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ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.
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ObjectiveTo analyze the needs and current situation of home-based exercise rehabilitation for people with disabilities, develop service plans for different types of disabilities, and assess its health benefits for people with severe disabilities. MethodsBased on the World Health Organization (WHO) Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World and WHO Guidelines on Physical Activity and Sedentary Behavior, functional and individualized home-based exercise rehabilitation plans for people with severe disabilities were developed. Begining from May, 2023, a six-month intervention was conducted for 37 people with severe disabilities. They were assessed with International Physical Activity Questionnaire (IPAQ), WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), WHO Quality of Life (WHOQOL-BREF) before and after intervention. ResultsThe time of low-intensity leisure physical activity of IPAQ increased after intervention, while the scores of domains of cognition, mobility, self-care, getting along, life activities and participation, and total score of WHODAS 2.0 decreased, and the scores of physical health, psychological health, independence, and environment dimensions, and total score of WHOQOL-BREF increased. ConclusionThe functioning-oriented and individualized home exercise rehabilitation program can improve the level of physical activity, enhance the level of activity and boost the quality of life for people with severe disabilities.
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ObjectiveTo construct the physical activity intervention effect category and framework for college students with mental and behavioral health and functioning problems based on International Classification of Functioning, Disability, and Health (ICF). MethodsThe typical mental and behavioral health and functioning condition of college students were systematically analyzed using ICF. Relevant literatures about the health and functioning outcomes of college students participating in physical activity were retrieved from the databases of PubMed, Web of Science, EBSCO, and CNKI, from the establishment to August 20th, 2022, and reviewed systematically. ResultsTen English literatures were included, involving ten randomized controlled trials with 848 participants aged 15 to 34 years from seven countries, mainly from the journals of rehabilitation science, sports rehabilitation, rehabilitation psychology and health psychology, and were mainly published after 2016. The typical mental and behavioral health and functioning problems of college students mainly focused on stress, anxiety, depression, sleep disorders, learning fatigue, mobile phone addiction, alcohol drinking disorder, sedentary behavior and physical inactivity. Physical activity interventions included Biodanza, Hatha Yoga, Tai Chi, basketball, Baduanjin, cycling, swimming, roller skating, baseball, skill training, stretching exercise, resistance training, and aerobic exercise, etc. The frequency of interventions was mainly a long-term (four to 14 weeks, one to three times per week) program of high-, moderate-, or low-intensity physical activity. The health outcomes included improving cognitive function, relieving stress, anxiety, depression and learning fatigue, reducing negative automatic thinking, enhancing mindfulness, reducing loneliness and deficiency, improving sleep quality, improving upper limb muscle endurance; promoting the development of exercise habits, increasing physical activity participation, improving activity performance and academic performance, reducing sedentary behavior, drinking behavior and problematic mobile phone use; increasing social interaction, improving health perception and psychosocial function, enriching and improving recreation and campus life, and improving the quality of interpersonal relationships, quality of life and well-being. ConclusionA conceptual framework of physical activity participation of college students with mental and behavioral health and functioning problems is constructed using ICF. The typical mental and behavioral health and functioning problems of college students are mainly classified as mental health and functioning problems, behavioral health and functioning problems. The intervention types of physical activity are divided into physical fitness category, skill category, sports category and combination category. Health outcomes can be reflected in three dimensions: physical and mental health, activity and behavioral health, and overall functioning and quality of life.
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ObjectiveTo systematically review the effects of psychosocial support-related activities on mental health of older adults. MethodsRandomized controlled trails (RCTs) on mental health benefits for older adults were retrieved from PubMed, Web of Science, EBSCO and CNKI, until August, 2022. A systematic review was conducted. ResultsSeven RCTs were included, from Spain, Chile, Canada, Finland, the United Kingdom, South Korea and the United States, mainly from psychiatry, mental health of the elderly and other journals, published after 2017. The subjects aged 60 to 80 years, accounting to 1 258 cases. Psychosocial interventions included Pilates, mindfulness, behavioral activation, cognitive stimulation, daily difficult problem solving training, pain and depression symptom management, health education and guidance, nursing coordination, group exercise (such as circuit training, pedal training or rubber band training), and water sports, etc. The frequency of intervention was 30 to 120 minutes a time, one to nine times a week, and the intensity of the intervention was low to high intensity for four to 64 weeks. Intervention sites included sports venues, community health centres, ageing services, and intervention staff included sports therapists (yoga), psychologists, health professionals, community health services, and health care workers. All interventions were carried out under supervision. The benefits of psychosocial intervention on the mental health of the older adults mainly reflected in the improving cognitive function and self-efficacy, reducing anxiety and depression, improving depressed mood or loneliness, improving sleep quality, increasing sense of social integration and relieving pain and other problems. ConclusionMental health interventions (psychological interventions or support, social interventions or support, psychosocial interventions) and mental health-related interventions (physical activity interventions) benefit older people's mental health, including improving cognitive function, alleviating anxiety and depression, improving sleep quality, and improving quality of life and well-being.
