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.
Objective To construct a prediction model for high responsiveness to short-term aerobic training in patients with Parkin-son's disease(PD)based on dual-task gait assessment,and to provide evidence for identifying individuals who are most likely to benefit from such interventions. Methods A total of 42 patients with PD who visited the outpatient clinic of Tianjin Huanhu Hospital between August 29,2023 and December 19,2024 were enrolled.All participants completed a 4-week home-based aerobic cycling training program and underwent dual-task gait assessments pre-and post-training.Patients were classified into high-response group(n=12)and low-response group(n=30)according to whether the improvement in gait speed reached the minimal clinically important difference of 0.1 m/s.The clinical validity of this grouping was verified by comparing differences in cardiopulmonary exercise testing parameters and dual-task gait indicators between the two groups pre-and post-training.Based on baseline characteristics,Firth's penalized maximum like-lihood logistic regression was applied to construct a predictive model for high responsiveness,and the discrimina-tive performance of the model was assessed preliminarily. Results The high-response group showed significantly greater improvement in gait speed,step length,cadence and the anaerobic threshold to maximal oxygen uptake ratio after training compared with the low-response group(P<0.05),confirming the clinical validity of the grouping.The baseline anaerobic threshold to maximal oxygen up-take ratio(OR=3.348),body mass index(OR=2.229)and age(OR=0.428)demonstrated certain discrimina-tive ability in the present sample.The area under the receiver operating characteristic curve was 0.831,with an overall prediction accuracy of 81.0%,specificity of 83.3%and sensitivity of 75.0%.Robustness of the model was confirmed via internal validation using the Bootstrap method,which suggested that the results were informative,but further validation was still required. Conclusion The anaerobic threshold/maximal oxygen uptake ratio,body mass index and age may predict the response to short-term aerobic training in patients with PD.
Objective To develop a novel precision rehabilitation service model for structural problems in rural rehabilitation servic-es for persons with disabilities in China,such as shortages of professional resources,imprecise assessment and lack of service continuity,guided by International Classification of Functioning,Disability and Health(ICF)and supported by digital technologies. Methods Using ICF as an analytical tool and rural disability rehabilitation services as the application scenario,this study adopted a problem-oriented approach focused on current service challenges.Through literature review,situation analysis and strategy exploration,elements of body functions and structures,activities and participation,environ-mental factors,and digital technologies were organically integrated to form systematic solutions. Results A precision rehabilitation service model developed for rural persons with disabilities was constructed based on ICF and integrated with digital technologies such as the Internet of Things,big data and telerehabilitation.The model encompassed three dimensions:precise assessment of body functions,precise matching of intervention modalities and precise adjustment of environmental factors.An implementation pathway for digital technology-empowered precision rehabilitation in rural areas was proposed. Conclusion The digitally empowered precision rehabilitation service model based on ICF is helpful for addressing the challenges of equity and precision in rural rehabilitation services in China,promoting access fairer,more accessi-ble and systematically continuous rehabilitation services.
Objective To systematically evaluate the effect of intermittent theta burst stimulation(iTBS)on lower extremity motor function and balance function in patients with stroke. Methods A systematic literature search was conducted in the Cochrane Library,Embase,PubMed,Web of Science,CNKI,SinoMed,Wanfang data and VIP from inception to February 19,2025.Randomized controlled trials com-paring iTBS with conventional rehabilitation or sham iTBS in patients with post-stroke lower extremity motor and balance dysfunction were included.The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool.Meta-analysis was performed using RevMan 5.4 and Stata 14.0. Results A total of 16 articles involving 647 patients were included.Meta-analysis showed that iTBS improved the Fugl-Meyer Assessment-Lower Extremities score(MD=2.58,95％CI 1.61 to 3.55,P<0.001),Berg Balance Scale score(MD=4.11,95％CI 2.43 to 5.79,P<0.001),Barthel Index score(MD=4.95,95％CI 0.97 to 8.92,P=0.010)and motor-evoked potential(MEP)latency(MD=-1.42,95％CI-2.54 to-0.30,P=0.010).Subgroup analyses suggested that at subacute stage,cerebellar iTBS,more than ten treatment sessions,and 1 200 pulses per day may be more effective. Conclusion iTBS may improve lower extremity motor function and activities of daily living in patients with stroke,and shorten MEP latency,and it may also confer potential benefits in improving balance function in these patients.
