Exercise remains a cornerstone in the prevention and management of diabetic complications in patients with type 2 diabetes. However, there have been few discussions about the precautions and implementation key points of exercise intervention for diabetic complications. In this study, we presented some recommendations of exercise intervention, the precautions related to exercise intervention, the selection of exercise timing, and the interactive effects between sports and medications for patients with diabetic complications, based on the latest guidelines on diabetes prevention and management, the expert consensus, and the latest research trials, aiming to provide some practical guidance and evidence-based guidelines for exercise intervention in patients with diabetic complications.

With global population ageing, sarcopenic obesity has become a common and serious condition in older adults. Exercise guidelines issued by the American College of Sports Medicine (ACSM) are authoritative in exercise science. For older adults with sarcopenic obesity, these guidelines provide multidimensional recommendations on exercise dose, including intensity, frequency, and duration for aerobic and resistance training.

To compare the effects of exercise doses with high adherence to ACSM recommendations versus those with low or uncertain adherence on body composition [body fat percentage, BMI, body weight, appendicular skeletal muscle mass (ASM) ] and physical function (grip strength and walking speed) in older adults with sarcopenic obesity.

Relevant studies on exercise interventions for older adults with sarcopenic obesity were systematically searched in PubMed, Embase, Web of Science, Cochrane Library, Ovid, and China National Knowledge Infrastructure (CNKI). The search period was from database inception to 2023-12-26 for the first four databases, and from database inception to 2024-01-14 for Ovid and CNKI. Two investigators independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Study quality was evaluated using the risk-of-bias tool for randomized controlled trials, and Meta-analysis was performed using RevMan 5.4. Based on whether the intervention group's exercise dose adhered to ACSM recommendations, studies were classified as high adherence or low/uncertain adherence. The effects of these two exercise-dose categories on body fat percentage, BMI, body weight, ASM, grip strength, and walking speed were analyzed. Higgins I² was used to assess heterogeneity among studies, and sensitivity analysis was performed by omitting one study at a time.

A total of 15 studies involving 810 participants were included, of which 7 studies had high adherence to ACSM recommendations and 8 had low or uncertain adherence. Eleven studies reported body fat percentage as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in body fat percentage (MD=-3.54, 95%CI= -5.65 to -1.44, P<0.05), whereas the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=-0.94, 95%CI=-2.54 to 0.67, P>0.05). Five studies reported BMI as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in BMI (MD=-1.98, 95%CI=-3.02 to -0.93, P<0.05). The low/uncertain-adherence intervention group also showed a reduction in BMI, but the difference was not statistically significant (MD=-1.72, 95%CI=-3.42 to -0.03, P=0.05). Five studies reported body weight as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in body weight (MD=-4.85, 95%CI=-7.84 to -1.86, P<0.05), while the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=-1.56, 95%CI=-5.94 to 2.81, P>0.05). Four studies reported ASM as an outcome. For both high-adherence and low/uncertain-adherence exercise doses, no statistically significant differences were observed in ASM compared with the control group (MD=-0.18, 95%CI=-1.03 to 0.67; MD=-0.05, 95%CI=-0.85 to 0.76, P>0.05). Eight studies reported grip strength as an outcome. Compared with the control group, the high-adherence intervention group showed a greater increase in grip strength (MD=2.86, 95%CI=0.76 to 4.97, P<0.05), whereas the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=3.04, 95%CI=-0.26 to 6.34, P>0.05). Seven studies reported walking speed as an outcome. The high-adherence intervention group improved walking speed more than the control group (MD=0.32, 95%CI=0.23 to 0.41, P<0.05), while the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=0.05, 95%CI=-0.01 to 0.11, P>0.05).

High-adherence exercise interventions had significant effects on improving body fat percentage, BMI, body weight, grip strength, and walking speed in patients with sarcopenic obesity. However, exercise intervention had no effect on ASM. Further studies are needed to verify these findings.

Stroke hand dysfunction seriously affects the quality of life of patients. In recent years, studies of robot-assisted training for functional recovery of stroke patients has gradually increased, but the improvement effect lacks effective systematic evaluation and analysis, and assist specific training programs still needs to be further explored.

