Rural doctors are the most convenient providers of community-based rehabilitative services for chronic disease patients and disabled people in rural areas, with the promotion of graded diagnosis and treatment policies, people began to pay attention to the competence of community-based rehabilitative services among rural doctors.

By investigating the competence of community-based rehabilitative service among rural doctors, analyzing the shortage of competence, and providing references for improving it.

A multi-stage stratified cluster sampling and purposive sampling methods were used to select 3 916 rural doctors from five provinces in east, central, and western China. The survey was conducted from July to August 2020. The questionnaire mainly focused on investigating the possession of rural doctors' competence in rehabilitation function assessment and community rehabilitation guidance, as well as whether the competence could meet their actual work needs.

Of the 3 916 rural doctors surveyed, 2 391 (61.1%), 3 704 (94.6%), 2 365 (60.4%) were found to have competence in rehabilitation function assessment, community rehabilitation guidance, and comprehensive community-based rehabilitative service, respectively. The comparison of the rehabilitation function assessing competence, community rehabilitation guiding competence, and comprehensive community rehabilitation service competence of rural doctors in the eastern, central, and western regions showed statistically significant differences (P<0.001), while the rural doctors in the western region had the lowest proportion of competence; There were statistically significant differences (P<0.05) in the proportion of the rehabilitation function assessing competence and the comprehensive competence of community rehabilitation services among rural doctors with different educational backgrounds and practicing qualifications. Rural doctors with an educational background of technical secondary school/ high school or below had a relatively higher proportion of competence, and general practitioners also had a relatively higher proportion of competence. The proportion of rural doctors who need to provide six services in daily work, including muscle strength grading assessment, motor function assessment, joint activity assessment, rehabilitation guidance for common disease patients, rehabilitation guidance for chronic disease patients, and rehabilitation guidance for disabled patients, was 73.5% (2 880/3 916), 73.8% (2 891/3 916), 74.1% (2 900/3 916), 96.3% (3 773/3 916), 95.9% (3 754/3 916), 89.1% (3 490/3 916), respectively. The proportion of the three classification competencies included in the rehabilitation function assessment competence that meet the work needs does not exceed 75.0%, and the three classification competencies included in the community rehabilitation guidance competence meet the work needs with a rate of 92.4% (3 487/3 916), 91.7% (3 441/3 916), 85.6% (2 987/3 916), respectively.

Overall, the community-based rehabilitation service competence of rural doctors in China is in relatively good condition. However, there are deficiencies in the competence of rural doctors in western China. The community-based rehabilitation service competence of rural doctors could meet the needs of rural residents, and with the gradual formation of the continuous rehabilitation service mode of staying in the hospital during the acute period and returning to the community during the recovery period, rural residents will have a higher demand for the community-based rehabilitation service of rural doctors. Therefore, positive measures should be taken to enhance the rehabilitation service competence of rural doctors, and practical exercises are the more effective measures we have found.

Coronary microcirculation disorder refers to the clinical syndrome caused by the abnormal structure and/or function of the precoronary arterioles and arterioles, which is closely related to the prognosis of cardiovascular diseases such as acute coronary syndrome, coronary offender vascular revascularization and heart failure. As a non-drug intervention for the prevention and treatment of cardiovascular diseases, exercise rehabilitation improves endothelial function and oxidative inflammation stimulation in patients with coronary microcirculation disorders through signaling molecules, restores mitochondrial autophagy level, and induces functional recovery of perivascular adipose tissue. This article reviewed the research progress of exercise rehabilitation intervention in coronary microcirculation disorder, aiming to provide more ideas and references for exercise rehabilitation treatment of coronary microcirculation disorder.

The modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) has been shown to be useful to assess and monitor patients in post-COVID-19 syndrome in developed countries. However, its reliability and validity in the Chinese population remains unclear.

To translate the C19-YRSm into a Chinese version (C19-YRSm-C), and test the reliability and validity of the Chinese version.

After obtaining the approval of the translation and use authority of the C19-YRSm from MANOJ SIVAN's team at the University of Leeds, United Kingdom, the research team translated the C19-YRSm and formed the C19-YRSm-C after translation, back-translation, and cross-cultural adaptation, according to the Translation and Cross-cultural Adaptation Procedure. From May 1 to 7, 2023, a simple random sampling method was used to select post COVID-19 patients from the "Wen Juan Xing" platform sample pool as the study subjects. The General Information Questionnaire and the C19-YRSm-C were used to survey them. 13 experts were invited to evaluate the content validity of the scale. The C19-YRSm-C was subjected to item analysis, reliability and validity analysis.

A total of 512 questionnaires were distributed and 370 valid questionnaires were recovered, with a valid recovery rate of 72.3%. The results of item analysis showed that the CR values of the items ranged from 6.589 to 22.725 (P<0.001), and the item-total correlation coefficients of the scale ranged from 0.460 to 0.815 (P<0.001). For reliability, the Cronbach's α coefficient, Guttman Split-half coefficient and test-retest reliability of the C19-YRSm-C was 0.881, 0.837 and 0.833, respectively. For content validity, the item-level content validity index (I-CVI) of the C19-YRSm-C ranged from 0.692 to 1.000, and the scale-level validity index (S-CVI) was 0.914. The results of confirmatory factor analysis (CFA) showed that the fitting indicators of the initial model were undesirable. After the establishment of a covariance correlation between error variables e12 and e13 according to the indication prompts, the fitting indicators of the modified model were within the acceptable range except for the adjusted goodness-of-fit index (AGFI). The results of discriminant validity analysis showed that the differences in scores for the 4 subscales of the C19-YRSm-C among post-COVID-19 patients with different chronic disease history and cumulative number of COVID-19 showed statistically significant differences (P<0.05). The differences were statistically significant when comparing the scores of the 3 subscales in addition to other symptoms before and after COVID-19 infection (P<0.05) .

The C19-YRSm-C has good reliability and validity, with good applicability in Chinese population, which can be used to assess and monitor the rehabilitation status of post COVID-19 patients in China.

Although exercise rehabilitation has been proven to be safe and effective for cardiovascular patients, compliance remains suboptimal. The sustained benefits of exercise are closely related to compliance, yet current research has failed to delineate the relationship between exercise compliance and the recurrence of atrial fibrillation (AF) in patients undergoing radiofrequency ablation.

To investigate the impact of adherence to home-based exercise rehabilitation programs and other relevant factors on the recurrence of atrial fibrillation in patients following radiofrequency ablation.

Convenience sampling was used to select patients with AF who underwent radiofrequency ablation surgery in the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University from May to November 2020. Patients routinely underwent a 6-minute walk test, balance and flexibility assessments, and cardiopulmonary exercise testing, and individualized exercise prescriptions were formulated based on the assessment results. General patient data were collected, and exercise rehabilitation compliance was assessed using the Cardiac Rehabilitation Inventory (CRI) to evaluate the cardiac rehabilitation needs and willingness of patients with cardiovascular diseases, and the Patient Activation Measure (PAM13) was used to measure the level of knowledge, skills, behaviors, and confidence in participating in their own health management and health care during the disease diagnosis and treatment process. Compliance data on intensity-time and frequency were followed up at the 1st week, 3rd month, 6th month, 9th month, and 12th month. The generalized estimating equations (GEE) model was used to explore the influencing factors of the recurrence of AF in patients after radiofrequency ablation surgery.

A total of 151 patients aged 29 to 84 years, with an average age of (61.7±11.0) years, and 23 patients experienced a recurrence of AF. The changes in intensity-time compliance and frequency compliance of AF patients after radiofrequency ablation surgery at different follow-up stages were statistically significant (P<0.05). After controlling for time, BMI, smoking, type of AF, activation, process anxiety, and outcome anxiety, the GEE analysis showed that intensity-time compliance≥100% was a protective factor for the recurrence of AF after radiofrequency ablation surgery (P<0.05) .

The compliance with home-based exercise rehabilitation in AF patients after radiofrequency ablation surgery changes over time, and it is recommended that clinical medical staff pay attention to the guidance and supervision of exercise intensity, take targeted measures to reduce process and outcome anxiety, in order to more effectively improve patient outcomes through exercise rehabilitation.

