statistical results. However, the relevance and specific mechanism of this are still unclear. Therefore, this provides a new direction for future research on the factors related to spasticity in SCI individuals. It also suggests that clinicians should pay more attention to the prevention and management of spasticity in young individuals with SCI during diagnosis and treatment. Other factors related to spasticity after SCI Neuropathic pain Neuropathic pain and spasticity may occur together. In this study, the incidence of spasticity was higher in individuals with neuropathic pain (31.17%) than that in individuals without neuropathic pain (21.70%), but the difference was not statistically significant( p = 0.148). A large cross-sectional study conducted by Müller et al. [ 20 ] showed that the probability of chronic pain problems in individuals with spasticity increased by 2.38 times. Heijmans [ 21 ] found that the 5-HT system plays an important role in chronic neuropathic pain, indicating that 5-HT may simultaneously contribute to the occurrence of spasticity and neuropathic pain. However, we also paid attention to the cases in which neuropathic pain was significantly reduced after some individuals were treated with anti-spasticity medications; this indicates that there may be a relationship between them. Lower extremity deep venous thrombosis The results of this study showed that the proportion of individuals without lower limb deep vein thrombosis combined with spasticity was (29.06%), which was relatively higher than that of those with thrombosis (18.33%)( p = 0.217). This conclusion is consistent with the findings of Do et al. [ 22 ] . Gaber [ 23 ] reported that the spasticity of calf muscles can improve the efficiency of calf intramuscular pump and promote the emptying of lower limb venous blood; thus, the probability of individuals with spasticity suffering from deep venous thrombosis of the lower extremities is relatively low. From this point of view, spasticity may be beneficial to individuals. Therefore, in clinical work, the risk of spasticity can also be predicted by colour Doppler ultrasound and coagulation indicators of the deep veins of both lower limbs. Limitations In this study, the proportion of individuals with spasticity after SCI is lower than that reported in previous studies. There may be several reasons for this difference. First, most of the individuals included in the present study were in the acute stage and subacute stage of SCI, of which 83.06% had a disease course of less than 6 months, so the incidence rate of spasticity was low. Second, all the individuals with SCI were treated with manipulation and physical factors while being hospitalised in our department. During hospitalisation, the individuals were actively taught some occupational therapy to prevent spasticity and they were assigned homework. Previous studies have clearly shown that rehabilitation treatment can help improve the spasticity symptoms of individuals with SCI, thus delaying or reducing the occurrence of spasticity [ 24 ] . Third, we use the modified Ashworth evaluation scale to evaluate the degree of spasticity of the individuals in our study. During hospitalisation, some individuals may have some symptoms of spasticity, but they cannot meet the standard of the modified Ashworth evaluation scale to evaluate the spasticity, so the proportion of individuals with spasticity is low. However, this does not affect the judgment of the incidence and the trend of spasticity. Finally, there is a lack of follow-up in community hospitals or in families for discharged individuals in the later period of SCI, which is not conducive to obtaining more comprehensive and detailed data on spasticity after SCI. Conclusions The study’s results show that the course of the disease, the injured segment and the presence of pressure ulcers were all independent factors influencing spasticity in individuals with SCI. The prolongation of the course of the disease and the presence of pressure ulcers were independent risk factors, and the low injury segment was a protective factor. Risk factors that may lead to spasticity, such as individuals with neuropathic pain, should also be actively concerned. Because there are relatively few studies on the factors related to spasticity after SCI, and there are some differences in the findings reported in existing studies, in order to clarify the factors that influence spasticity and optimise the strategy to manage spasticity after SCI, it may be necessary to conduct multi-centre and large-scale clinical studies in the future. Declarations DATA AVAILABILITY The datasets generated and analysed during this study are available from the corresponding author on request. AUTHORS’ CONTRIBUTIONS This study was conceived by SW. NS and LYD prepared the original draft. JW screened qualified subjects and collected the primary data. The funding was provided by SW and LYD. NS finished the statistical analysis. XBW supervised the implement of the current study. SW reviewed and edited the manuscript. The final version of the manuscript was approved by all authors. FUNDING This work was supported by National Natural Science Foundation of China (82060419;82260452),Guizhou Science and Technology Planning Project (Guizhou Science and Technology Cooperation Foundation -ZK[2022] Key 045),Guizhou Science and Technology Planning Project (Guizhou Science and Technology Cooperation Foundation -ZK[2022] General 438) and Science and technology foundation of Guizhou Provincial Health Commission[Grant NO.gzwkj2023-014] ETHICAL APPROVAL This study was approved by the ethics committee of the Affiliated Hospital of Guizhou Medical University (No. 2022-435). Informed written consent was obtained from all individuals. COMPETING INTERESTS The authors declare no competing interests. References Pandyan A, Gregoric M, Barnes M. Spasticity: clinical perceptions, neurological realities and meaningful measurement [J]. Disability and rehabilitation, 2005, 27: 2-6. 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Heijmans L, Mons M, Joosten E A systematic review on descending serotonergic projections and modulation of spinal nociception in chronic neuropathic pain and after spinal cord stimulation [J]. Molecular pain, 2021, 17: 143-151. Do J, Kim d H, Sung D Incidence of deep vein thrombosis after spinal cord injury in Korean individuals at acute rehabilitation unit [J]. Journal of Korean medical science, 2013, 28(9): 1382-1387. Gaber T Significant reduction of the risk of venous thromboembolism in all long-term immobile individuals a few months after the onset of immobility [J]. Medical hypotheses, 2005, 64(6): 1173-1176. Beverungen H, Klaszky S, Klaszky M. Rehabilitation Decreases Spasticity by Restoring Chloride Homeostasis through the Brain-Derived Neurotrophic Factor-KCC2 Pathway after Spinal Cord Injury [J]. Journal of neurotrauma, 2020, 37(6): 846-859. