Swimming training combined with fecal microbial transplantation protects motor functions in rats with spinal cord injury by improving the intestinal system

•Combination therapy has gradually become a therapeutic trend, and studies on the intervention program combining fecal microbial transplantation and aerobic exercise are novel.•Fecal microbial transplantation and aerobic exercise can effectively improve intestinal dysfunction after spinal cord injury and further enhance neurological function.•Researchers may be able to use the intestinal system or other organs as intervention targets to achieve repair of spinal cord injury. Spinal cord injury (SCI) leads to severe intestinal dysfunction and decreased motility. There is an interaction between the intestine and the nervous system, intestinal intervention through microbial regulation and exercise is a potential treatment option for spinal cord injury. We investigated the effects of swimming rehabilitation training combined with fecal microbial transplantation on intestinal as well as neurological functions in rats with spinal cord injuries, and explored the potential mechanisms. The animals were randomly divided into five groups: sham-operated control group (Sham), spinal cord injury only group (SCI), swimming training group (Swimming), fecal microbial transplantation group (FMT) and combined interventions group (Combined). Behavioral assessments, pathological and immunological analyses were performed after the interventions. Compared to rats in the spinal cord injury group, rats subjected to swimming training, fecal microbial transplantation and combined interventions group exhibited improved intestinal transit, barrier functions, motility, and motor conduction pathway conductivity(P