To systematically evaluate the intervention effect of rehabilitation robot-assisted training on the hand motor function in stroke patients.

Randomized controlled trials of rehabilitation robot-assisted training for hand motor function in stroke patients were searched in PubMed, Embase, Scopus, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and SinoMed, the time limit for searching was from the establishment of each database to December 2023. Literature screening, extraction of raw data and evaluation of the methodological quality of the literature were carried out in strict accordance with the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 and Stata 17.0.

A total of 23 studies and 693 stroke patients were included in the literature. The results of meta-analysis showed that the experimental group's Fugl-Meyer Motor Function Assessment-Upper Limb(FMA-UL) (SMD=0.37, 95%CI=0.17-0.58, P<0.001), FMA-UL of wrist (MD=1.66, 95%CI=0.14-3.17, P=0.03) and hand portion (MD=2.00, 95%CI=1.17-2.83, P<0.001), Upper Extremity Movement Study Scale (SMD=0.27, 95%CI=0.01-0.53, P=0.04), handgrip strength (SMD=0.54, 95%CI=0.09-1.00, P=0.02), and hand pinch (SMD=0.62, 95%CI=0.16-1.09, P=0.008) scores improved better than those of the control group, there were significant differences between two groups. There were no significant differences in Block-Box Test (MD=1.23, 95%CI=-0.90 to 3.35, P=0.26), Modified Ashworth Scale (SMD=-0.47, 95%CI=-1.28 to 0.35, P=0.26), and Barthel Index (SMD=0.38, 95%CI=-0.07 to 0.83, P=0.10) scores.

Rehabilitation robot-assisted training is beneficial to the recovery of hand motor function in stroke patients, which can effectively improve hand mobility, grip and pinch ability, but the improvement in hand tone, dexterity and daily living ability scores is relatively small. Future studies with large samples, multi-center, and longer follow-up periods are needed to further evaluate its efficacy and safety.

Successful aging helps to slow the process of social aging, and there is a lack of comprehensive research on the association between health physical fitness and successful aging.

To explore the relationship between health physical fitness and successful aging among community-dwelling middle-aged and elderly adults.

A cross-sectional study was conducted among older adults aged 50 years and older in Hangzhou City. Based on the successful aging model of low risk of disease and disability, high level of physical and cognitive function, and active social engagement, 895 community-dwelling middle-aged and elderly adults of different genders were classified into the successful aging group and the unsuccessful aging group, and the differences in health physical fitness such as physical shape, physical function, and physical quality were compared between these two groups. Binary categorical Logistic regression was used to analyze the association between health physical fitness and successful aging.

Regardless of gender, the successful aging population had lower waist circumference, waist-to-hip ratio, BMI, and better lower limb strength compared to the unsuccessful aging population. The successful aging female population had lower systolic blood pressure and better endurance, balance, and upper extremity flexibility, whereas the successful aging male population had faster gait speed and better lower extremity flexibility (all P<0.05). After adjusting for age, education, visual impairment, smoking history, and alcohol consumption history, balance and lower limb strength were found to be significantly associated with successful aging in females, with corresponding ORs of 1.015 (1.003-1.028) and 1.080 (1.009-1.156), respectively. Whereas, in males, there was a significant association between lower limb strength and successful aging, with a corresponding OR of 1.119 (1.005-1.246) (P<0.05) .

Successful aging population is better than unsuccessful aging population in terms of body shape, physical function, and physical quality indicators, and the relationship between successful aging and health physical fitness varies in different genders. It is recommended to adopt appropriate health physical fitness management measures for different genders to promote the realization of successful aging.

Against the background of the increasingly younger onset of non-communicable diseases, physical inactivity has become an important and modifiable risk factor affecting the health of the working population. Although physical activity promotion has been consistently emphasized in national health policies in China, clearer and more operational pathways are still needed to systematically embed physical activity advice into routine general practice. This article focuses on the core concept of "embedding physical activity into daily life" proposed in the 10th edition of the Guidelines for Preventive Activities in General Practice issued by the Royal Australian College of General Practitioners (RACGP). Drawing on the World Health Organization guidelines on physical activity and sedentary behavior, as well as evidence from domestic and international literature, the paper interprets and discusses the role of general practitioners in physical activity promotion, key practice considerations, and potential implementation pathways. Experiences from community-based general practice in Shenzhen are also discussed to examine the contextual application and practical relevance of this concept in health management among the working population. This article aims to provide practical reference for promoting physical activity within general practice settings.