Community rehabilitation has much in common with primary health care. While providing primary health care for key groups, primary health care institutions will be of great significance if they can accurately provide rehabilitation services to people in need, reduce their degree of dysfunction, improve their quality of life, and realize the functional positioning of "rehabilitation at the grassroots level". This paper focuses on the coordinated development of community rehabilitation and primary health care, proposes several strategies in service delivery, service cooperation, and service financing, in order to provide references for the expansion of rehabilitation capabilities in primary health care institutions, and hopes to contribute to higher general public health standards and reduced medical expenditures.

With the promotion of "strengthening the primary health" measures, the number of primary health professionals in China has increased significantly, but there is still a gap between the ability of primary care physicians and basic medical needs of residents.

To understand the current situation, characteristics and deficiencies of Chinese primary care doctors' community rehabilitation service ability, so as to provide scientific basis for making countermeasures to improve ability.

The method of multi-stage stratified sampling combined with typical sampling was adopted to carry out an online questionnaire survey on doctors in primary health institutions in Jiangsu province, Anhui province, Henan province, Chongqing City and Gansu province. The current situation of community rehabilitation service ability of primary care physicians was evaluated from four aspects: rehabilitation function evaluation, rehabilitation medical service, traditional Chinese medicine health guidance and traditional Chinese medicine physiotherapy.

A total of 8 374 questionnaires were analyzed. Among the primary doctors surveyed, 4 697 cases (56.1%), 6 396 cases (76.4%), 5 833 cases (69.7%) and 4 834 cases (57.7%) were equipped with the ability of rehabilitation function assessment, rehabilitation medical services, TCM health guidance and TCM physiotherapy, respectively. Moreover, the abilities of primary doctors in rural areas were better than that in urban areas, and the difference was statistically significant (P<0.05). There were statistically significant differences in the rates of rehabilitation medical service guidance, traditional Chinese medicine health care guidance and traditional Chinese physiotherapy ability of primary doctors in different ages, educational qualifications, and positions (P<0.05). The pairwise comparison results showed that in terms of age. In terms of assessment ability of rehabilitation function, doctors under 30 years old and over 60 years old had a higher rate than those 30-<45 years old and 45-<60 years old (P<0.016), and doctors 45-<60 years old had a higher rate than those 30-<45 years old (P<0.016). The rate of rehabilitation medical service guidance ability of primary doctors under 45 years old was lower than that of primary doctors over 45 years old (P<0.016). The ability rate of doctors under 30 years old to provide TCM health care guidance and TCM physiotherapy was lower than that of 30-< 45 years old, 45-< 60 years old and over 60 years old (P<0.016), and the ability rate of doctors 30-<45 years old was lower than that of 45-< 60 years old and over 60 years old (P<0.016). The ratio of doctors aged 45-<60 years old was lower than that of doctors aged over 60 years old (P<0.016) .The ability rate of primary doctors with high school/secondary school education or below was higher than that of college degree and bachelor degree (P<0.016), and the ability rate of junior college degree doctors was higher than that of bachelor degree (P<0.016). The possessing rate of general practitioners was higher than that of rural physicians and practicing (assistant) physicians (P<0.016), and the possessing rate of rural physicians was higher than that of practicing (assistant) physicians (P<0.016). The rate of basic doctors in TCM post possessing TCM health care guidance and TCM physiotherapy ability was higher than that in clinical post and other post (P<0.016), and the rate of clinical post possessing was higher than that in other post (P<0.016). The rate of comprehensive ability of rehabilitation medicine was higher than that of traditional Chinese medicine (P<0.05) .

The ability of community rehabilitation was insufficient on the whole, and the ability of traditional Chinese medicine rehabilitation was relatively weak. It is necessary to improve the construction of the tiered diagnosis and treatment system, promote primary care physicians' experience and abilities. Also to strengthen the joint training of traditional Chinese medicine rehabilitation and modern Western medicine rehabilitation techniques, complete the training and construction of primary rehabilitation personnel, so that they can assume the responsibility of community rehabilitation.

Post-stroke patients are often left with different degrees of functional impairment, and in the process of returning from the medical institution to the community and home, it is necessary for medical institutions at all levels to cooperate and interact, so as to form a good full-cycle rehabilitation closed loop. At present, the application of full-cycle stroke rehabilitation is progressing, but some resistance still exists. This articel is based on the concept of full-cycle rehabilitation for stroke, combined with the current situation of the development of community-based rehabilitation, we also think about the development of the full-cycle rehabilitation and community-based rehabilitation link for stroke. The article emphasizes the importance of "community-based inflection-point rehabilitation" and the need to establish standards of community-based rehabilitation. Moreover, the article also mentions the need to emphasize the full-cycle stage of rehabilitation for stroke patients, explore the development strategy of community-based rehabilitation, and effectively improve the quality of life in community and family.

With China's aging population, the incidence of stroke is increasing year by year, and the high disability rate places a significant burden on patients, families, and society. It is extremely important to strengthen the rehabilitation self-efficacy of home-based stroke patients in order to assist them return to society as soon as feasible. Currently, less emphasis is being paid to the influence of environmental factors on rehabilitation self-efficacy in stroke.

To investigate the current status of rehabilitation self-efficacy of stroke patients in community, and explore the influence of different environmental factors on rehabilitation self-efficacy of stroke patients.

Using convenience sampling, from December 2019 to September 2020, 262 stroke patients in the subordinate communities of 4 community health service centers in Zhengzhou, Henan Province were enrolled in the survey. The Demographic Information Questionnaire was used to collect general data, the Modified Rankin Scale was used to assess the physical function of stroke patients, the Measure of Stroke Environment was used to assess the current situation of stroke environment, and the Chinese Version of Stroke Self-efficacy Questionnaire was used to assess the rehabilitation self-efficacy of stroke patients. The effects of various environmental factors on rehabilitation self-efficacy of stroke patients were investigated by hierarchical regression analysis.

A total of 285 questionnaires were distributed, a total of 262 valid questionnaires were collected, with an effective response rate of 91.93%. The rehabilitation self-efficacy score of 262 stroke patients was (76.1±26.3). Receptivity, physical environment and communication environment accounted for 30.9% of the total variation in rehabilitation self-efficacy (P<0.05) .

The rehabilitation self-efficacy of community stroke patients is in the medium level. Receptivity, physical environment and communication environment are the important influence factors for self-efficacy of stroke patients. In the future, we should attach importance to the environmental construction of stroke patients, explore positive stroke environmental construction models, effectively guide the rehabilitation of stroke patients, enhance rehabilitation self-efficacy, improve prognosis, and help them return to society as soon as possible.

Nowadays, cardiac rehabilitation is mostly transferred from the hospital to a home environment. Mobile health applications assist patients in bridging the support gap from hospital to home environment, which encourages home-based recovery processes. Unfortunately, numerous quality difficulties accompany its promise, and the service quality of cardiac rehabilitation applications must be ＂confirmed＂ as soon as possible.

To develop a quality assessment indicator system for home-based rehabilitation APP services for heart failure patients, and to provide a model for standardizing and increasing the quality of mobile health APP.

This study was conducted from July 2022 to January 2023, using semi-structured interviews, literature review, the expert consultation method and analytic hierarchy process (AHP) to determine the content of indicator system and the weight for each index.

2 rounds of expert consultations resulted in the effective response rates of 100%, with the authority coefficients of 0.867, and the coordination coefficients of 0.128-0.154 and 0.151-0.197 respectively (P<0.001). As a result, an assessment indicator system for home-based rehabilitation APP services for heart failure patients was developed from three dimensions: software usability, medical professionalism, and behavioral science, with 7 primary indicators, 24 secondary indicators, and 51 tertiary indicators.

The developed quality assessment indicator system for home-based rehabilitation APP services for heart failure patients is comprehensive and scientific, and can be useful for assessing and measuring the quality of heart rehabilitation APP services, as well as facilitating the benign development of similar APP services.