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2373882","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":162592635,"identity":"38f2180b-7eac-43fd-af15-6e9f32cbe669","order_by":0,"name":"Shuang Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtUlEQVRIiWNgGAWjYBACgwMMjA8SKmx4+NkbiNfCbPDgTJqMZM8B4rWwST5sO2xjcMOBWC030h9IJLCd52G4wcD44WMOEVrMbuQYGCTw3OZhnN3ALDlzG3FaGBISJG7zMMscYGPmJU5L+oMDCQbneNiAziNOi/2NBMOGhIQDPDxEa7E888aYIeFAMo8Ez8Fm4vxicDz9+c+f/+zs7Y83H/zwkRgtSICxgTT1o2AUjIJRMApwAwCuATrFTWDW2gAAAABJRU5ErkJggg==","orcid":"","institution":"Affiliated Hospital of Guizhou Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Shuang","middleName":"","lastName":"Wu","suffix":""},{"id":162592636,"identity":"0449c626-8cc5-4e73-880a-f4472fb21735","order_by":1,"name":"Ning Song","email":"","orcid":"","institution":"Affiliated Hospital of Guizhou Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ning","middleName":"","lastName":"Song","suffix":""},{"id":162592637,"identity":"669ba7fa-e92c-4bab-94b5-1082a9c206b8","order_by":2,"name":"Luoyi Deng","email":"","orcid":"","institution":"Affiliated Hospital of Guizhou Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Luoyi","middleName":"","lastName":"Deng","suffix":""},{"id":162592638,"identity":"ed881362-8168-4d55-b5d5-6c5dbbd3cb35","order_by":3,"name":"Jia Wang","email":"","orcid":"","institution":"Affiliated Hospital of Guizhou Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jia","middleName":"","lastName":"Wang","suffix":""},{"id":162592639,"identity":"2e149e80-8398-4c25-8da4-860586300f39","order_by":4,"name":"Xianbin Wang","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xianbin","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2022-12-13 12:16:57","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2373882/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2373882/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":33026838,"identity":"9bf72864-1e5d-4948-9784-8e8b46031551","added_by":"auto","created_at":"2023-02-16 12:14:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":592609,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2373882/v1/654a58fe-d7e0-4436-b1d8-61cb41d043ca.pdf"}],"financialInterests":"","formattedTitle":"Analysis of the influencing factors related to spasticity in patients with spinal cord injuries: a retrospective study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSpasticity is a kind of limb motor dysfunction caused by intermittent or continuous muscle activation, An often used definition of spasticity is a motor disorder characterized by a velocity dependent increase in the tonic stretch reflex with exaggerated tendon jerks \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Spasticity is one of the common complications after spinal cord injury (SCI). Moderate spasticity can have a positive effect; for example, an extensor spasticity of the lower extremity can help individuals carry out posture transfer in their daily life. It can act as a venous muscle pump to promote the circulation of blood in the veins in the lower limbs and prevent the formation of deep vein thrombosis. However, severe spasticity can lead to joint contracture, pain, difficulty in walking and urinary tract infection, and increase the risk of joint dislocation, fracture and heterotopic ossification in SCI individuals, which has a negative impact on the daily life and prognosis of individuals with this type of injury \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. At present, relevant literature has analysed the factors that impact SCI that is complicated by urinary tract infection\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e and neuropathic pain\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e ; however, no studies have conducted a relevant factor analysis of spasticity after SCI. According to previous studies, spasticity affect 65% of SCI individuals discharged from a community hospital \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e and create many challenges in their daily lives. The proportion of spasticity in different stages and segments of SCI varies. Thus, this study aimed to identify the epidemiological characteristics of spasticity, determine the protective or risk factors for spasticity after SCI, minimise the impact of spasticity and improve the quality of life of individuals with SCI.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv class=\"Section2\" id=\"Sec3\"\u003e\n \u003ch2\u003eSetting and data sources\u003c/h2\u003e\n \u003cp\u003eThis retrospective study retrospectively analysed 183 individuals with SCI who were hospitalised in the Department of Rehabilitation Medicine of the Affiliated Hospital of Guizhou Medical University from January 2019 to December 2021. The inclusion criteria were in accordance with the diagnostic criteria of SCI based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). The ISNCSCI, also referred to as the ASIA Impairment Scale (AIS), was developed by the American Spinal Injury Association (ASIA). Which level or degree of SCI was confirmed by imaging examination. The following exclusion criteria were applied: the individual had spasticity caused by cervical and lumbar diseases, upper motor neuron diseases, other injuries or diseases. Individuals with serious diseases or tumours of the heart, lung, brain and other important organs were also excluded, as were individuals with incomplete clinical data. This study was approved by the ethics committee of the Affiliated Hospital of Guizhou Medical University (No. 2022\u0026thinsp;\u0026minus;\u0026thinsp;435).\u003c/p\u003e\n \u003cp\u003eAccording to ISNCSCI, SCI is divided into five grades. Grade A refers to a complete injury and Grade B, Grade C, Grade D and Grade E refer to an incomplete injury\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. According to the diagnostic criteria for spasticity\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e based on the modified Ashworth spasm scale, all individuals were divided into spasticity group and normal group.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec4\"\u003e\n \u003ch2\u003eResearch methods\u003c/h2\u003e\n \u003cp\u003eThe gender, age, injury segment, ASIA grade and cause of damage were analysed for 183 individuals with SCI that were included in this study. The presence of complications, such as press ulcer, neuropathic pain and lower extremity deep venous thrombosis, was also analysed. Moreover, the occurrence of these characteristics and the factors influencing spasticity after SCI were evaluated.