Objective To investigate the effect of cerebellar intermittent theta-burst stimulation(iTBS)on postural control and fall risk in stroke patients. Methods From October,2024 to August,2025,45 stroke patients were recruited from Huadong Hospital Affiliated to Fu-dan University.They were randomly divided into control group(n=15),group A(n=15)and group B(n=15).All the groups received conventional medication and rehabilitation.Group A was additionally administered iTBS over the ipsilesional primary motor cortex(M1),while group B received iTBS over the contralesional cerebel-lum,for three weeks.Before and after intervention,postural stability indexes(eyes open/closed),limits of stabili-ty,directional control score and reaction time were measured using Biodex Balance System,and they were as-sessed with Berg Balance Scale(BBS),Timed Up&Go Test(TUGT)and 10-meter walk test(10MWT). Results After intervention,significant group-time interaction effects were observed for eyes open/closed postural stabili-ty indexes,limits of stability,directional control score,reaction time,BBS score,TUGT and 10MWT(F>23.487,P<0.001).All the groups improved in all the indexes after intervention(P<0.01).The eyes open/closed postural stability indexes,limits of stability,directional control score and reaction time were the best in group B,followed by group A,and the worst in the control group(P<0.05),while BBS,TUGT and 10MWT were better in groups A and B than in the control group(P<0.05). Conclusion Cerebellar iTBS can effectively improve postural control disorders and reduce fall risk in stroke patients,and may be superior to M1 iTBS.
Objective To systematically evaluate the effect of exercise intervention on multidimensional health outcomes in adults with Down syndrome,and to explore the moderating effects of different exercise components on intervention out-comes. Methods A computerized search was conducted in CNKI,Wanfang data,VIP,CBM,PubMed,Web of Science,Co-chrane Library and Embase from inception to March 10,2026.Literatures were screened followed the PICO framework.Study quality was assessed using the Cochrane Risk of Bias Tool.Statistical analyses and publication bias tests were performed using Stata 18.0 and RevMan 5.4. Results Twelve articles comprising 14 studies and 397 participants(157 in the control group and 240 in the intervention group)were included.Meta-analysis revealed that,compared with the control group,exercise intervention could improve waist circumference,absolute peak oxygen uptake,minute ventilation,maximal heart rate,handgrip strength,standing long jump,sit-and-reach,sit-ups,8-foot up-and-go test,30-second chair stand test,6-minute walk distance,balance performance,tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)in adults with Down syndrome(P<0.05).Subgroup analyses indicated that,reductions in waist circumference were relatively greater with aerobic exercise programs of≥60 minutes per session,three sessions per week and≥10 weeks;im-provements in maximal heart rate were relatively greater with aerobic exercise programs of<40 minutes per ses-sion,three sessions per week and nine to twelve weeks;enhancements in handgrip strength were relatively great-er with combined exercise programs of 40 to 60 minutes per session,three sessions per week,and nine to twelve weeks;improvements in 6-minute walk distance were relatively greater with aerobic exercise programs of<40 minutes per session,three sessions per week and nine to twelve weeks. Conclusion Exercise intervention can safely and effectively improve indicators related to body composition,cardiorespi-ratory fitness,motor function and inflammatory status in adults with Down syndrome.Specific exercise types and dose parameters yield superior effects for different health outcomes.
Objective To investigate the effect of repetitive peripheral magnetic stimulation(rPMS)combined with upper limb intel-ligent robotic training on muscle tension,motor function and cortical excitability in children with unilateral spas-tic cerebral palsy(USCP). Methods From March,2023 to December,2024,90 children with USCP admitted to Children's Hospital of Soochow University were selected and randomly divided into control group(n=30),rPMS group(n=30)and combined group(n=30).The control group received conventional occupational therapy.The rPMS group received rPMS intervention followed by conventional occupational therapy.The combined group received rPMS followed by up-per limb intelligent robot training,for four weeks.Before and after treatment,muscle tension of biceps brachii was assessed using the modified Ashworth Scale(MAS);upper limb motor function was evaluated using the Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and upper limb intelligent parameters;and cortical excit-ability was measured using transcranial magnetic stimulation(TMS),including resting motor threshold(RMT)and motor-evoked potential(MEP)amplitude of the affected hemisphere. Results After treatment,MAS grades improved in all groups(|Z|>3.523,P<0.001),and the improvement in the com-bined group was superior to that in the control group(P<0.05).Significant intra-group(F>65.21,P<0.001),inter-group(F>17.94,P<0.001)and interaction effects(F>5.36,P<0.01)were observed in FMA-UE scores,upper limb intelligent parameters and TMS parameters.Post Hoc analysis showed that the combined group dem-onstrated significantly greater improvements in FMA-UE scores,upper limb intelligent parameters,and TMS pa-rameters compared with both the control and rPMS groups(all P<0.01).Except for FMA-UE scores,the rPMS group showed significantly greater improvements than the control group in upper limb intelligent parameters(me-chanical feedback,trajectory,and range of motion)and TMS parameters(RMT and MEP amplitude)(P<0.05). Conclusion rPMS combined with upper limb intelligent robotic training can reduce upper limb muscle tension,improve motor function,and enhance cortical excitability in children with USCP.