The maintenance of exercise rehabilitation effect in patients with chronic heart failure depends on good adherence to exercise rehabilitation. It is of great practical significance to evaluate the adherence to exercise rehabilitation effectively and scientifically, however, there is still a lack of accepted tools to evaluate the adherence to exercise rehabilitation in patients with chronic heart failure at home and abroad.

To develop an exercise rehabilitation adherence scale for patients with chronic heart failure, and provide a scientific and appropriate tool for the rapid and convenient evaluation of adherence to exercise rehabilitation in patients with chronic heart failure.

Based on the previous summary of the best evidence and qualitative research on exercise rehabilitation of patients with chronic heart failure, the initial pool of entries was formed through literature review, combining the opinions of the research group; the clinical test version of the scale was formed based on a small sample pre-survey and Delphi expert correspondence. Patients with stable chronic heart failure who were treated in the cardiovascular department from three tertiary-level hospitals in Jiangsu Province from November 2020 to January 2021 were selected as the study subjects using a convenience sampling method. In the first phase, 274 valid scales were recovered, aiming to screen the items of the scale and conduct exploratory factor analysis by combining item response theory and classical test theory to form the official version of the scale; in the second phase, 282 valid scales were recovered, aiming to perform confirmatory factor analysis and test on reliability and validity of the official version of the scale to form the final version of the scale.

The formal scale consisted of 11 items in 2 dimensions. The difficulty of each item was reasonable without no inverse threshold, and the item differentiation, item information content, and item characteristic curve were all superior. The total Cronbach's α coefficient of the exercise rehabilitation adherence scale for patients with chronic heart failure was 0.905, of which the dimension of "prescription adherence" was 0.895, the dimension of "monitoring adherence" was 0.910. The total Spearman-Brown split reliability coefficient of the scale was 0.724, and the retest reliability was 0.902. The results of exploratory factor analysis showed that the two factors could explain 70.231% of the total variation. The results of further confirmatory factor analysis showed that the model was better fitted with each parameter.

The exercise rehabilitation adherence scale for patients with chronic heart failure developed in the study is reasonable in terms of item difficulty, differentiation, the information content of the items is good with high reliability and validity, which can be used as an evaluation tool for adherence to exercise rehabilitation in patients with chronic heart failure.

Somatosensory and motor dysfunctions are common after stroke, both lead to limitations in activities of daily living and social participation, there is still a lack of research evidence to analyze the relationship between the two from multiple perspectives.

To investigate the relationship between somatosensory and motor function among overall, upper and lower extremities in different-age-group patients within one year after stroke.

This prospective study enrolled the poststroke patients within one year from several hospitals in Fujian Province from October 2022 to April 2023. The sensory subscale of the Fugl-Meyer assessment (FMA-S) and the sensory subitem of National Institute of Health Stroke Scale (NIHSS) were used to evaluate the patient's somatosensory function. The motor subscale of the Fugl-Meyer assessment (FMA-M), Brunnstrom assessment, Berg Balance Scale (BBS) and the motor subitem of NIHSS were used to evaluate the patient's motor function. Modified Barthel Index (MBI) was used to evaluate the patient's activities of daily living (ADL). Hospital Anxiety and Depression Scale (HADS) was used to evaluate the patient's psychosomatic function. They were divided into two groups (the elderly group/the young and middle-aged group) according to their age, we compared the differences in general information and rehabilitation assessments between the two groups. And we analyzed the correlation between somatosensory function and motor function/ADL/psycho-psychological function.

A total of 254 patients were included, with an average age of (61.0±12.3) years and an average disease course of 30.0 (17.0, 65.5) days. There were 112 cases (44.1%) in the elderly group and 142 cases (55.9%) in the young and middle-aged group. FMA-S and FMA-M scores were positively correlated in both groups (r_s values were 0.313 and 0.171, both P<0.05), NIHSS sensory items were all negatively correlated with FMA-M scores (r_s values were -0.199 and -0.177, both P<0.05). In the elderly group, FMA-S-UE related scores were positively correlated with FMA-M-UE, Brunnstrom-UE, and Brunnstrom-HAND scores; they were negatively correlated with NIHSS-UE score (all P<0.05). In the young and middle-aged group, FMA-S-UE total and light-touch scores were positively correlated with FMA-M-UE and Brunnstrom-HAND scores; FMA-S-UE proprioception score was positively correlated with FMA-M-UE, Brunnstrom-UE scores (all P<0.05). In the older group, FMA-S-LE related scores were positively correlated with FMA-M-LE, Brunnstrom-LE, and BBS scores; FMA-S-LE total and light touch scores were negatively correlated with NIHSS-LE scores (all P<0.01). In the young and middle-aged group, FMA-S-LE total and proprioception scores were positively correlated with FMA-M-LE, Brunnstrom-LE, and BBS scores; FMA-S-LE light touch score was positively correlated with Brunnstrom-LE and BBS scores; FMA-S-LE total and proprioception scores were each negatively correlated with NIHSS-LE score (all P<0.05). In the elderly group, FMA-S was positively correlated with MBI (r_s=0.270, P<0.05), FMA-S score was negatively correlated with HADS-A and HADS-D scores (r_s were respectively -0.300 and -0.374, P<0.01), NIHSS sensory item was positively correlated with HADS-D score (r_s=0.235, P<0.01) .

There is a positive correlation between somatosensory and motor function in different-age-group patients within one year after stroke, and age may affect the correlation between somatosensory function and motor function/ADL/psychosocial function.

Post-stroke cognitive impairment (PSCI) can significantly limit the recovery of stroke patients at all stages and lead to a decline in activity participation and quality of life.

Based on the concept of full-cycle rehabilitation in stroke, by investigating the incidence of PSCI, to analyzed the differences of PSCI in different age and disease period and its potential influencing factors.

Stroke patients were hospitalized in the rehabilitation departments of 27 hospitals in different regions of China from October 2022 to July 2023 using simple random sampling method for cross-sectional analysis. A total of 402 patients were finally included according to the study criteria, and categorized into the young and middle-aged group (18-64 years old, n=234) and the elderly group (≥65 years old, n=168) according to the criteria of the National Bureau of Statistics of China, and the patients were also categorized into the acute-phase group (1-7 d, n=25), subacute-phase group (8-180 d, n=338), and the chronic-phase group (>180 d, n=39) according to the International Stroke Rehabilitation Alliance. Baseline information on patients was collected through interviews, assessments, and an electronic case system. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and subscores and total scores were calculated for each cognitive domain. Using the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Hospital Anxiety Scale (HADS-A), and the Hospital Depression Scale (HADS-D) were used to assess the disease conditions and physical functioning of the patients. Spearman's rank correlation analysis was used to investigate the correlation between cognitive function levels and other clinical indicators at different ages and different stages of disease.

The prevalence of PSCI in stroke patients was 76.4% (307/402), including 81.0% (136/168) in elderly patients and 73.1% (171/234) in young and middle-aged patients; the prevalence of PSCI in stroke patients was 56.0% (14/25) in the acute phase, 78.4% (265/338) in the subacute phase, and 71.8% (28/39) in the chronic phase. The results of grouping by age and disease period showed that the elderly group had lower visuospatial and executive function, attention, numeracy, delayed recall scores and total MoCA scores than those in the young and middle-aged group (P<0.05). Patients in the subacute-phase group had lower visuospatial and executive function, language, delayed recall scores and total MoCA scores than those in the acute-phase group (P<0.05). Correlation analysis showed that the total MoCA score was positively correlated (P<0.001) with educational level (r_s=0.314), stroke type (r_s=0.114), FMA-UE (r_s=0.245), FMA-LE (r_s=0.242), BBS (r_s=0.265), MBI (r_s=0.293), and was negatively correlated (P<0.05) with gender (r_s=-0.107), age (r_s=-0.103), history of hypertension (r_s=-0.112), hemiplegic side (r_s=-0.139), disease duration (r_s=-0.135), NIHSS (r_s=-0.107), HADS-A (r_s=-0.239), HADS-D (r_s=-0.280). Further stratified analyses showed that the young and middle-aged and elderly groups were correlated with the total MoCA score in terms of the educational level, NIHSS and physical function indicators such as FMA-UE, FMA-LE, BBS, MBI, HADS-A, and HADS-D (P<0.05). In the acute-phase group, disease duration, FMA-UE, and HADS-A were related to total MoCA score (P<0.05). In the subacute-phase group, age, education level, hypertension, history of alcohol consumption, type of stroke, hemiplegic side, disease duration, NIHSS, and physical function indicators such as FMA-UE, FMA-LE, BBS, MBI, HADS-A, HADS-D were correlated with the total MoCA score (P<0.05), and only educational level, hypertension, and HADS-D were correlated with the total MoCA score in the chronic-phase group (P<0.05) .