\u003c/p\u003e\n \u003cp\u003eThe collection of all the above data and related evaluations were completed by two senior rehabilitation physicians. Informed consent was obtained from all individuals during the investigation, and complete data were available for all subjects included in this study.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec5\"\u003e\n \u003ch2\u003eStatistical methods\u003c/h2\u003e\n \u003cp\u003eAll statistical analyses were performed using SPSS version 20.0 software (SPSS Inc., Chicago, IL, USA). All measurement data are expressed by (x̄ \u0026plusmn;\u0026thinsp;s). Count data are expressed by percentage (%). The chi-squared test was used for univariate analysis. The variables with statistical significance in the univariate analysis were subjected to dichotomous logistic regression analysis. A \u003cem\u003ep\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicates that the difference was statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv class=\"Section2\" id=\"Sec7\"\u003e\n \u003ch2\u003eGeneral information\u003c/h2\u003e\n \u003cp\u003eOf the 183 individuals with SCI included in this study, 141 (77.05%) were male and 42 (22.95%) were female. The average age was 43.51\u0026thinsp;\u0026plusmn;\u0026thinsp;14.25 years (range: 9\u0026ndash;75 years). The main cause of SCI was a fall from a high place (61 cases, 33.33%). Most of the injuries were ASIA Grade A (61 cases, 33.33%), followed by ASIA Grade C (36 cases, 19.68%), ASIA Grade D (30 cases, 16.39%) and ASIA Grade B (28 cases, 15.30%); 28 cases (15.30%) were assigned the \u003cspan class=\"Underline\" name=\"Emphasis\" type=\"Underline\"\u003ecauda equina injury\u003c/span\u003e .The cervical segment was the main injury site in 81 cases (44.26%). The disease course was mainly concentrated in the range of 0\u0026ndash;3 months (113 cases, 61.75%). In terms of comorbidities, 26 cases (14.21%) were complicated with press ulcer, 77 cases (42.08%) were complicated with neuropathic pain, 60 cases (32.79%) were complicated with venous thrombosis, 93 cases (50.82%) were complicated with anaemia, 95 cases (51.91%) were complicated with hypoalbuminemia, 88 cases (48.09%) were complicated with elevated D-dimer, 59 cases (32.24%) were complicated with urinary tract infection and 32 cases (17.49%) were complicated with hydronephrosis (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). \u0026nbsp;\u003c/p\u003e\n \u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eGeneral Information\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003eNumber(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003eConstituent ratio(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003eNumber(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003eConstituent ratio (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003ePressure ulcer\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e77.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e14.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e22.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e85.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeuropathic pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u0026lt;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e18.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e42.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e[30,60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e68.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e57.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e13.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower extremity venous thrombosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease course (months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e32.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e61.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e63.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e[3,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e21.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e3.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e16.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInjury segment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e50.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eC1-C7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e44.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e49.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eT1-T12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e28.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD-Dimer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eL1-L5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e27.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e48.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eASIA Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e40.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e11.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e15.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHydronephrosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e19.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e17.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e16.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e59.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eCauda equina injury\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e15.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e22.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCause of injury\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypoproteinemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eTraffic accident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e17.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e51.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eFall from a high place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e47.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eHit by heavy objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e18.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eFall down\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e24.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrinary tract infection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 17.1913%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 16.6268%;\"\u003e\n \u003cp\u003e7.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e32.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e66.