Application of WeChat App-Based Remote Rehabilitation Training in Patients with Spinal Muscular Atrophy Type II and III

INTERVENTION: Trial Group:WeChat App‐based remote rehabilitation program (including breathing exercises, trunk control training, balance training, and mobility training), performed at home for no less than 5 times per week, each session lasting at least 30 minutes, for 24 weeks, without initiating new physical activities;Control Group:Standard home‐based rehabilitation (home exercise program based on Chinese expert consensus and international guidelines for multidisciplinary management of spinal muscular atrophy, including stretching and relaxation exercises), performed at home for no less than 5 times per week, each session lasting at least 30 minutes, without initiating new physical activities, with one outpatient rehabilitation session per week; CONDITION: Spinal Muscular Atrophy PRIMARY OUTCOME: Hammersmith functional motor scale Expanded; SECONDARY OUTCOME: Pediatric Quality of Life Inventory‐Chinese Version;Functional Independence Measure for Children; INCLUSION CRITERIA: 1. Inclusion Criteria for SMA Type III Participants: All of the following conditions must be met: (1) Genetically confirmed diagnosis of spinal muscular atrophy type III, with homozygous deletion of exon 7 (with or without deletion of exon 8) and three copies of the SMN2 gene; (2) Age between 3 and 17 years (this range is set based on disease subtype characteristics and cognitive capacity considerations); (3) Ability to walk at least 10 meters independently or with orthoses/walking aids; (4) Initiation of nusinersen treatment at the study hospital to ensure standardized follow‐up assessments by the same physical therapy team; (5) Thorough understanding of the trial objectives, procedures, etc., and signed informed consent obtained from the patient or their legal guardian. 2. Inclusion Criteria for SMA Type II Participants: All of the following conditions must be met: (1) Diagnosis of SMA type II confirmed by a neurologist through genetic