With the accelerating trend of global population aging, intrinsic capacity has gained increasing attention as a core metric of healthy aging. Intrinsic capacity encompasses the composite of an individual's physical and mental abilities, specifically comprising five dimensions: cognition, locomotion, vitality (nutrition and metabolism), sensory (vision and hearing), and psychology. Decline in intrinsic capacity is strongly associated with adverse outcomes such as frailty, disability, falls, hospitalization, and death. Establishing a scientifically valid and effective system for the early screening and assessment of intrinsic capacity is therefore crucial for maintaining functional status in older adults and promoting healthy aging. Currently, China lacks standardized consensus on intrinsic capacity screening and comprehensive assessment protocols. To address this gap, the Chinese Geriatrics Society and the National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital) spearheaded the development of this consensus. Based on evidence-based medicine and utilizing the GRADE framework for evidence grading this consensus systematically integrates the latest research. It aims to establish a scientific and standardized screening and comprehensive assessment system for intrinsic capacity, implement strategies for early identification and dynamic monitoring, and ultimately provide a reference for delaying the decline of intrinsic capacity and maintaining functional independence.

The "Healthy China 2030" initiative clearly proposes to establish an exercise prescription library to promote the integration of sports and medicine and give full play to the role of scientific fitness in the prevention and rehabilitation of chronic diseases. However, how general practitioners in primary care institutions can play a role in prescribing medical exercise to patients is still under exploration. Based on the current status of exercise prescription at home and abroad, this study mainly uses literature search and data collection methods, supplemented by expert consultation and field research methods, to explore the responsibilities and importance of general practitioners in the application of medical exercise prescription, summarize the shortcomings and put forward corresponding suggestions to promote the integrated development of community sports and medicine.

Fall is one of the most common and serious problems in the elderly, and fall efficiency is an important influencing factor. There are various exercise ways to improve fall efficiency in the elderly, and the merits and demerits of various exercise intervention effects are still uncertain.

To compare the effects of different exercise modes on fall efficacy in the older people, aiming to provide a reference for patients to choose the best exercise mode.

A literature search was conducted in databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, SinoMed, PubMed, CINAHL, Web of Science, Embase, Cochrane Library, and FMRS to identify relevant studies on the effectiveness of exercise in reducing falls among the elderly. The search period was from the establishment of the databases to August 15, 2025. The outcome measures were the Falls Efficacy Scale-International (FES-I), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT). The Cochrane bias assessment tool was used to evaluate the quality of the literature. Stata 18 software was used to perform a network meta-analysis, and the surface under the cumulative ranking curve (SUCRA) was used to rank the effectiveness of different treatment regimens.

A total of 35 studies were included in this study, involving 2, 627 subjects and 13 types of exercise. In terms of fall efficacy, Otago (MD=8.94, 95%CI=3.51-14.38), Tai Chi (MD=9.24, 95%CI=4.96-13.51), step marching exercise (MD=8.60, 95%CI=2.56-14.64) and pilates (MD=6.86, 95%CI=1.19-12.53) were more effective than the usual care group (P<0.05), with Tai Chi having the highest likelihood of being the most effective intervention (SUCRA=81.2). In terms of balance function, Otago (MD=3.87, 95%CI=2.71-5.02), Tai Chi (MD=3.87, 95%CI=1.71-6.03), and resisted + balance training (MD=3.26, 95%CI=0.53-6.00) were more effective than the usual care group (P<0.05), with Otago having the highest likelihood of being the most effective intervention (SUCRA=68.1). In terms of mobility, Otago (MD=3.90, 95%CI=2.77-5.04), Tai Chi (MD=4.44, 95%CI=3.50-5.39), Baduanjin (MD=2.25, 95%CI=1.47-3.02), Baguazhang (MD=2.35, 95%CI=1.26-3.43), Gait balancing enercises (MD=3.60, 95%CI=2.15-5.05) were more effective than the usual care group (P<0.05), with Tai Chi having the highest likelihood of being the most effective intervention (SUCRA=95.0).