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 18.8995%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 9.5642%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 16.6268%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 28.0872%;\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 9.5642%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" style=\"width: 17.1913%;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec8\"\u003e\n \u003ch2\u003eUnivariate analysis of spasticity in individuals with SCI\u003c/h2\u003e\n \u003cp\u003eIn this study, the relevant factors influencing spasticity included: gender, age, course of the disease, injury segment and ASIA grade; the comorbidities and complications included press ulcer, neuropathic pain, deep venous thrombosis of the lower limbs, anaemia, hypoalbuminemia, the presence or absence of D-dimer elevation, urinary tract infection and hydronephrosis. The Chi-square test was performed by measuring the frequency number of each influence factor. The results show that the course of the disease, the injured segment and the press ulcer of the individuals with SCI were statistically significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01) (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2. Univariate analysis of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003cstrong\u003epasticity\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;in patients with spinal cord injury\u003c/strong\u003e\u003c/p\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpasticity\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003egroup\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eZ/\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e2.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e0.544\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e0.762\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e＜30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e[30,60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u0026ge;60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e19\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCause of injury\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e4.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e0.326\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eTraffic accident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eFall from a high place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e49\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eHit by heavy Objects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eFall down\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eASIA Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e5.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCauda equina injury\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInjury segment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e23.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eC1-C7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eT1-T12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003eL1-L5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease course (months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e11.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e＜3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e[3,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.78481012658228%\"\u003e\n \u003cp\u003e6~\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.050632911392405%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"23.146473779385172%\"\u003e\n \u003cp\u003e17 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.743218806509946%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.2748643761302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cstrong\u003e*\u003cem\u003ep\u003c/em\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003ctable border=\"1\" id=\"Tab3\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eEffects of comorbidities or complications on spasticity in patients with spinal cord injury\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSpasticity\u003c/p\u003e\n \u003cp\u003egroup(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNormal group(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eZ/\u0026chi;\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePressure ulcer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeuropathic pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypoproteinemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.702\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eD-Dimer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.698\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.428\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrinary tract infection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.400\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHydronephrosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.935\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower extremity venous thrombosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUncertain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003ep\u003c/span\u003e\u0026thinsp;\u003cstrong\u003e\u0026lt;\u0026thinsp;0.01\u003c/strong\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec9\"\u003e\n \u003ch2\u003eLogistic regression analysis of the factors influencing spasticity\u003c/h2\u003e\n \u003cp\u003eThe course of the disease, the injury segment and the press ulcer were screened using univariate analysis and analysed using binary logistic regression. The results show that all three were independent factors influencing spasticity in individuals SCI. the prolongation of the course of the disease and press ulcer were found to be independent risk factors (or \u003cem\u003e\u0026gt;\u003c/em\u003e\u0026thinsp;1) and the low injury segments were found to be protective factors (or \u003cem\u003e\u0026lt;\u003c/em\u003e\u0026thinsp;1) (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). \u0026nbsp;\u003c/p\u003e\n \u003ctable border=\"1\" id=\"Tab4\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eLogistic regression analysis of the influencing factors of spasticity in patients with spinal cord injury\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026beta;\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eS.E.\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eWald \u0026chi;\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e(95%\u003cem\u003eCI\u003c/em\u003e)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInjury segment\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eC1-C7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT1-T12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5.376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.363(0.154\u0026thinsp;~\u0026thinsp;0.855)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eL1-L5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-3.