Objective To construct an actor-network for integrating physical activity into rehabilitation services based on the World Health Organization Rehabilitation in Health Service System framework and actor-network theory(ANT). Methods Content analysis was employed using the six building blocks of health service systems as the theoretical frame-work.Actors related to rehabilitation services were extracted and categorized into a rehabilitation actor pool,while a physical activity actor pool was formed based on four major physical activity scenarios.Actors from both pools were integrated,deduplicated and classified to form a final list of integrated actors.Using ANT,the con-struction process of the actor network integrating physical activity into rehabilitation was analyzed through the four stages of translation:problematization,interessment,enrollment and mobilization. Results A dynamic integration network was constructed,comprising human actors(patients,rehabilitation professionals,researchers,sports coaches,government departments,medical institutions,community organizations and industry media,etc.)and non-human actors(assistive devices,sports infrastructure,smart equipment,information sys-tems,online exercise guidance systems,laws and regulations,strategic documents,and exercise prescriptions,etc.).The study identified maximizing rehabilitation outcomes as the mandatory passage point and elaborated on the critical role of government departments as focal actors in coordinating various stakeholders. Conclusion The integration of physical activity into rehabilitation services is a dynamic network constructed by diverse actors through a process of translation.ANT provides an operational theoretical framework for cross-departmen-tal governance of rehabilitation policies in China,promotes the spatial expansion of the rehabilitation field,and drives its transformation toward a networked and ecological system.The government needs to play a leading role in facilitating role reconstruction and synergy among heterogeneous actors in both the sports and rehabilitation sectors through mechanism design,to create a bidirectional empowerment mechanism that fosters mutual prog-ress and ensures the sustainable development of integrated services.
Objective To construct a theoretical framework for rehabilitation fitness and sports services for people with disabilities,analyze the practical challenges facing their development,and propose targeted optimization pathways to im-prove service quality. Methods Using literature review,policy analysis and logical reasoning,this study integrated the six building blocks of the World Health Organization health service system into a theoretical framework for rehabilitation fitness and sports services.From macro system architecture,meso-level element coordination and micro-level implementa-tion,it elucidated the internal operational logic of each component,combined with a systematic analysis ground-ed in China's national context. Results The theoretical framework of rehabilitation fitness and sports services for people with disabilities comprised six key elements:policy and regulation,financial support,human resources,service content,technological support and information monitoring.These elements formed a progressively deepening operational pathway from macro to micro levels,creating a continuous structure of top-level design,institutional coordination and practical imple-mentation.The current services in China still faced structural constraints,including insufficient institutional coor-dination,a single-source funding structure,imbalanced resource allocation,weak professional support,lagging accessibility environments and inadequate digital governance,requiring systematic optimization through targeted interventions. Conclusion Rehabilitation fitness and sports services for people with disabilities should strengthen top-level design and establish a diversified and coordinated policy system,expand funding channels to build a sustainable multi-source financing mechanism,enhance human resource development to improve long-term competency,clarify service processes to increase integration and alignment,advance the development of accessible technologies and expand the application of assistive devices,and build an intelligent regulatory system to leverage digital technolo-gies.