This study indicates that Tai Chi and Otago exercises are effective in improving fall efficacy, balance function, and mobility in older adults. Clinical healthcare professionals should select appropriate exercise methods based on the health status and needs of older adults to enhance fall efficacy, effectively prevent falls, and promote patient health. Meanwhile, further high-quality researches are needed to validate these findings.

With the acceleration of population aging, there has been a continuous increase in the number of elderly individuals suffering from multiple chronic conditions and impaired activities of daily living (ADL), imposing a substantial healthcare burden on society. While multiple chronic conditions are highly associated with impairment in ADL, the specific mechanisms and combinatorial effects have not been fully elucidated.

This study aims to analyze the current status of multiple chronic conditions among the elderly in China and explore the association between different comorbidity combinations and ADL, thereby providing scientific evidence for chronic diseases management and functional maintenance in older adults.

Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), this study focused on individuals aged 60 years and older to compare the prevalence of impaired ADL across demographic subgroups. The Apriori algorithm was employed to perform association rules analysis to identify primary comorbidity combinations. Binary Logistic regression models were used to assess the impact of these comorbidity combinations on ADL impairment.

The study included 10 999 elderly participants, and the prevalence of multiple chronic conditions was 64.91% (7 140/10 999). 3 819 individuals (34.72%) exhibited ADL impairment, 1 149 (10.45%) demonstrated basic activities of daily living (BADL) impairment, and 3 662 (33.29%) showed instrumental activities of daily living (IADL) impairment. Statistically significant differences (P<0.05) in ADL, BADL and IADL impairment rates were observed across gender, age, education level, marital status, type of residence, and the presence of multiple chronic conditions (P<0.05). The Apriori algorithm identified 8 association rules, with the highest support rule being "dyslipidemia and hypertension" (support=8.237%), the highest confidence rule being "dyslipidemia, diabetes or high blood sugar and hypertension" (confidence=78.707%), and the highest lift rule being "asthma and chronic pulmonary diseases" (lift=4.188). Hypertension exhibited the highest frequency across all comorbidity combinations. Adjusted binary Logistic regression revealed that, multiple comorbidity combinations "stroke and hypertension" "asthma and chronic pulmonary diseases", and "kidney disease, stomach or other digestive diseases, and arthritis or rheumatism" significantly impacted ADL, BADL, and IADL impairment (P<0.05). Notably, the "stroke and hypertension" combination posed the highest risk for BADL impairment, the risk of being one level more severely impaired in BADL for individuals with this comorbidity combination was 4.480 times higher than that of the population without this comorbidity combination (OR=4.480, 95%CI=3.754-5.347).

Hypertension serves as a central hub in elderly comorbidities networks, demonstrating strong associations with multiple chronic conditions. Multiple comorbidity combinations significantly increase the risk of ADL impairment, with the "stroke and hypertension" combination being the most pronounced. Healthcare systems should prioritize elderly populations with comorbidities, develop effective long term care policies tailored to different comorbidities, reduce the risk of disability, delay functional decline, and enhance quality of life in elderly population.

Excess body weight and adiposity are closely related to the pathogenesis of various chronic diseases. To address this health crisis, the American College of Sports Medicine released the Consensus Statement on Adult Physical Activity and Excess Body Weight and Adiposity in 2024. This consensus supports the inclusion of physical activity in the medical treatment of excess body weight and adiposity (drug therapy, metabolic and bariatric surgery) when medically deemed appropriate. And put forward insights on the application of physical activity in these treatments. This consensus particularly points out: (1) For weight loss and the prevention of weight gain, the effect may be most significant when engaging in at least 150 minutes of moderate-intensity physical activity per week. (2) High-intensity interval training is not superior to the physical activity effect of moderate to high-intensity continuous training in terms of weight regulation. (3) Low-intensity physical activities can be used as an alternative under the premise of ensuring energy consumption. (4) Various forms of exercise are equivalent in weight management. To achieve overall health benefits beyond weight control and fat loss, it is recommended to adopt multiple modes of physical activity. This consensus emphasizes the importance of physical activity in the prevention, treatment and management of overweight and obesity. This guideline interpretation aims to conduct an in-depth analysis of the core points of this consensus statement, provide new suggestions for the prevention and treatment of overweight/obesity through physical activity in our country, and help primary care doctors manage overweight/obesity patients more effectively.