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.034(0.004\u0026thinsp;~\u0026thinsp;0.268)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease course (months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[3,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.441(0.968\u0026thinsp;~\u0026thinsp;6.157)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5.090(1.883\u0026thinsp;~\u0026thinsp;13.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePress ulcer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.484\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.481(0.961\u0026thinsp;~\u0026thinsp;6.406)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003ep\u003c/span\u003e\u0026thinsp;\u003cstrong\u003e\u0026lt;\u0026thinsp;0.01\u003c/strong\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFeatures of spasticity after SCI\u003c/h2\u003e \u003cp\u003eThe prevalence of SCI is increasing every year. Spasticity caused by SCI seriously affect a individual\u0026rsquo;s mood, sleep, disease prognosis and quality of life. The mechanism of spasticity is unclear; currently, it is thought to be a complete γ-loop stretch reflex caused by abnormal muscle tone due to the cone system, extrapyramidal system, brainstem reticular formation and cerebellar participation. When the cone system or extrapyramidal system is damaged, excessive γ motor neuron activity occurs and can present as cramps. Studies have suggested that spasticity are caused by changes in the network excitability of interneurons after SCI and the adaptive changes of motor neurons below the injury plane, such as the decrease in the levels of inhibitory neurotransmitter γ-aminobutyric acid (GABA)\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e, the change in the number of 5-HT receptors\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e and the decrease in the presynaptic inhibitory activity of Class Ia proprioceptive afferent fibre terminals\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e .\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eAnalysis of the factors related to spasticity\u003c/h2\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003eRelationship between the disease course and spasticity\u003c/h2\u003e \u003cp\u003eThis study\u0026rsquo;s findings suggest that the duration of the SCI is one of the risk factors for spasticity(when the course of disease was 3 to 6 months and 6 months or more, the incidence of spasticity was 2.441 times (95% CI, 0.968\u0026thinsp;~\u0026thinsp;6.157) and 5.090 times (95% CI, 1.883\u0026thinsp;~\u0026thinsp;13.76), compared with a disease course of less than 3 months), and as the duration is prolonged, the incidence of spasticity increased. Previous studies have shown that the incidence of spasticity gradually increases with the prolongation of the course of SCI\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Those results are consistent with the present study\u0026rsquo;s findings. Moreover, relevant animal experiments have explored the relationship between spasticity and the course of disease or the formation of chronic spasticity in individuals with SCI. Kapitza et al.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e reached the same conclusion. They performed complete sacral spinal cord transection in rats at the S2 level of the spinal cord, and the rats gradually showed signs of tail spasm one week after surgery; that study also found that the number of inhibitory GABA neurons was significantly reduced one week after injury. Therefore, one of the possible causes of spasticity after SCI could be the main structural changes in the interneuronal circuit connections in the spinal cord below the transection level. Emre et al. \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e reported that the denervation structure at the spinal cord level restructured and changed the upper and lower conduction fibre bundles, leading to the formation of chronic spasticity in individuals with SCI.\u003c/p\u003e \u003cp\u003eAt present, it is unclear which neural pathways or substances play a key role in the formation of chronic spasticity. Therefore, researchers should continue to conduct more studies on the relationship between various substances in the spasticity -related pathways and the disease course after SCI, and conduct early interventions of spasticity in high-risk individuals with SCI to prevent limb spasticity from seriously affecting their daily life.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between injury segment and spasticity\u003c/h2\u003e \u003cp\u003eThe protective factor for spasticity increases when the SCI occurs at lower the level of the spinal cord (the incidence of spasticity in thoracic and lumbar spinal cord injuries was 0.363 times (95% CI, 0.154\u0026thinsp;~\u0026thinsp;0.855) and 0.034 times (95% CI, 0.004\u0026thinsp;~\u0026thinsp;0.268) higher than that in cervical spinal cord injuries). In the present study, the incidence of spasticity was significantly lower in individuals with a lumbosacral SCI in comparison to individuals with thoracic and cervical SCIs. This conclusion is consistent with the research results of Holtz et al. \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. At present, there are few reports on the mechanism between spasticity and injured spinal cord segments after SCI. We hypothesised that the possible reason for spasticity was that the upper motor nerve damage weakened the inhibitory effect on the lower motor neurons. The incidence of spasticity was higher in individuals with a cervical SCI segment than those with a thoracolumbral SCI segment. Thus, the inhibitory effect was more obvious in the cervical SCI individuals, resulting in a higher proportion of spasticity. Some individuals with a high SCI (above C4), especially those with complete SCI, may die due to severe respiratory complications in the process of clinical diagnosis and treatment and may fail to be transferred to a rehabilitation department of a hospital; however, that does not affect the final statistical results of our study. It is worth noting that our study also found that individuals with cervical SCI with the same degree of injury had a higher probability of organ and limb dysfunction due to the higher injury segment, so the prognosis and the ability to function in their daily lives were worse for individuals with cervical SCI than those with an SCI in another segment of the spine. Some individuals with cervical SCI have diaphragmatic and upper limb spasticity, which significantly affects their airway clearance, respiratory function. Therefore, we should pay more attention to the spasticity of individuals with cervical SCI and actively address it to prevent more serious complications from affecting the quality of their daily life.