PSCI is closely related to age, disease development period, education level, physical function, balance, activities of daily living, anxiety and depression levels in stroke patients, and individualised preventive strategies and interventions should be developed for patients based on different stratified cognitive potential influencing factors, as well as increased screening and attention to cognition in the early stages of the disease to the later stages of rehabilitation.

Wrist motor dysfunction is a common sequela at post-stroke, and the wrist has an important role in improving hand practicality. Therefore, improving the range of motion of the wrist can effectively promote the activities of daily life in post-stroke patients. Although repetitive peripheral magnetic stimulations (rPMS) have been shown to have a significant effect on improving the range of motion of the wrist, the therapeutic effect of different stimulation sites still needs to be further explored.

To investigate the effect of rPMS on wrist extensor muscle and radial nerve for the motor function of wrist of subacute stroke patients.

A total of 60 subacute stroke patients with wrist motor dysfunction admitted to Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study subjects. The included patients were randomly divided into control group (20 cases), muscle stimulation group (20 cases) and nerve stimulation group (20 cases) by simple randomized grouping method using a random number table. Patients in all the three groups received routine rehabilitation training, and those in the muscle stimulation group and nerve stimulation group were additionally managed by rPMS on the wrist extensor muscle and the radial nerve, respectively. Before and after the interventions for 10 times of rPMS, integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) on the surface of the wrist extensor muscle, the Fugl-Meyer Assessment for upper extremity (FMA-UE), the Action Research Arm Test (ARAT) and the modified Barthel Index (MBI) were measured to assess the upper limb function of the affected side.

During the intervention period, there were 2 cases of data loss due to voluntary withdrawal or forced termination of the trial, and finally 20 cases were included in the control group, 19 cases in the muscle stimulation group, and 19 cases in the nerve stimulation group. There were no significant differences in iEMG, RMS and MF of wrist extensor muscle among three groups before treatment (P>0.05). After treatment, iEMG, RMS and MF of wrist extensor muscle in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The iEMG, RMS and MF of wrist extensor muscle in nerve stimulation group were significantly higher than those of muscle stimulation group (P<0.05). The iEMG, RMS and MF of the wrist extensor muscle after treatment were higher than those before treatment in the three groups (P<0.05). There were no significant differences in FMA-UE, ARAT and MBI scores among the three groups before treatment (P>0.05). After treatment, FMA-UE, ARAT and MBI scores in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The scores of FMA-UE, ARAT and MBI in nerve stimulation group were significantly higher than those in muscle stimulation group (P<0.05). The scores of FMA-UE, ARAT and MBI in three groups were significantly higher after treatment than before treatment (P<0.05) .

rPMS on the wrist extensor muscle and the radial nerve can improve the wrist motor dysfunction after stroke, and the effect on the radial nerve is more significant than that on the wrist extensor muscle.

Physical and medical integration is essential for promoting the health of community residents and is an important guarantee for the high-quality development of community medical services, and practitioners are the foothold and focus of physical medicine integration services. However, there is currently a lack of relevant research on the impact of community medical institutions in carrying out physical medicine integration services from the perspective of practitioners.

To study the understanding and views of practitioners on how to carry out the integrated service of physical medicine in the community to provide ideas and references for the community to better carry out the integrated service of physical medicine.

In March and April 2023, 11 practitioners from 5 community health service centers in Zhuzhou city, Hunan Province, were selected as survey subjects by means of an objective sampling method. The descriptive research method was adopted to conduct "one-on-one" semistructured in-depth interviews with community practitioners. With the help of the content analysis software Nvivo 12.0, text transcription recording, analysis unit formation, content coding and theme extraction were carried out for the interview content. Finally, the interview data were logically analyzed using descriptive phenomenological analysis to capture GPs' understanding and perceptions of the influences on the development of body-health integration services in the community, and to summarize the themes of the interviews.

The factors affecting the development of physical and medical integration services in communities can be summarized into 4 themes and 10 subthemes. There was an urgent need to optimize the service environment for the integration of physical medicine (insufficient site supply, lagging atmosphere, and insufficient publicity) , improve the ability of practitioners (insufficient cognitive ability for the integration of physical medicine and the ability to issue sports prescriptions) , lack of support in community hospitals (lack of training activities related to the integration of physical medicine, insufficient fund allocation and shortage of human resources) , and lack of patient cognition of the integration of physical and medicine (patients have poor cognition of the efficacy of body-medicine integration, and patients have poor cognition of the risk of body-medicine integration) .

There are still many shortcomings in the service ability of community practitioners. To promote better development of community integrated services, it is urgent to optimize the service environment of community integrated services, to improve practitioners' integrative cognition ability and exercise prescription ability, to strengthen the support and guarantee of community health service institutions, and to improve patients' awareness of the efficacy and risk of physical and medical integration services.

Due to its unique advantages, virtual reality rehabilitation (VR) training has been widely used in the field of rehabilitation therapy, but there is a lack of study on its application efficacy in patients with sudden deafness and vertigo.

To observe the efficacy of coventional vestibular rehabilitation training and vestibular rehabilitation training assisted by VR technology in patients with sudden deafness and vertigo.

From January 2022 to January 2023, 84 patients with sudden deafness and vertigo were selected from the Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University and randomly divided into the two groups, with 42 cases in each group. The control group was given drug therapy combined with coventional vestibular rehabilitation training, while the observation group was given vestibular rehabilitation training assisted by VR technology on the basis of drug therapy. The Dizziness Disorder Scale (DHI) and Hospital Anxiety and Depression Scale (HADS) were respectively used to evaluate the two groups before intervention, 7 and 14 days after the intervention.

Finally 81 patients completed the trial, including 41 patients in the observation group and 40 patients in the control group. Group and time had interaction effects on DHI-Function (F), DHI-Emotion (E) and DHI-Physical (P) scores and total DHI score (P<0.05). The main effects of group and time on DHI sub-scores and total score were significant (P<0.05). There was no significant difference between the two groups in DHI sub-scores and total score before intervention (P>0.05) ; DHI sub-scores and total score in both groups after 7 and 14 days of intervention were lower than those before intervention (P<0.05). DHI sub-scores and total score in the observation group were higher than the control group after 7 and 14 days of intervention (P<0.05). Group and time had interaction effects on HADS-Anxiety Scale (A), HADS-Depression Scale (D) scores and total HADS score (P<0.05). The main effect of group and time on HADS sub-scores and total score was significant (P<0.05). There was no significant difference in HADS sub-scores and total score between the two groups before intervention (P>0.05). HADS sub-scores and total score in both groups after 7 and 14 days of intervention were lower than those before intervention (P<0.05). After 7 and 14 days of intervention, there was no significant difference in HADS sub-scores and total score between the two groups (P>0.05) .

Vestibular rehabilitation training is effective for patients with sudden deafness and vertigo, and the vestibular rehabilitation training assisted by VR technology can obviously improve patients' balance disorders and quality of life.

Telerehabilitation based on digital medical care can efficiently improve the health status of patients after radiofrequency ablation of atrial fibrillation. However, the current participation rate in telerehabilitation is low.

To analyse the reasons for refusal of exercise rehabilitation in patients after radiofrequency ablation of atrial fibrillation in the context digital medical care based on the theory of leisure constraints.