With the intensification of population aging in China, the issue of frailty among the elderly is becoming increasingly prominent, making research on its prevention and intervention particularly important. Currently, most studies lack discussion on the dynamic relationship between changes in physical activity and frailty.

This study is based on the five waves of data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, aiming to explore the association between physical activity changes trajectories and frailty in older adults, and to provide a scientific basis for the prevention and intervention of frailty in the elderly.

Group-based trajectory modeling (GBTM) was used to identify the potential subgroups and trajectory characteristics of physical activity over time among the survey participants during the follow-up period. Multivariate unconditional logistic regression models were employed to analyze the association between different physical activity trajectory types and frailty, as well as subgroup analyses.

The physical activity trajectories of the survey participants were divided into four groups: persistent low group (262 individuals, 13.87%), low-to-increasing group (993 individuals, 52.57%), high-to-decreasing group (122 individuals, 6.46%), and persistent high group (512 individuals, 27.10%). There were significant differences in frailty among the four groups (χ²=20.867, P<0.001). After adjusting for confounding factors such as age and gender, multivariate unconditional Logistic regression indicated that compared with the persistent low group, the low-to-increasing group (OR=0.581, 95%CI=0.414-0.815, P=0.002) and the persistent high group (OR=0.546, 95%CI=0.373-0.799, P=0.002) had significantly lower risks of frailty. Subgroup analysis revealed that, compared with the consistently low group, the initially low then rising group demonstrated significant reductions in frailty risk among the following elderly subgroups: age≥65 years (OR=0.502, 95%CI=0.345-0.730), males (OR=0.539, 95%CI=0.326-0.891), urban residents (OR=0.441, 95%CI=0.211-0.922), those without a partner (OR=0.312, 95%CI=0.160-0.606) (P<0.05). Similarly, the consistently high group exhibited protective effects against frailty in elderly individuals aged≥65 years (OR=0.425, 95%CI=0.274-0.658), females (OR=0.539, 95%CI=0.328-0.886), urban residents (OR=0.280, 95%CI=0.101-0.780), and those without a partner (OR=0.347, 95%CI=0.164-0.737) (P<0.05).

Different trajectory groups are associated with the risk of frailty. Physical activity trajectories characterized by a low-to-increasing pattern and persistent high levels can significantly reduce the incidence of frailty in older adults.

In recent years, physical impairment (PI) combined with cognitive impairment (CI) is a common comorbidity in the elderly. An early detection of PI combined with CI in the elderly and timely interventions may help to improve the quality of life of the elderly and reduce the burden on their families and society. However, relevant studies on the comorbidity of PI and CI in the elderly and its influencing factors have been rarely reported.

To observe the clinical characteristics of the comorbidity of PI and CI in the elderly and the influencing factors.

Elderly patients hospitalized in Peking University People's Hospital from September 2018 to November 2019 were selected. A total of eligible 244 subjects meeting the inclusion criteria were surveyed for the physical function and cognitive function using the Short Physical Performance Battery (SPPB) and the Mini-mental State Examination (MMSE), respectively. PI was diagnosed with lower than 10 points of the SPPB, and CI was diagnosed with lower than 27 points of the MMSE. Patients were divided into non-PI+non-CI, PI+non-CI, non-PI+CI, PI+CI. Social demographic, anthropometric, laboratory examination and other indicators of patients were collected, and Logistic regression analysis was used to explore the influencing factors for PI combined with CI in the elderly.