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between pressure ulcers and spasticity\u003c/h2\u003e \u003cp\u003ePressure ulcers are one of the common complications in individuals with SCI, especially in individuals with high SCI who are in bed for a prolonged period. In this study, pressure ulcers were an important risk factor for spasticity in individuals with SCIs (the incidence of spasticity in patients with pressure ulcers was 2.481 times (95% CI, 0.961\u0026thinsp;~\u0026thinsp;6.406) higher than that without pressure ulcers. Previous studies have also shown that the presence of spasticity in the chronic stage of SCI is associated with an increased prevalence of pressure ulcers\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. In individuals with SCI, pressure ulcers and spasticity also affect each other. Jaul et al.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e found that the damage to skin and muscle soft tissues caused by pressure ulcers results in a series of changes in the neurons innervated by pressure ulcers and promote the occurrence of spasticity. After spasticity occurs, the muscle tension increases in the limbs and the soft tissue of the spasm muscle group and skin cells are damaged, which can promote the reoccurrence of pressure ulcers. Both are common and serious complications after SCI; this not only significantly interferes with the rehabilitation process of individuals with SCI, but also increases the economic burden of the individuals\u0026rsquo; families. Therefore, in the early stage of SCI, it is important to pay attention to pressure ulcers that may develop in individuals, increase the nursing care for of individuals with pressure ulcers and, as much as possible, reduce the risk of spasticity caused by those sores in the later stage of SCI.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between age of onset and spasticity\u003c/h2\u003e \u003cp\u003ePrevious studies have shown that in the analysis of related factors of spasticity in individuals with SCI, there is a significant correlation between the age of onset and spasticity; the incidence of spasticity is relatively low in elderly individuals. In the study by Mills et al.\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e, For every 10 years increase in onset age, the probability of spasticity limiting function at community follow-up decreased by 4%; Field-Fote\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e and DiPiro\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e also reached the same conclusion. In their study on post-stroke muscle spasm, B\u0026eacute;seler et al. \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e found that the incidence of spasticity was lower in elderly individuals than younger individuals; the possible reason for this was that the muscle stretch reflex and tension related to spasticity in the elderly were weak, so the incidence of spasticity was lower. It is worth noting that, in the univariate analysis of SCI individuals with spasticity in this study, although there was no statistical difference between the age factor and the occurrence of spasticity(p\u0026thinsp;=\u0026thinsp;0.762), the probability of spasticity is higher in young individuals with SCI than in elderly individuals. The reason may be that the sample size is too small, which leads to the bias of statistical results. However, the relevance and specific mechanism of this are still unclear. Therefore, this provides a new direction for future research on the factors related to spasticity in SCI individuals. It also suggests that clinicians should pay more attention to the prevention and management of spasticity in young individuals with SCI during diagnosis and treatment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eOther factors related to spasticity after SCI\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eNeuropathic pain\u003c/strong\u003e \u003cp\u003eNeuropathic pain and spasticity may occur together. In this study, the incidence of spasticity was higher in individuals with neuropathic pain (31.17%) than that in individuals without neuropathic pain (21.70%), but the difference was not statistically significant(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.148). A large cross-sectional study conducted by M\u0026uuml;ller et al.\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e showed that the probability of chronic pain problems in individuals with spasticity increased by 2.38 times. Heijmans\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e found that the 5-HT system plays an important role in chronic neuropathic pain, indicating that 5-HT may simultaneously contribute to the occurrence of spasticity and neuropathic pain. However, we also paid attention to the cases in which neuropathic pain was significantly reduced after some individuals were treated with anti-spasticity medications; this indicates that there may be a relationship between them.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLower extremity deep venous thrombosis\u003c/strong\u003e \u003cp\u003eThe results of this study showed that the proportion of individuals without lower limb deep vein thrombosis combined with spasticity was (29.06%), which was relatively higher than that of those with thrombosis (18.33%)(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.217). This conclusion is consistent with the findings of Do et al.\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. Gaber\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e reported that the spasticity of calf muscles can improve the efficiency of calf intramuscular pump and promote the emptying of lower limb venous blood; thus, the probability of individuals with spasticity suffering from deep venous thrombosis of the lower extremities is relatively low. From this point of view, spasticity may be beneficial to individuals. Therefore, in clinical work, the risk of spasticity can also be predicted by colour Doppler ultrasound and coagulation indicators of the deep veins of both lower limbs.