Patients after radiofrequency ablation of atrial fibrillation in the inpatient department or outpatient clinic of Department of Cardiology, at the First Affiliated Hospital of Nanjing Medical University from July to September 2022 were selected as the study subjects by using the purposive sampling method. The phenomenological approach was adopted to collect data from patients who refused exercise telerehabilitation after radiofrequency ablation through semi-structured interviews, and Colaizzi analysis was used to summarize the reasons.

A total of 14 patients were finally included in this study. Three themes including self-limiting factors, interpersonal limiting factors, and structural limiting factors, and twelve sub-themes were extracted, namely, low level of digital literacy, negative illness perception, psychological distress caused by disease, digital medical trust crisis, deep-rooted personal exercise habits, alienation sense from rehabilitation team, insufficient social network establishment, economic burden related to equipment acquisition, harsh climate, low rehabilitation service capacity in primary care, constraints of available time by role pressure, and poor applicability of wearable devices.

The reasons for refusal to exercise telerehabilitation include lack of literacy and trust in digital medical care, high level of illness perception and psychological distress, poor exercise habits, rehabilitation team and peer alienation, economic burden, harsh climate, lack of capacity and personal time for rehabilitation service capacity in primary care, and inadequate applicability of existing wearable devices.

Pregnancy and vaginal delivery are important factors leading to pelvic floor dysfunction (PFD) in women, manifested as pelvic organ prolapse (POP), stress urinary incontinence (SUI), and sexual dysfunction. Postpartum pelvic floor function rehabilitation has become a research hotspot in recent years. Stimulating the pelvic floor muscle groups through active exercise and passive contraction can improve detrusor stability and levator muscle function to prevent and treat PFD.

To investigate the clinical value of biofeedback electrical stimulation combined with pelvic floor muscle training (PFMT) therapy in the rehabilitation of pelvic floor function after vaginal delivery through a clinical controlled study.

Postpartum women with PFD after delivery implemented in Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2020 to January 2022 were selected as the research subjects, and divided into the observation group and the control group using a random number table method. The observation group was treated with biofeedback electrical stimulation combined with PFMT, while the control group was treated with PFMT alone. The muscle strength of the pelvic floor class Ⅰ and class Ⅱ muscle fibers, the ratio of SUI and POP level of the two groups before and after treatment; postpartum PFMT situation; scores of Pelvic Floor Dysfunction Questionnaire (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7), and International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICI-Q-SF) before and at 3 and 6 months after the treatment.

A total of 327 cases were included in the observation group and 343 cases in the control group. After the treatment, the strength recovery of type Ⅰ and Ⅱ muscle fibers in the observation group was better than the control group (P<0.001). The ratio of SUI in the observation group was lower than that in the control group (P=0.005). There was no significant difference in POP level between the two groups (P>0.05). The proportion of PFMT frequency≥5 times/week in the observation group was higher than that in the control group at 3 months and 6 months after treatment (P<0.001) ; the PFDI-20, PFIQ-7, and ICI-Q-SF scores of the observation group were lower than those of the control group at 3 months and 6 months after treatment (P<0.05) .

Compared with PFMT alone, the patients of vaginal delivery with the treatment of biofeedback electrical stimulation combined with PFMT had better muscle strength recovery, lower SUI ratio, higher compliance with PFMT, and better quality of life score.

The number of chronic obstructive pulmonary disease (COPD) patients in China is huge, and respiratory rehabilitation training, as an important part of the management of COPD patients in the stabilization period, can effectively improve their lung function and quality of life, as well as reduce the burden on their families and society. Current data from Europe and the United States have shown that the implementation of respiratory rehabilitation under telemedicine management can improve the lung function and QOL of patients, however, there is a lack of relevant practice in China, especially in the west.

To assess the impact of respiratory rehabilitation training via telemedicine management in combination with conventional therapy on improving ventilatory capacity and lung function in elderly patients with moderate-to-severe COPD.

This study was a prospective randomized controlled study, enrolling consecutive COPD patients who attended the Fourth People's Hospital of Sichuan Province and five joint community clinics from June 2021 to June 2022. The included patients were randomly divided into the experimental group and control group by simple randomized grouping method using random number table. The control group received traditional long-term regular inhalation bronchodilator and oral medication, and the experimental group was guided by telemedicine on the basis of the treatment plan of the control group. A six-month study was conducted on two groups of patients, lung function, Borg score, 6MWT, and quality of life score (QOL score) were recorded at 1 month before and 1, 3, 6 months after intervention.

The study subjects were divided into 72 cases in the control group and 73 cases in the experimental group, and there was no significant difference in gender, age and lung function at baseline [the forced expiratory volume in one second/predicted value ratio (FEV₁%pred) , and the ratio of the forced expiratory volume in one second to the forced vital capacity (FEV₁/FVC) ] between the two groups (P>0.05) . There was an interaction between time and group for dyspnea and mood in FEV₁%pred, FEV₁/FVC, 6MWT level and QOL score (P<0.05) . After 1, 3, and 6 months of intervention, FEV₁%pred, FEV₁/FVC, 6MWT, Borg score, and QOL score of the experimental group were better than those of the control group (P<0.05) ; FEV₁%pred, FEV₁/FVC, Borg score, 6MWT, and QOL scores at 3 and 6 months post-intervention were better than those at 1 month post-intervention in the experimental group (P<0.05) .

The use of telemedicine technology for respiratory rehabilitation of elderly moderate-to-severe COPD patients in the stable stage can effectively improve the pulmonary function, quality of life and the quality of survival of this group of patients after 3, 6-months intervention.

There is a lack of research on rehabilitative families based on hospital field experiences in the context of stroke-exacerbated family and social burdens.

To analyze the socio-cultural atmospheres present in hospital rehabilitation halls in four narrative dimensions of patients, relatives, families, and medical providers.

The interviews were conducted with participants from the rehabilitation department of Traditional Chinese Medicine Hospital in T city between April and July 2021 to examine the socio-cultural atmospheres in the rehabilitation hall from four perspectives of patients' narratives, relatives' narratives, families' narratives, and doctors' narratives.

Stroke survivors have enjoyed the positive experience of "post-traumatic growth" in individual and collective joint progress; relatives have spontaneously established a club culture during mutual communications and played the role of "doctor-patient bridge" in accompanying each other; stroke-rehabilitative families as a whole suffered from two tensions, including the external tension due to financial burden on the family, and the internal tension arising from the difficulties in mutual understanding between family members and patients. Doctors were able to be more rational with stroke-rehabilitative families. A comparison between doctor-patient and teacher-student relationships illustrated that doctors would play the role of teacher to some extent when dealing with patients.

As revealed in the analysis of the socio-cultural atmospheres in the rehabilitation hall, the prevention and treatment of stroke are facing two problems, including difficulty in implementing key effort of prevention and treatment in the primary level, and troubles in accessing medical care resources of some patients. Research on medical humanities, especially the research methodology of medical anthropology, is conducive to constructing a positive doctor-patient relationship.

The prevalence of atrial fibrillation (AF) in China is increasing year by year, and the prognosis and quality of life of patients urgently need attention. Current studies have confirmed that exercise rehabilitation is a beneficial way to improve the prognosis and poor quality of life in patients with AF after radiofrequency catheter ablation (RFCA). Adherence is a key measure of whether the benefits of exercise rehabilitation persist, but its trajectory remains unknown.

To examine the development trajectory and predictors of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA using five-period follow-up data based on prospective longitudinal observation.

Convenience sampling method was used to select 246 patients with AF who attended the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University for RFCA from May to November 2020 for follow-up. The baseline survey was conducted 1 week after enrollment, and the follow-up survey was conducted at 3, 6, 9 and 12 months after enrollment. The general and clinical data of patients were collected. The strength-duration adherence was monitored and recorded using smart devices or fitness log to assess exercise adherence in terms of strength-duration adherence; Self-efficacy for Exercise Scale (SEE), Fear of Activity in Patients with Chronic Heart Failure (Fact-CHF), Perceived Social Support Scale (PSSS), Patient Activation Measure 13 (PAM13) were used for assessing self-efficacy of exercise, fear of activity, social support and motivation level. Mplus tool was used to construct latent class growth model (LCGM), and the optimal fitting model was selected to determine the development trajectory of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA. Logistic regression analysis was used to identify the predictors of trajectory categories.