Among the 244 patients, there were 102 (41.80%), 64 (26.23%), 26 (10.66%) and 52 (21.31%) cases of non-PI+non-CI, PI+non-CI, non-PI+CI and PI+CI, respectively. Multivariate binary Logistic regression analysis showed that compared with non-PI+non-CI cases, age (P<0.001, OR=1.216, 95%CI=1.217-1.312) and grip strength (P<0.001, OR=0.875, 95%CI=0.813-0.941) were independent influencing factors for PI+CI cases. Compared with PI+non-CI cases, fatty liver disease (P=0.007, OR=0.200, 95%CI=0.062-0.646), hypertension (P=0.007, OR=3.596, 95%CI=1.414-9.143), and grip strength (P=0.038, OR=0.943, 95%CI=0.891-0.997) were independent influencing factors for PI+CI cases. Compared with non-PI+CI cases, age (P=0.008, OR=1.104, 95%CI=1.026-1.189) and grip strength (P=0.004, OR=0.889, 95%CI=0.821-0.963) were independent influencing factors for PI+CI cases.

Grip strength is the independent influencing factor for PI combined with CI in the elderly. Among the elderly patients without PI and CI, age and grip strength were the influencing factors of PI and CI. In elderly patients with PI and no CI, fatty liver, hypertension and grip strength were the influencing factors of PI and CI.

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.

The prevalence of multiple chronic conditions (MCCs) is continuously increasing among older adults in China, but few studies have explored complex pattern of MCCs from perspectives of patient demand and disease management.

This study aims to investigate the pattern distributions, correlates, and treatment burdens of MCCs.

Data were obtained from the 2018 and 2020 China Health and Retirement Longitudinal Study (CHARLS) waves, and the study sample included older adults aged≥60 years old (n=15 349). The generalized ordered logit model and the generalized linear model were used to examine correlates of MCCs complex pattern and its associations with outpatient/inpatient utilization and expenditure, respectively. All statistical analyses were weighted except for sample size.

Among the total sample of 15 349 older adults, there were 7 147 in 2018 and 8 202 in 2020; 2 054 participants[13.0%, defined as the relatively healthy group (RH group) ] had none of 12 chronic conditions defined in this study, 5 228 participants [33.7%, defined as the simple chronic illness group (SCI group) ] had 1-5 non-complex chronic conditions, 6 737 participants [44.7%, defined as the minor complex chronic illness group (MiCCI group) ] had 1-2 complex chronic conditions, and <6 non-complex chronic conditions, and 1 330 participants[8.6%, defined as the major complex chronic illness group (MaCCI group) ] had ≥3 complex chronic conditions or ≥6 non-complex chronic conditions. The proportion of MiCCI and MaCCI groups had an increase of 2.1% and 1.9% between 2018 and 2020, respectively. Among the SCI and MiCCI groups, the most prevalent chronic conditions were hypertension (49.2% and 56.1%) and arthritis/rheumatism (51.9% and 47.4%), respectively. Among MaCCI group, 82.0% had heart disease, and 67.9% had chronic lung diseases. There were statistically significant differences in the prevalence of chronic conditions among the three groups (P<0.05). Age, sex, education level, annual household expenditure per capita, medical insurance, depression status, and survey year were associated with being in SCI, MiCCI, and MaCCI groups (P<0.05) ; age, education level, urban-rural location, region, annual per capita household expenditure, and survey year were associated with being in MiCCI and MaCCI groups (P<0.05) ; age, region, annual per capita household expenditure, depression status, and survey year were associated with being in MaCCI group (P<0.05). In 2018, compared to the RH group, the MiCCI and MaCCI group had more outpatient numbers, and the SCI, MiCCI, and MaCCI groups had higher outpatient expenses, inpatient numbers and expenses (P<0.05). In 2020, compared to the RH group, the SCI, MiCCI, MaCCI groups utilized more outpatient and inpatient services (P<0.05) .

According to the most recent CHARLS data, over half of older adults in China suffers from complex chronic comorbidities, with 44.7% for the MiCCI group and 8.6% for MaCCI group. The heart disease and chronic lung disease was the most prevalent in the MaCCI group. Furthermore, as the complexity of multimorbidity increases, there is a noticeable increase in outpatient and inpatient utilization as well as medical expenditures. Therefore, it is recommended to explore effective MCC management models based on healthcare demands to improve health outcomes and reduce disease burdens.