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eIn this study, the proportion of individuals with spasticity after SCI is lower than that reported in previous studies. There may be several reasons for this difference. First, most of the individuals included in the present study were in the acute stage and subacute stage of SCI, of which 83.06% had a disease course of less than 6 months, so the incidence rate of spasticity was low. Second, all the individuals with SCI were treated with manipulation and physical factors while being hospitalised in our department. During hospitalisation, the individuals were actively taught some occupational therapy to prevent spasticity and they were assigned homework. Previous studies have clearly shown that rehabilitation treatment can help improve the spasticity symptoms of individuals with SCI, thus delaying or reducing the occurrence of spasticity\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Third, we use the modified Ashworth evaluation scale to evaluate the degree of spasticity of the individuals in our study. During hospitalisation, some individuals may have some symptoms of spasticity, but they cannot meet the standard of the modified Ashworth evaluation scale to evaluate the spasticity, so the proportion of individuals with spasticity is low. However, this does not affect the judgment of the incidence and the trend of spasticity. Finally, there is a lack of follow-up in community hospitals or in families for discharged individuals in the later period of SCI, which is not conducive to obtaining more comprehensive and detailed data on spasticity after SCI.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study\u0026rsquo;s results show that the course of the disease, the injured segment and the presence of \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003epressure ulcers\u003c/span\u003e were all independent factors influencing spasticity in individuals with SCI. The prolongation of the course of the disease and the presence of pressure ulcers were independent risk factors, and the low injury segment was a protective factor. Risk factors that may lead to spasticity, such as individuals with neuropathic pain, should also be actively concerned. Because there are relatively few studies on the factors related to spasticity after SCI, and there are some differences in the findings reported in existing studies, in order to clarify the factors that influence spasticity and optimise the strategy to manage spasticity after SCI, it may be necessary to conduct multi-centre and large-scale clinical studies in the future.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analysed during this study are available from the corresponding author on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHORS\u0026rsquo; CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conceived by SW. NS and LYD prepared the original draft. JW screened qualified subjects and collected the primary data. The funding was provided by SW and LYD. NS finished the statistical analysis. XBW supervised the implement of the current study. SW reviewed and edited the manuscript. The final version of the manuscript was approved by all authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by National Natural Science Foundation of China (82060419;82260452),Guizhou Science and Technology Planning Project (Guizhou Science and Technology Cooperation Foundation -ZK[2022] Key 045),Guizhou Science and Technology Planning Project (Guizhou Science and Technology Cooperation Foundation -ZK[2022] General 438) and Science and technology foundation of Guizhou Provincial Health Commission[Grant NO.gzwkj2023-014]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eETHICAL APPROVAL\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the ethics committee of the Affiliated Hospital of Guizhou Medical University (No. 2022-435). Informed written consent was obtained from all individuals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePandyan A, Gregoric M, Barnes M. Spasticity: clinical perceptions, neurological realities and meaningful measurement [J]. Disability and rehabilitation, 2005, 27: 2-6.\u003c/li\u003e\n\u003cli\u003eMcKay W, Sweatman W, Field-Fote E The experience of spasticity after spinal cord injury: perceived characteristics and impact on daily life [J]. Spinal cord, 2018, 56(5): 478-486.\u003c/li\u003e\n\u003cli\u003eStampas A, Dominick E, Zhu L Evaluation of functional outcomes in traumatic spinal cord injury with rehabilitation-acquired urinary tract infections: A retrospective study [J]. The journal of spinal cord medicine, 2019, 42(5): 579-585.\u003c/li\u003e\n\u003cli\u003eDeng L, Chen Y, Wang Z. Analysis of the influencing factors related to neuropathic pain in individuals with spinal cord injuries: a retrospective study [J]. British journal of neurosurgery, 2022: 1-6.\u003c/li\u003e\n\u003cli\u003eHoltz K, Lipson R, Noonan V. Prevalence and Effect of Problematic Spasticity After Traumatic Spinal Cord Injury [J]. Archives of physical medicine and rehabilitation, 2017, 98(6): 1132-1138.\u003c/li\u003e\n\u003cli\u003eRupp R, Biering-S\u0026oslash;rensen F, Burns S. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019 [J]. Topics in spinal cord injury rehabilitation, 27(2): 1-22.\u003c/li\u003e\n\u003cli\u003eBaunsgaard C, Nissen U, Christensen K. Modified Ashworth scale and spasm frequency score in spinal cord injury: reliability and correlation [J]. Spinal cord, 2016, 54(9): 702-708.\u003c/li\u003e\n\u003cli\u003eGong C, Zheng X, Guo F. Human spinal GABA neurons alleviate spasticity and improve locomotion in rats with spinal cord injury [J]. Cell reports, 2021, 34(12): 108889.\u003c/li\u003e\n\u003cli\u003eFauss G, Hudson K, Grau J Role of Descending Serotonergic Fibers in the Development of Pathophysiology after Spinal Cord Injury (SCI): Contribution to Chronic Pain, Spasticity, and Autonomic Dysreflexia [J]. Biology, 2022, 11(2).\u003c/li\u003e\n\u003cli\u003eDeForest B, Bohorquez J, Perez M Vibration attenuates spasm-like activity in humans with spinal cord injury [J]. The Journal of physiology, 2020, 598(13): 2703-2717.\u003c/li\u003e\n\u003cli\u003eHitzig S, Campbell K, McGillivray C. Understanding age effects associated with changes in secondary health conditions in a Canadian spinal cord injury cohort [J]. Spinal cord, 2010, 48(4): 330-335.\u003c/li\u003e\n\u003cli\u003eDiPiro N, Li C, Krause J A longitudinal study of self-reported spasticity among individuals with chronic spinal cord injury [J]. Spinal cord, 2018, 56(3): 218-225.\u003c/li\u003e\n\u003cli\u003eKapitza S, Z\u0026ouml;rner B, Weinmann O. Tail spasms in rat spinal cord injury: changes in interneuronal connectivity [J]. Experimental neurology, 2012, 236(1): 179-189.\u003c/li\u003e\n\u003cli\u003eEmre M, Benecke R. Spasticity: the current status of research and treatment [M]. Spasticity : the current status of research and treatment, 1989.