Objective To explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom,motor function,activities of daily living,serum markers,as well as brain functional connectivity(FC)and net-work topological properties in patients with post-stroke depression(PSD). Methods A total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September,2022 to September,2023 were enrolled and randomly divided into control group(n=20)and experimental group(n=20).The control group received cluster scalp acupuncture alone,while the experimental group underwent Taijiquan training in addition,for four weeks.They were assessed with Hamilton Depression Scale-17(HAMD-17),Fugl-Meyer Assessment(FMA)and Barthel Index(BI)before and after treatment,while the serum levels of dopamine(DA),5-hydroxytryptamine(5-HT),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected with enzyme-linked immunosorbent assay.Resting-state functional magnetic resonance imaging(rs-fMRI)was applied to assess brain FC,as well as the global efficiency(Eg)and small-world property(σ)of brain networks. Results The scores of HAMD-17,FMA and BI improved in both groups(t>2.922,P<0.01)after treatment,and im-proved more in the experimental group than in the control group(t>2.517,P<0.05).The serum levels of DA and 5-HT increased in both groups(t>2.637,P<0.05),and increased more in the experimental group(t>2.192,P<0.05).The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment(t>4.059,P<0.001),and they were less than those in the control group(t>2.154,P<0.05).FC between left mid-dle frontal gyrus and right anterior cingulate gyrus,as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment(t>3.867,P<0.001),while Eg and σ increased in both groups(t>2.828,P<0.05),and they were higher in the experimental group(t>2.675,P<0.05). Conclusion Combination of Taijiquan training is more effective on depressive symptoms,motor function and activities of daily living in PSD patients,which may be related to up-regulation of serum DA and 5-HT,reduction of in-flammatory factors,enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.
Objective To investigate the lower limb muscle synergy patterns during jumping in patients after anterior cruciate liga-ment reconstruction(ACLR). Methods From March to November,2022,23 patients after ACLR were enrolled as observation group,and 24 healthy ones matched in height,body mass and exercise level were recruited as control group at Wuhan Sports Universi-ty.Surface electromyography(sEMG)data of lower limb muscles were collected during a single-leg vertical jump task.Non-negative matrix factorization was applied for synergy analysis.The number of synergies,vari-ance accounted for,synergy structure(muscle weight)and activation coefficient were extracted. Results Three types of muscle synergy patterns were identified on the affected side and contralateral side of the observa-tion group,and the control group.For Synergy 1,the weight of biceps femoris was higher on both the affected and contralateral sides than in the control group(P<0.01);the weight of semitendinosus was higher on the af-fected side than on the contralateral side(P<0.05).For Synergy 2,the weight of lateral gastrocnemius and sole-us were higher on both sides of the observation group than in the control group(P<0.05).For Synergy 3,the weight of gluteus maximus was lower on the affected side than on the contralateral side and in the control group(P<0.05);the weight of tibialis anterior was higher on the affected side than on the contralateral side and in the control group(P<0.001);the weight of vastus lateralis was lower on the contralateral side than on the affected side and in the control group(P<0.001).In the observation group,the peak activation time and stop time of Syn-ergy 3 were delayed bilaterally(P<0.05). Conclusion Patients after ACLR exhibit altered structural and temporal characteristics of lower limb muscle synergy dur-ing jump task.The hamstrings show increased participation during the pre-activation phase,and calf muscles un-dertake more stabilizing functions during the landing phase.
Objective To quantitatively evaluate the effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients using electrical impedance tomography(EIT). Methods Thirty-five stroke patients were enrolled at the First Affiliated Hospital of Chongqing Medical University from September,2024 to June,2025,and all received standardized phrenic nerve-abdominal muscle electrical stimula-tion.Percentage of ventilation in gravity-dependent regions of interesting(ROI%),center of ventilation(COV),global inhomogeneity index(GI)and change in end-expiratory lung impedance(ΔEELI)were measured with EIT monitoring before treatment(T0),immediately after treatment(T1),and at five,ten,15,20,25,30,40 and 50 minutes after treatment(T2 to T9). Results There were significant differences in ROI%(F=7.003,P<0.001)and COV(F=5.722,P<0.001)at different time points,both peaking at T1,followed by a downward trend until T5.No significant differences were ob-served in GI(F=1.849,P=0.097)and ΔEELI(F=0.208,P=0.871)across time points;however,GI at T7 was lower than that at T0(P<0.05). Conclusion Phrenic nerve-abdominal muscle electrical stimulation can improve the ventilation ratio in gravity-depen-dent regions and shift the center of ventilation dorsally.The improvement in ventilation distribution generally peaks at the end of treatment and lasts for approximately 20 minutes.