A total of 202 patients were included in the final analysis with 44 patients lost to follow-up. The number of patients at baseline, 3 months, 6 months, 9 months, and 12 months after exercise were 202, 201, 185, 174 and 159, respectively, and the strength-duration adherence were (0.83±0.55), (1.07±0.54), (0.99±0.57), (0.91±0.55) and (0.89±0.60). The LCGM results showed group heterogeneity in the process of change in strength-duration adherence to exercise rehabilitation in patients, which was divided into 3 latent classes based on their development trajectories, including 69 in slow decline-low level group (34.2%), 14 in rapid increase-high level group (6.9%), and 119 in sustained adherence group (58.9%). Multinomial unordered Logistic regression showed higher levels of intensity-time adherence in the rapid increase-high level group and sustained adherence group using the slow decline-low level group as the reference group (P<0.001). The patients in the rapid increase-high level group and sustained adherence group were older, with higher level of exercise self-efficacy (P<0.05). The level of fear of activity was lower in the rapid increase-high level group, and the level of activation was higher in the sustained adherence group (P<0.05) .

The strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA showed a multi-class curve growth trajectory. In the future, intensive interventions can be conducted periodically according to the time-varying characteristics and predictors, to improve and stabilize the adherence to home-based exercise rehabilitation.

Promoting appropriate health technology to rural and urban communities is an important measure to improve the technical level and service capacity of primary care institutions. The First Affiliated Hospital of Xinjiang Medical University carried out the promotion of appropriate health technology in southern Xinjiang.

To evaluate the effect of appropriate technology promotion for stroke rehabilitation in southern Xinjiang, understand the needs of rehabilitation workers in southern Xinjiang for appropriate technology promotion for stroke rehabilitation and the goals they hope to achieve by participating in appropriate technology promotion for stroke rehabilitation projects, providing a basis for health administrative departments to implement appropriate rehabilitation technology promotion work.

The rehabilitation workers from the rehabilitation medicine departments of 8 people's hospitals, affiliated township health centers and communities health centers, federation of the disabled, civil affairs system and other rehabilitation institutions in 8 deep poverty-stricken counties which were considered as sample source sites by using a multi-stage sampling method in July 2018. The appropriate technology promotion for stroke rehabilitation was performed followed by a investigation by using self-designed questionnaire. The monthly outpatient volume, hospitalization volume and treatment income of the rehabilitation medicine department of people's hospitals before (January 1, 2018 to June 30, 2018) and after participation (July 1, 2020 to December 31, 2020) in technology promotion for stroke rehabilitation projects were compared.

The appropriate technology promotion for stroke rehabilitation in acute, subacute and convalescent stages, as well as community and family rehabilitation of stroke was performed from January 1, 2018 to June 30, 2018, involving motor function rehabilitation training, functional electrical stimulation, mandatory exercise therapy techniques, constraint induced movement therapy (CIMT) , mirror therapy, management and rehabilitation training of dysphagia, daily living activities training and rehabilitation care of stroke patient. A total of 384 valid questionnaires were collected. Among the 384 rehabilitation workers, 63.3% (243/384) identified the appropriate technology promotion within districts (counties) as very meaningful; 46.1% (177/384) thought the project was very applicable in their local area; 37.5% (144/384) believed that the technology for stroke rehabilitation can be carried out in their medical institutions with a slight improvement of the relevant conditions; 46.9% (180/384) believed that the difficulty level of the appropriate technology promotion project was easy in terms of operation skills; after the training, 42.2% (162/384) claimed to be knowledgeable about the technology and need to learn and receive further training. The monthly outpatient volume and monthly treatment income of the rehabilitation medicine department of people's hospitals after participating in stroke rehabilitation technology promotion projects increased significantly compared with before participation (P<0.05) . In terms of technology promotion for stroke rehabilitation, rehabilitation workers have the highest demand for practical training〔63.0% (242/384) 〕, and the lowest demand for teaching rounds〔19.8% (76/384) 〕. The percentages of workers who expected to improve operational ability〔77.1% (296/384) 〕and theoretical level 〔65.6% (252/384) 〕by participating in the appropriate technology promotion for stroke rehabilitation project ranked 1st and 2nd, respectively.

The promotion work of appropriate technology for stroke rehabilitation has achieved significant results. At present, there is a huge demand for rehabilitation of stroke patients in southern Xinjiang, but the overall rehabilitation medical service capacity is far from meeting the social needs. A series of initiatives can be taken to effectively improve the level of rehabilitation therapy in southern Xinjiang, including strengthening the promotion of appropriate health technology, encouraging rehabilitation workers to participate in further education and training, actively carrying out telehealth services, and accelerating the construction of medical associations.

It has been a consensus that cardiac rehabilitation is an effective comprehensive intervention for patients with coronary heart disease (CHD), but the quality of relevant guidelines is still unclear, and recommendations from the guidelines need to be integrated.

To systematically review the guidelines on cardiac rehabilitation in patients with CHD, providing evidence to inform clinical practice.

In June 2022, guidelines on cardiac rehabilitation in patients with CHD were searched in electronic databases of the Cochrane Library, Web of Science, PubMed, CNKI, CQVIP and Wanfang Data, relevant guideline repositories and association websites from inception to 30 June 2022. Literature screening and data extraction were performed by two researchers separately according to the inclusion and exclusion criteria. The quality of included guidelines was assessed using the Appraisal of Guidelines for Research & EvaluationⅡ (AGREEⅡ), and recommendations from which were summarized.

Ten guidelines (eight of them are foreign guidelines) with publication time ranging from 2011 to 2020 were eventually included. The average score of every AGREEⅡ domain was 71% for scope and purpose, 65% for stakeholder involvement, 58% for rigor of development, 80% for clarity of presentation, 64% for applicability, and 45% for editorial independence. Four guidelines were rated as grade A and the remaining six as grade B. Six aspects are involved in recommendations, including basic requirements of cardiac rehabilitation, heath education, risk factors control, psychological support, exercise training, and improvement of cardiac rehabilitation participation.

The quality of included guidelines is at a moderate to high level. More efforts are needed to improve the domains in stakeholder involvement, rigor of development, applicability, and editorial independence. Recommendations of the 10 guidelines tend to be consistent, but there are still insufficient recommendations on improving cardiac rehabilitation participation. There is a gap in the quality between domestic and foreign guidelines, so it is necessary to develop a high-quality guideline on cardiac rehabilitation for patients with CHD in China.

Prolonged disorders of consciousness (pDoC) severely affects the patients' survival and quality of life, and causes an extremely heavy disease burden. At present, considerable resources and studies have focused on the acute care of patients with pDoC, and substantial progress has been made in detecting, predicting and promoting recovery of consciousness, but there is little research on post-acute rehabilitation outcomes and care. In views of this, we reviewed the definition, epidemiological surveys, clinical symptoms and diagnosis criteria of pDoC, summarized the associated factors, interventions and nursing regarding rehabilitation outcomes of pDoC. Then, we put forward the following recommendations relevant to future research and practice in China: (1) improving the epidemiological data related to pDoC to provide data for relevant decision-making; (2) studying and applying new technologies to interventions for pDoC rehabilitation, and integrating clinical practice, rehabilitation prediction and prognostic management; (3) further identifying key elements and trajectory for pDoC recovery to reduce the uncertainty of prognostic outcomes due to excessive disease duration; (4) establish a continuity of care system based on the pDoC rehabilitation trajectory from acute transition, sub-acute to chronic period to improve the quality of and access to care and achieve continuous improvement in the quality of care; (5) systematically reforming the current care system to further improve the continuity of care system that contributes to rehabilitation, and strengthening the participation of the patient's family, community, disability agencies and other stakeholders besides the multidisciplinary team and the cooperation between them. It is hoped that we can provide insights into the development of research and clinical practice of pDoC in China.