Objective To evaluate the effect of neuromuscular electrical stimulation(NMES)on pain,quadriceps strength and motor function of patients after total knee arthroplasty(TKA). Methods The databases of CNKI,Wanfang data,VIP,PubMed,Embase,Cochrane,Web of Science and Scopus were re-trieved from inception to April,2025.Randomized controlled trials(RCT)related to the intervention of NMES after TKA were collected.The quality of the included literature was evaluated using the Cochrane Risk of Bias Assessment Tool and the Physical Therapy Evidence Database(PEDro)scale.Meta-analysis was performed with RevMan 5.4. Results A total of twelve RCT were included,involving 772 subjects.The PEDro scale score ranged from four to seven.NMES improved postoperative quadriceps muscle strength(SMD=0.61,95％CI 0.34 to 0.88,P<0.001)and knee flexion range of motion(SMD=1.35,95％CI 0.30 to 2.41,P=0.010),and reduced the Timed Up and Go Test(TUGT)time(SMD=-0.86,95％CI-1.45 to-0.26,P=0.005).Compared with the control group,the in-tervention group achieved better outcomes in the 2-Minute Walk Test(2MWT)(SMD=19.44,95％CI 10.44 to 30.43,P<0.001),3-Minute Walk Test(SMD=23.57,95％CI 14.77 to 32.36,P<0.001),6-Minute Walk Test(SMD=42.29,95％CI 9.71 to 74.86,P=0.010),Western Ontario and McMaster Universities Osteoarthritis In-dex(WOMAC)(SMD=-0.52,95％CI-1.00 to-0.04,P=0.040),as well as the Physical Component Summary(PCS)(SMD=2.90,95％CI 0.73 to 5.06,P=0.009)and Mental Component Summary(MCS)(SMD=2.84,95％CI 1.40 to 4.28,P=0.040)of the 36-Item Short Form Health Survey(SF-36).Subgroup analysis demonstrat-ed that two to four weeks after surgery,NMES enhanced patients'quadriceps muscle strength(SMD=0.90,95％CI 0.58 to 1.21,P<0.001),shortened TUGT time(SMD=-1.28,95％CI-2.57 to-0.02,P<0.05)and in-creased walking distance in 2MWT(SMD=20.43,95％CI 10.44 to 30.43,P<0.001).For patients followed up for two to three months,NMES yielded improvements in WOMAC scores(SMD=-0.44,95％CI-0.79 to-0.09,P=0.010)and SF-36 MCS scores(SMD=4.17,95％CI 2.43 to 5.91,P<0.001). Conclusion NMES can significantly improve the quadriceps strength and walking ability of the TKA patients two to four weeks after surgery,and enhance the quality of life of patients two to three months after surgery.
Objective To explore the diagnostic value of resting-state functional magnetic resonance imaging(rs-fMRI)for mild cognitive impairment(MCI)stage of Alzheimer's disease(AD),and to investigate the changes in brain functional connectivity in default mode network(DMN)and medial temporal lobe(MTL)regions. Methods Literatures were retrieved from multiple databases including CNKI,PubMed,Medline,and Embase,etc.from January,2020 to October,2025,investigating the changes in functional connectivity of DMN and MTL in pa-tients with MCI compared to health control(HC)using rs-fMRI.Two researchers independently screened and ex-tracted the literatures and methodological quality was assessed using QUADAS-2.Review Manager 5.4 was used to perform a meta-analysis of neuroimaging indicators in MCI patients and HC subjects.Stata and SDM were uti-lized to summarize diagnostic efficacy and brain functional connectivity,calculating the over all sensitivity,speci-ficity and summary receiver operating characteristic-area under the curve(SROC-AUC).Deeks funnel plots were drawn,literature weights were analyzed,and subgroup analyses were conducted. Results A total of ten literatures were ultimately included,involving 1 010 patients with MCI and 1 714 HC subjects.MCI patients showed decreased or abnormal blood oxygen level dependence signals in DMN,focusing on bilater-al medial prefrontal cortex(mPFC)and posterior cingulate cortex.The SROC-AUC was 0.91.In MTL,there was a characteristic decrease of spontaneous neural functional connectivities between the hippocampus and other re-gions,reflecting the obstruction of information transmission from episodic memory to the central nodes.Abnor-mal functional connectivity in DMN and MTL resulted in compensatory resting-state functional connectivity en-hancement in other subnetworks or local functional connections,such as frontoparietal network and the hippo-campal-parietal network.Abnormal activation of mPFC suggested atrophy of the hippocampus or abnormal brain function.The decline in functional connectivity between DMN and MTL indicated impairment of memory and in-formation processing in the early stage. Conclusion The early functional decoupling between DMN and MTL is a crucial neural mechanism at the MCI stage of AD,providing important neuroimaging evidence for the early diagnosis of AD.