Posterior circulation ischemic stroke patients with vestibular symptoms usually do not present with obvious limb paralysis with certain walking ability after improvement of dizziness and vertigo symptoms, however, their fall risk is high and clinical attention to walking ability is lacking. Functional assessment using dual-task paradigms can better detect potential gait abnormalities in patients and provide a basis for early rehabilitation intervention.

To investigate the effect of dual task on walking ability of posterior circulation ischemic stroke patients with vestibular symptoms.

Forty patients diagnosed with posterior circulation ischemic stroke accompanied by vestibular symptoms and treated at Tianjin Huanhu Hospital from 2021 to 2022 were selected as the study subjects. Gait parameters including gait speed, step frequency, step size, proportion of double support phase time, step duration, trunk coronal plane and sagittal plane swing angles were collected using single-task walking, motor-motor dual-task walking, and cognitive-motor dual-task walking paradigms. The differences in gait parameters among the three task conditions and the differences in dual-task costs between the two dual-task walking.

Compared to single-task walking, the trunk coronal plane and sagittal plane swing angles were decreased in patients during motor-motor dual-task walking (P<0.05) ; the gait speed was increased, proportion of double support phase time and trunk coronal plane swing angle were increased in patients during cognitive-motor dual-task walking (P<0.05). Compared to motor-motor dual-task walking, the dual-task costs of cognitive-motor dual-task walking in terms of gait speed, step size and the proportion of double support phase time were increased (P<0.05) .

Dual task leads to decreased gait stability in posterior circulation ischemic stroke patients with vestibular symptoms. Additionally, cognitive-motor dual-task walking requires more attentional resources and is more likely to result in gait disturbances compared to motor-motor dual-task walking.

Breast cancer has become the most prevalent cancer worldwide, which leads to both physical symptom burden and psychological distress among patients. Although available literature has demonstrated the effect of physical activity in improving psychological health among breast cancer survivors, the underlying psychosocial mechanism is relatively understudied.

To investigate the association of walking with positive and negative affect among breast cancer patients, and examine the potential mediating effects of different dimensions of posttraumatic growth between them.

From April to July, 2019, 256 breast cancer patients receiving community-based management were recruited using convenience sampling from Shanghai Pengpuxincun Community Health Center to attend a household survey. Two hundred and thirty-five of them who completed the survey were included as final participants (achieving a response rate of 91.8%) . Levels of walking were measured using International Physical Activity Questionnaire-Long Form (IPAQ-long) , posttraumatic growth was assessed using Posttraumatic Growth Inventory-Short Form (PTGI-SF) , emotional health was assessed using the 20-item Positive and Negative Affect Scale (PANAS) . Structural equation modeling was conducted to test the parallel mediating effects of different dimensions of posttraumatic growth between walking and positive and negative affect.

The result of intermediary effect analysis show that, walking was associated with greater positive affect through facilitating the personal strength dimension of posttraumatic growth among breast cancer patients, with an indirect effect of 0.07〔95%CI (0.02, 0.13) 〕. Moreover, walking was associated with lower level of negative affect through facilitating the appreciation for life dimension of posttraumatic growth, with an effect size of -0.13〔95%CI (-0.21, -0.05) 〕. The result of the intermediary model show that, the level of walking activity promoted positive emotions (β=0.34, P<0.01) by promoting the personal strength dimension of post-traumatic growth (β=0.21, P<0.01) . In addition, walking activity decreased negative mood (β=-0.37, P<0.01) by promoting the life appreciation dimension of post-traumatic growth (β=0.35, P<0.01) .

Posttraumatic growth plays an important role as a mediator between walking and emotional health in breast cancer patients. In view of this, physicians from community health centers, the institutions responsible for long-term health management of cancer patients, should value walking as a potential intervention for improving psychological health of breast cancer patients in the future community health management. In addition, it is recommended to use both physical activity and psychological interventions to improve posttraumatic growth, in order to further enhance the intervention efficacy.