The importance of phase Ⅰ cardiac rehabilitation after percutaneous coronary intervention (PCI) has been confirmed, but there is suboptimal adherence among patients. Therefore, investigating the adherence of PCI patients to phaseⅠ cardiac rehabilitation and the influencing factors can provide a theoretical foundation for improving the adherence of patients.

To clarifythe influencing factors of the adherence of PCI patients to phaseⅠ cardiac rehabilitation and the effect pathways by the structural equation model construction, in order to provide the oretical support for improving the adherence of PCI patients to phase Ⅰ cardiac rehabilitation.

Patients with PCI enrolled in the Cardiac Rehabilitation Center of the Second Hospital of Harbin Medical University from August to December in 2021 were selected as the research objects by convenience sampling. The general demographic information questionnaire, therapy adherence questionnaire, health belief of coronary heart disease questionnaire, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiexy Disorde-7 (GAD-7), Family Adaptability and Cohesion Evaluation Scale (FACES), Chronic Illness Resource Survey (CIRS), Gensini score were used to investigate the patients by the end of phaseⅠ cardiac rehabilitation. Spearman rank correlation analysis was used to verify the correlations between health belief, depression, anxiety, family adaptability and cohesion, chronic illness resource utilization and cardiac rehabilitation adherence, respectively. Based on correlation analysis, the hypothetical model of the influencing factors of the adherence of PCI patients to phaseⅠ cardiac rehabilitation was constructed combined with Anderson's model of health service utilization. Maximum likelihood method was used to fit and modify the model constantly. Structural equation model was used to analyze the relationship among influencing factors.

A total of 443 questionnaires were distributed and 430 valid questionnaires were returned, with a valid return rate of 97.06%. The results of multiple linear regression analysis showed that health belief (β=0.427), depression (β=-0.057), anxiety (β=-0.130), family adaptability and cohesion (β=0.242), chronic illness resource (β=0.140) were independent factors of the adherence to phaseⅠcardiac rehabilitation of PCI patients (P<0.05). The results of the correlation analysis showed that cardiac rehabilitation adherence score of PCI patients was positively correlated with health beliefs, family adaptability and cohesion, chronic illness resource utilization (P<0.05) and negatively correlated with depression and anxiety (P<0.05). A structural equation model of the adherence of PCT patients to phaseⅠ cardiac rehabilitation was constructed using health belief, depression, anxiety, family adaptability and cohesion, chronic illness resource and the model fits well: χ²/df=3.092<5, standardized root mean square residual (SRMR) =0.070<0.080, goodness of fit indices (GFI) =0.981, adjusted goodness of fitindices (AGFI) =0.936, comparative fit index (CFI) =0.992, normed fit indexes (NFI) =0.989, with all of them>0.9. The results of the intermediate effects test showed that health belief, family adaptability and cohesion, chronic illness resource had positive direct effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation (β=0.395, 0.277, 0.152, P<0.01) ; health belief, family adaptability and cohesion had a positive indirect effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation through chronic disease resource utilization (β=0.057, 0.065, P<0.01). Depression and anxiety had a direct negative effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation (β=-0.055, -0.116, P<0.05) .

The adherence of PCI patients to phaseⅠ cardiac rehabilitation is influenced by multiple factors. There are complex pathway relationships among the influencing factors. Health belief, family adaptability and cohesion, chronic illness resource have a positive direct effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation; depression and anxiety have a negative direct effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation; health beliefs, family adaptability and cohesion have a positive indirect effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation through chronic illness resource utilization, and have a negative indirect effect on the adherence of PCI patients to phaseⅠ cardiac rehabilitation through anxiety and depression.

COVID-19 may impair the central nervous system, but the prevalence and related factors of very early cognitive impairment in discharged COVID-19 convalescents are still unclear.

To assess the prevalence of very early cognitive impairment in discharged COVID-19 convalescents, and to identify its influencing factors.

This study included 574 COVID-19 convalescents from August 28 to September 30, 2020, including individuals who were discharged from designated hospitals for treating COVID-19 in Wuhan from December 2019 to April 2020 randomly selected from the hospital information system, and those with informed consent recruited through news media. According to the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) score, the subjects were divided into a very early cognitive impairment group (AD8≥2) and a non-very early cognitive impairment group (AD8<2). A questionnaire survey was conducted with the subjects by four investigators at Hubei Provincial Hospital of Traditional Chinese& Western Medicine, using the General Information Questionnaire to collect demographic information and past disease history of the patients (including gender, age, underlying disease, classification of COVID-19 on admission, interval between discharge and the current survey, and various symptoms present at the time of follow-up), using the Generalized Anxiety Disorder-7 (GAD-7), the PTSD Check List–Civilian Version (PCL-C), and the Short Form 36 Health Survey Questionnaire (SF-36) to assess patients' anxiety, post-traumatic stress disorder, and quality of life, respectively. Three hundred and eleven cases finally completed the cognitive function screening. Multiple Logistic regression was used to evaluate the effects of gender, age, underlying disease and admission classification of COVID-19 on very early cognitive impairment. A restricted cubic spline model was used to assess the quantitative relationship between anxiety level and very early cognitive impairment.

311 (54.18%) who effectively responded to the survey was finally enrolled, including 170 (54.7%) with very early cognitive impairment and 141 (45.3%) without. 230 (23.9%) had residual symptoms after discharge. Comparisons of gender, age, insomnia, fatigue, chest tightness, shortness of breath, loss of appetite, generalized anxiety disorder, PTSD positive, and the score of each SF-36 entry among COVID-19 convalescents with and without very early cognitive impairment were statistically significant (P<0.05). Multivariate Logistic regression analysis suggested that females〔OR (95%CI) =2.658 (1.528, 4.625) 〕, advanced age〔OR (95%CI) =3.736 (1.083, 12.890) 〕, and having generalised anxiety disorder〔OR (95%CI) =5.081 (1.229, 21.008) 〕were influential factors in increasing very early cognitive impairment (P<0.05). Restricted cubic spline models indicated a linear quantitative relationship between anxiety level and very early cognitive impairment, with higher levels of anxiety associated with a greater likelihood of very early cognitive impairment (P for non-linear test =0.132) .

The incidence of very early cognitive impairment is high in COVID-19 convalescents, and it may be higher in those who are older, female, or have generalized anxiety symptoms. Timely interventions for psychiatric problems and alleviation of anxiety symptoms in COVID-19 convalescents, especially in older women, may help to improve their cognitive function and Alzheimer's disease.

The traditional core stability rehabilitation training has been proven to be effective in improving the rehabilitation in patients with chronic non-specific low back pain (CNSLBP) , but with poor long-term compliance. We independently developed a new core stabilization rehabilitation training program (NO.2021107165452) for CNSLBP patients, but the intervention effects of which are still unclear.

To explore the intervention effect of a novel core stabilization rehabilitation training program in CNSLBP patients.

Twenty-one male CNSLBP patients were recruited from Guangxi Normal University and Guilin College from December 2021 to January 2022, and randomly divided into an experimental group (n=11) and a control group (n=10) , receiving a six-week intervention using the core stabilization rehabilitation training program independently developed by our research group, and traditional core stability rehabilitation training, respectively. The visual analogue scale (VAS) was used to evaluate the pain level. The Oswestry Disability Index (ODI) was used to evaluate the status of lumbar dysfunction. The Hoggan MicroFET 2 was used to measure muscle force and muscle force signals of the flexor muscles, extensor muscles, and rotatores muscles of the low back. The Y-balance test (YBT) was used to assess the dynamic balance ability.

The values of VAS and ODI were significantly reduced in both groups after the intervention (P<0.05) , and they were more lower in the experimental group (P<0.05) . The muscle strength of upper abdominal flexors, spinal extensors, spinal left rotators, and spinal right rotators increased significantly in both groups after the intervention (P<0.05) . The left and right YBT scores were increased notably in both groups after the intervention (P<0.05) , and they were more higher in the experimental group (P<0.05) .