Objective To explore ethical dilemmas in amputation treatment, focusing on patient autonomy, informed consent and decision-making interaction between family members and medical teams, to provide references for clinical ethical decision-making and rehabilitation practice. Methods The decision-making process of amputation was analyzed from three dimensions, including patient autonomy, informed consent and shared decision-making of families and medical teams, in light of ethical principles such as non-maleficence, beneficence and justice. Results Ethical decision-making in amputation was based on adequate informed consent of patients and their families. Medical teams made decisions on the premise of respecting patients' true will. Postoperative psychological support and social security system played a vital role in patients' rehabilitation, and national policy support was indispensable. Conclusion Ethical decision-making for amputation should balance the responsibilities of medical teams and family participation on the basis of respecting patient autonomy and ensuring informed consent. Sound postoperative psychological support and social security system are essential for patients' comprehensive rehabilitation, which should be fully considered in clinical ethical practice.
Objective To explore the effect of the medical-community linkage model on activities of daily living,psychological sta-tus and motor function of stroke patients in the community. Methods A total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District,Beijing,from January,2024 to August,2025 were enrolled and randomly divided into control group(n=30)and intervention group(n=30).The control group received routine medicine,dietary care and re-habilitation management,while the intervention group underwent rehabilitation with the medical-community linkage model,for twelve weeks.They were assessed with modified Barthel Index(MBI),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Fugl-Meyer Assessment(FMA)before and after inter-vention. Results After intervention,the MBI,HAMA,HAMD and FMA scores of patients improved in both groups(|t|>5.599,P<0.001),and improved more in the intervention group than in the control group(P<0.05),except MBI.The HAMA and HAMD scores of family members decreased in both groups(|t|>10.333,P<0.001),and decreased more in the intervention group than in the control group(t>5.681,P<0.001). Conclusion The medical-community linkage model can further improve the motor function of stroke patients in commu-nity,as well as the psychological status of both patients and their family members.
Objective To explore effect of the ankle soft robotic exosuits (ASRE) on gait function in stroke patients. Methods Databases including PubMed, Embase, Scopus, Web of Science, CNKI, Wanfang and VIP were searched for researches evaluating the impact of ASRE on gait function in stroke patients with hemiplegia, covering the period from January 1st, 2020 to May 1st, 2025. The PEDro scale and the Risk of Bias in Non-randomized Studies of In terventions tool were used to assess the quality of the included researches, and data were extracted for a scoping review. Results A total of twelve researches were finally included, consisting of three randomized controlled trials (RCT), three cross-over controlled trials and six pre-post controlled trials, which came from three countries of China, the United States and South Korea, involving 256 patients. The three RCT were rated as high-quality, while the remaining researches were presented moderate to serious risk of bias. Five researches employed a single-session intervention; and seven used multiple-session intervention, with 30 to 60 minutes a session, two to five sessions a week, for five to 20 sessions. ASRE was effective on walking speed, walking distance, propulsive force of the hemiplegic side, gait parameters and spatiotemporal symmetry, joint range of motion, as well as the scores of scales related to lower limb motor function, balance and gait, with favorable safety and reliability. Conclusion ASRE may improve the gait function in stroke patients.