\u003c/li\u003e\n\u003cli\u003eRichard-Denis A, Nguyen B, Mac-Thiong J The impact of early spasticity on the intensive functional rehabilitation phase and community reintegration following traumatic spinal cord injury [J]. The journal of spinal cord medicine, 2020, 43(4): 435-443.\u003c/li\u003e\n\u003cli\u003eJaul E, Factor H, Karni S. Spasticity and dementia increase the risk of pressure ulcers [J]. International wound journal, 2019, 16(3): 847-851.\u003c/li\u003e\n\u003cli\u003eMills P, Holtz K, Szefer E. Early predictors of developing problematic spasticity following traumatic spinal cord injury: A prospective cohort study [J]. The journal of spinal cord medicine, 2020, 43(3): 315-330.\u003c/li\u003e\n\u003cli\u003eField-Fote E, Furbish C, Tripp N. Characterizing the Experience of Spasticity after Spinal Cord Injury: A National Survey Project of the Spinal Cord Injury Model Systems Centers [J]. Archives of physical medicine and rehabilitation, 2022, 103(4): 764-772.e762.\u003c/li\u003e\n\u003cli\u003eB\u0026eacute;seler Soto M, Montes Garc\u0026iacute;a J, M\u0026aacute;\u0026ntilde;ez A\u0026ntilde;\u0026oacute;n I [Stroke spasticity: Is age a risk factor? Observational study of spasticity in neurovascular individuals in a retrospective series of two health sites] [J]. Revista espanola de geriatria y gerontologia, 2020, 55(5): 258-265.\u003c/li\u003e\n\u003cli\u003eM\u0026uuml;ller R, Brinkhof M, Arnet U. Prevalence and associated factors of pain in the Swiss spinal cord injury population [J]. Spinal cord, 2017, 55(4): 346-354.\u003c/li\u003e\n\u003cli\u003eHeijmans L, Mons M, Joosten E A systematic review on descending serotonergic projections and modulation of spinal nociception in chronic neuropathic pain and after spinal cord stimulation [J]. Molecular pain, 2021, 17: 143-151.\u003c/li\u003e\n\u003cli\u003eDo J, Kim d H, Sung D Incidence of deep vein thrombosis after spinal cord injury in Korean individuals at acute rehabilitation unit [J]. Journal of Korean medical science, 2013, 28(9): 1382-1387.\u003c/li\u003e\n\u003cli\u003eGaber T Significant reduction of the risk of venous thromboembolism in all long-term immobile individuals a few months after the onset of immobility [J]. Medical hypotheses, 2005, 64(6): 1173-1176.\u003c/li\u003e\n\u003cli\u003eBeverungen H, Klaszky S, Klaszky M. Rehabilitation Decreases Spasticity by Restoring Chloride Homeostasis through the Brain-Derived Neurotrophic Factor-KCC2 Pathway after Spinal Cord Injury [J]. Journal of neurotrauma, 2020, 37(6): 846-859.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Spasticity, correlative factors, pressure ulcers","lastPublishedDoi":"10.21203/rs.3.rs-2373882/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2373882/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eSTUDY DESIGN:\u003c/strong\u003e a retrospective study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOBJECTIVES: \u003c/strong\u003eThe aim of this study was to investigate the related influencing factors of spasticity in\u003cstrong\u003e \u003c/strong\u003eindividuals with spinal cord injury (SCI).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSETTING:\u003c/strong\u003e Individuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMETHODS:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIndividuals diagnosed with SCI between January 2019 and December 2021 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University, were screened for spasticity by using the modified Ashworth spasm scale. A total of 183 individuals diagnosed with SCI were finally included in the study. We collected the individuals’ basic information, including gender, age, disease course, injury segment, American Spinal Injury Association (ASIA) grade, Cause of injury. Univariate and dichotomous logistic regression analysis analyses were used to examine the influencing factors of spasticity in the individuals with SCI.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRESULTS:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe chi-squared test revealed that the course of the disease (\u003cem\u003ep=\u003c/em\u003e0.004), the injured segment (\u003cem\u003ep\u0026lt;\u003c/em\u003e0.001) and the pressure ulcers of the individuals (\u003cem\u003ep=\u003c/em\u003e0.002) with SCI had statistical significance. A dichotomous logistic regression analysis was performed to analyze the influencing factors of spasticity. the course of the disease, the injured segment and the pressure ulcers of the individuals with SCI were independent influencing factors of spasticity in individuals with SCI, among which the prolongation of the course of the disease (when the course of disease was 3 to 6 months and 6 months or more, the incidence of spasticity was 2.441 times (95% CI, 0.968~6.157) and 5.090 times (95% CI, 1.883~13.76), compared with a disease course of less than 3 months) and the presence of pressure ulcers were independent risk factors (the incidence of spasticity in patients with pressure ulcers was 2.481 times \u0026nbsp;(95% CI, 0.961~6.406) higher than that without pressure ulcers). the low injury segment was a protective factor (the incidence of spasticity in thoracic and lumbar spinal cord injuries was 0.363 times (95% CI, 0.154~0.855) and 0.034 times (95% CI, 0.004~0.268) higher than that in cervical spinal cord injuries).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONCLUSION:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, we found that there was no significant correlation between spasticity after SCI and gender, ASIA grade, cause of injury and other factors. However, the prolongation of the course of the disease and the presence of Pressure ulcers were independent risk factors, and the low injury segment was a protective factor.\u003c/p\u003e","manuscriptTitle":"Analysis of the influencing factors related to spasticity in patients with spinal cord injuries: a retrospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-01-03 19:04:06","doi":"10.21203/rs.3.rs-2373882/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6d8059dd-68d9-4f83-9dba-a2e554ebf1b5","owner":[],"postedDate":"January 3rd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":17942190,"name":"Health sciences/Risk factors"},{"id":17942191,"name":"Health sciences/Diseases/Neurological disorders/Spinal cord diseases"}],"tags":[],"updatedAt":"2023-02-16T12:14:06+00:00","versionOfRecord":[],"versionCreatedAt":"2023-01-03 19:04:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2373882","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2373882","identity":"rs-2373882","version":["v1"]},"buildId":"PRX_uewTKcrkEM4liVh3c","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}