Both kinds of intervention programs could improve the lumbar pain, lumbar dysfunction, the muscle strength of upper abdominal flexors, spinal extensors, and spinal rotators, and dynamic balance in CNSLBP patients, but our core stability rehabilitation training program was more effective in reducing lumbar pain, improving lumbar dysfunction, and enhancing dynamic balance, so this novel program is worth promoting.

Scoliosis is a common abnormal curvature of the spine. Patients with mild scoliosis are usually treated with outpatient physiotherapy, but satisfactory efficacy is associated with appropriate treatment time and frequency. The efficacy of offline physiotherapy may be affected by limited medical resources and patients' treatment time and geographical location. Remote rehabilitation may save patients' treatment time and increase the geographical accessibility of physiotherapy, making the therapy more simple and convenient.

To explore the efficacy of remote rehabilitation combined with outpatient treatment in mild adolescent idiopathic scoliosis (AIS) .

Fifty-eight eligible mild AIS patients were selected from Department of Rehabilitation Medicine, Tianjin Hospital from September 2020 to September 2021, and divided into three groups according to patients and their parents' selection of treatment: online group (n=18), combined group (n=20) and offline group (n=20). The online group received WeChat- and Tencent Video-based physiotherapeutic scoliosis specific exercise (PSSE), the combined group received both outpatient and WeChat- and Tencent Video-based PSSE treatment, and the offline group received outpatient PSSE treatment. Data of three groups were collected, including the main curve Cobb angle, coronal balance (CB), thoracic kyphosis (TK) angle, lumbar lordosis (LL) angle, sagittal vertical axis (SVA), angle of axial trunk rotation (ATR), parietal vertebra rotation (Raimondi), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), muscle activation rate (MAR) on both sides of paraspinal vertebrae, root mean square ratio (RMSR) of paraspinal muscles on both sides of paraspinal vertebrae, and the score of SRS-22 before and after treatment.

The main curve Cobb angle, TK, SVA, ATR, Raimondi, SS, MAR on paraspinal vertebrae, RMSR on the concave side of the parietal vertebra and SRS-22 self-image and mental health domain scores were significantly different from those before treatment in all groups (P<0.05). Specifically, the combined group was superior to the other two groups in improved ATR and treatment satisfaction. The combined group had significantly improved main curve Cobb angle after treatment than the online group. The improvement of the concave MAR in either the combined group or offline group was significantly better than that in the online group (P<0.05) .

In mild AIS patients, remote rehabilitation combined with outpatient treatment could effectively slow down the progression of AIS curve, improve sagittal abnormality of spine, abnormal posture and vertebral rotation, increase the activation rate of paraspinal muscles on the concave side of paraspinal vertebra and improve the balance of paraspinal muscles on both sides of paraspinal vertebrae. Moreover, the combined therapy also improved the quality of life.

Adolescent idiopathic scoliosis (AIS) is becoming increasingly common in clinical settings, imposing a heavy burden on the family and society. At present, few treatments are available with fair effects for AIS, and there is a lack of unified and effective treatment schemes for AIS.

To explore the effect of Schroth therapy with bonesetting massage in AIS.

Forty adolescent AIS patients treated in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from September 2018 to December 2020 were selected, and equally randomly divided into treatment group and control group, 20 cases in each group. Both groups received bone setting massage once a week, and the treatment group additionally received Schroth therapy, 90 minutes per time, 3 times per week. The treatment for both groups lasted for 6 months. Pre- and post-treatment Cobb angle and angle of trunk rotation (ATR) as well as clinical efficacy were compared between the two groups.

The Cobb angle after treatment was smaller than that before treatment in both groups (P<0.05). And the treatment group had a smaller post-treatment Cobb angle than the control group (P<0.05). ATR decreased after treatment in both groups (P<0.05), and it decreased more obviously in the treatment group (P<0.05). The response rate for either control group or treatment group was 95.0% (19/20) but the marked response rate was higher in the treatment group〔85.0% (17/20) vs. 30.0% (6/20) 〕 (P<0.001) .

Compared with bonesetting massage alone, Schroth therapy with bonesetting massage had better effect on improving the Cobb angle and ATR in AIS patients, so the combination therapy is recommended for clinical use.

Aquatic therapeutic exercise is an emerging physical therapy technique, which provides new ideas for improving the motor function and quality of life of patients with stroke. However, it is not clear that the rehabilitation benefits obtained by patients with stroke from aquatic therapeutic exercise, and the levels of methodological quality and evidence quality of relevant studies.

To overview the systematic reviews of aquatic therapeutic exercise in improving the rehabilitation in patients with stroke.

In June 2021, Systematic reviews assessing the effects of aquatic therapeutic exercise in stroke rehabilitation were searched in databases of PubMed, the Cochrane Library, EmBase, CINAHL, Web of Science, CNKI, WanFang Data, CQVIP and SinoMed from inception to June 15, 2021. Two researchers screened systematic reviews according to the inclusion and exclusion criteria and extracted data separately. The methodological quality was evaluated using AMSTAR 2. The reporting quality was evaluated using the PRISMA. The quality of evidence for major outcomes was evaluated using the GRADE system.

A total of 9 reviews were included, 2 of which were in Chinese and 7 were in English. The analysis showed that the methodological quality of 1, 1, and 7 reviews were moderate, low, and extremely low, respectively. The reporting quality of 7 reviews were relatively complete, 1 review had some flaws, and 1 review had a serious information flaw. There were a total of 9 outcome indicators, and 49 bodies of evidence, and the quality of bodies of evidence was mostly low or very low. Aquatic therapeutic exercise improved the balance function, mobility and muscle strength of stroke patients to a certain extent. And the rehabilitation benefits had proven to be more when it was used in combination with dryland trainings.

Aquatic therapeutic exercise has proven to be effective in improving balance function, mobility and muscle strength in stroke patients with good safety. But the overall methodological quality and quality of evidence for major outcomes of included systematic reviews are unsatisfactory. It is suggested that future studies use a larger sample size and an improved design, which will provide evidence-based guidance for clinical management of stroke rehabilitation with aquatic therapeutic exercise.

Telerehabilitation (TR) is an emerging model of rehabilitation service delivery based on communication technology, remote sensing and control technology, virtual reality technology and computer technology to to achieve cross-regional rehabilitation medical services. However, the effectiveness of TR in functional rehabilitation after stroke is still unclear, the methodological quality of related studies is uneven, and few researchers have systematically evaluated it.

To re-evaluate the systematic reviews/meta-analyses on the effectiveness of TR for functional rehabilitation after stroke.

In August 2021, PubMed, Web of science, the Cochrane Library, VIP, WanFang Data, CNKI and CBM were retrieved by computer for systematic reviews/meta-analyses on the effectiveness of TR applied to functional rehabilitation after stroke from the establishment of the database to August 2021. After the literature screen and data extract by two researchers independently, the methodological quality of the included literature was evaluated by AMSTAR 2 scale, and the evidence quality of the outcome index was graded by GRADE system. Descriptive analysis was used to analyze the effectiveness of TR in functional rehabilitation after stroke.

A total of 10 systematic reviews/meta-analyses were included, and the results of the AMSTAR 2 review showed that 2 systematic reviews were of high quality, 3 were of low quality, and 5 were of very low quality. The main reasons for the low methodological quality were the failure to report the preliminary study protocol, the list and reasons for excluded studies, the publication bias of the original study and the funding sources. The GRADE evidence quality assessment resulted in 10 systematic reviews addressing seven outcome measures, 41 bodies of evidence, with eight grade graded as intermediate, 23 grade graded as low, and 10 grade graded as very low. TR promoted the improvement of activities of daily living, motor function, quality of life, depressive symptoms and speech function of stroke patients to a certain extent, and had the same curative effect as face-to-face rehabilitation therapy or routine treatment, and even some TR rehabilitation effects were better than traditional rehabilitation therapy.

TR can promote the functional rehabilitation of stroke patients, but considering that the methodological quality and reliability of outcome measures of current systematic reviews/meta-analyses on the effectiveness of TR applied to functional recovery after stroke are mostly low, strict, standardized and comprehensive high-quality randomized controlled trials are still needed to provide evidence support; The results of this study can provide reference for the topic selection, research design and results report of future TR research.