Objective To systematically investigate the discrepancies between employment preferences and actual job placements among postgraduate students in rehabilitation medicine,explore the influencing factors,and elucidate the under-lying mechanisms of their employment decisions. Methods A cross-sectional questionnaire survey was conducted among 100 full-time postgraduate students who had graduated from Capital Medical University School of Rehabilitation in the past six years.A self-designed ques-tionnaire was used to collect information on personal background,self-assessed competencies,employment pref-erences,and actual job placements.Logistic regression models were employed to analyze the factors influencing employment preferences and actual job placements,respectively. Results Employment preferences among rehabilitation medicine postgraduates were highly concentrated on large tertia-ry hospitals(79.0%),yet the actual placement rate(61.0%)showed a significant gap.Preference for tertiary hos-pitals showed no significant association with individual factors such as gender,degree type or self-assessed com-petencies(P>0.05).Univariate analysis revealed that those who entered tertiary hospitals scored significantly higher in self-assessed clinical skills,research ability,communication and coordination,and resource integration(|t|>3.661,P<0.001),and demonstrated clearer career planning(P=0.012).Multivariate logistic regression analysis did not identify any independent predictors of actual employment within the context of this study sample(P>0.05). Conclusion Employment among rehabilitation medicine postgraduates is characterized by highly homogeneous prefer-ences coexisting with complexity of factors influencing actual employment.It is recommended to optimize the training system,deepen personalized career education,and establish diversified employment guidance mecha-nisms to promote rational talent flow and facilitate the balanced development of the rehabilitation medical ser-vice system.
Objective To observe the effect of functional pelvic floor muscle training on pelvic floor muscle function,incontinence symptoms and quality of life in female patients with stress urinary incontinence(SUI). Methods From February,2024 to July,2025,40 female patients with SUI were recruited from Beijing Bo'ai Hospital and advertisements.They were randomly divided into control group(n=20)and experimental group(n=20).The control group received conventional pelvic floor muscle contraction and relaxation training,and the experi-mental group received functional pelvic floor muscle contraction and relaxation training,for eight weeks.The da-ta of pelvic floor muscle strength,pelvic floor muscle surface electromyography(sEMG),1-hour urine pad test and Incontinence Quality of Life questionnaire(I-QOL)were collected before and after training.The compliance rate was counted after training. Results One case dropped down in the control group and three cases dropped down in the experimental group.After treatment,the pelvic floor muscle strength increased in both groups(|Z|>3.317,P<0.01),the pre-resting aver-age value,sustained contraction average value and durable contraction average value of sEMG improved in the control group(|t|>2.731,P<0.05),the mass of 1-hour urine pad significantly reduced(t>9.215,P<0.001)and the I-QOL score significantly increased(|t|>13.229,P<0.001)in both groups;compared with the control group,the pelvic floor muscle strength significantly increased(Z=-2.281,P=0.023),the mass of 1-hour urine pad significantly reduced(t=4.215,P<0.001),the I-QOL score significantly increased(t=-4.501,P<0.001),and the compliance rate significantly increased(Z=-2.798,P<0.01)in the experimental group. Conclusion Functional pelvic floor muscle training can significantly improve pelvic floor muscle strength,incontinence symptoms and quality of life in female patients with SUI.
Objective To explore the effect of blood flow restriction training(BFRT)under different intensities combined with low-intensity resistance training(LIRT)on motor function in stroke patients with frailty. Methods From August,2024 to August,2025,200 elderly ischemic stroke patients with frailty from Affiliated Hospital,North China University of Science and Technology were randomized into control group and observation groups 1,2 and 3,with 50 cases in each group.All the groups received 30%1RM resistance training.In addition,the ob-servation groups received BFRT of 40%,50%and 60%arterial occlusion pressure(AOP),respectively.Before training,and four and eight weeks after training,their motor function was evaluated with Fugl-Meyer Assess-ment-Upper Extremities(FMA-UE)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE),grip strength,10-Metre Walk Test(10MWT)and Berg Balance Scale(BBS);Fried Frailty Phenotype(FFP)was used to assess frailty status;and the score of modified Ashworth Scale(MAS),blood pressure and resting heart rate were record-ed. Results One case dropped out in each group.For the scores of FMA-UE and FMA-LE,the grip strength of both hands,the time of 10MWT and the score of BBS,the main effects of group and time,and interaction effect were all sig-nificant(F>2.745,P<0.05);four weeks after training,the above indexes were better in the observation groups than in the control group(P<0.05);eight weeks after training,the scores of FMA-UE and FMA-LE,the grip strength of both hand and the score of BBS were better in the observation group 3 than in the observation groups 1 and 2(P<0.05),and the time of 10MWT was better in the observation group 3 than in the observation group 1(P<0.05).For the score of FFP,the main effect of group was significant(F=688.360,P<0.001),however,the effects of time and interaction were not significant(P>0.05).For the score of MAS,the main effect of group was significant(F=7.171,P=0.008),however,the effects of time and interaction were not significant(P>0.05).For the blood pressure and resting heart rate,the main effects of group and time,and interaction effect were not significant(P>0.05). Conclusion BFRT under different intensities combined with LIRT can safely improve the motor function,grip strength,walking ability in elderly stroke patients,and 60%AOP may be more effective.