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ObjectiveTo evaluate the main structural and content features of four instruments for motor function and motor ability assessment and their psychometric properties for children and adolescents with disabilities, based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). MethodsPubMed, Medline and Web of Science databases were searched for literature on motor function and motor ability assessment for children and adolescents with disabilities published from establishment to May, 2023. The main structural and content characteristics of the tools were analyzed using ICF-CY, and the quality of measurement tools was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). ResultsNine papers were eventually included, and four assessment tools were identified, including Gross Motor Function Measure-88 (GMFM-88), Peabody Developmental Motor Scales second edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), and Movement Assessment Battery for Children second edition (MABC-2). The GMFM-88 consisted of 88 items in five dimensions: zone A (lying and rolling), zone B (sitting), zone C (crawling and kneeling), zone D (standing), and zone E (walking and running and jumping); it involved joint movement function (b710), random movement control function (b760), etc., in body function; and the change of basic body posture to maintain a body posture (d410) and maintain a body posture (d415) in activity and participation, with good to excellent levels of internal consistency reliability, test-retest reliability, content validity, and structural validity. The PDMS-2 consisted of six subtests, including reflexes, posture, movement, physical manipulation, grasping and visuomotor integration, with a total of 249 items; it involved memory function (b144) and joint mobility function (b710) in body function; as well as looking (d110) and imitation (d130) in activity and participation; with good psychometric properties in terms of internal consistency reliability, test-retest reliability, content validity, structural validity, and hypothesis testing and cross-cultural feasibility. There are two versions of BOT-2: long form and short form. The long form consisted of eight subtests with 53 items, involving joint mobility function (b710) and joint stability function (b715) in body function; as well as imitation (d130) and learned calculation (d150) in activity and participation; it achieved excellent levels of psychometric properties in terms of internal consistency reliability, content validity, and structural validity, and good level in reliability and test-retest reliability. MABC-2 consisted of two parts: an activity ability test and a checklist with 30 items; it involved joint mobility function (b710), joint stability function (b715), etc., in body function; as well as fine-hand use (d440), hand and arm use (d445) in activity and participation; with good psychometric properties such as reliability, content validity, and structural validity. ConclusionThis systematic review analyzed the main structural and content characteristics of four types of measurement tools for assessing motor function and motor ability in children and adolescents with disabilities based on the ICF-CY, and evaluated the quality of psychometric properties (internal consistency reliability, test-retest reliability, content validity, structural validity, and cross-cultural consistency, etc.) of the four types of measurement tools using the COSMIN criteria. For the structure and content, PDMS-2 appears the broadest content, and measures fine hand movements, dynamic and static balance, along with the BOT-2 and MABC-2. GMFM-88 focuses more on gross motor functions such as postural control. Four instruments show high internal consistency reliability, test-retest reliability, content validity and structural validity, while the BOT-2 and PDMS-2 show better reliability. To ensure the reliability and validity of the measures, rehabilitation workers and educators need to receive standardized training and qualification before using the standardized instruments for motor function and motor ability for children with disabilities. With norm-referenced measures, the results need to be converted to standard scores.
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ObjectiveTo investigate the current situation of accessible facilities construction and assistive technology application of existing sports venues in Shenzhen, and analyze the existing problems. MethodsFrom November 19, 2022 to Februry 17, 2023, using the standards for the construction of accessible sports venues, the accessible construction and services of public sports venues and the application of assistive technology in eight districts of Shenzhen were investigated and evaluated on the spot. ResultsThere were curb ramps and accessible public toilets for all the stadiums; surface indicator for 87.5% (7/8) stadiums; wheelchair ramps, accessible elevators and accessible wheelchair seats for 62.5% (5/8) stadiums; accessible route for 37.5% (3/8) stadiums; handrails for 12.5% (1/8) stadiums; accessible vehicles parking lots for 75% (6/8) stadiums; and 25% (2/8) stadiums used assistive technology. ConclusionThis study evaluated the accessibility of accessible facilities and assistive technologies in sports venues in Shenzhen, including entering the stadium, entering the interior of the stadium and taking exercise. In terms of accessible facilities, the number of venues for the construction of curb ramps and accessible public toilets is the most, the number of venues for the construction of accessible handrails is the least, and the application of assistive technology is the worst.
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ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.
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@#Objective To systematically research the policies and core contents of World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) documents on policies, guidelines and standards for health-promoting schools and health services. Methods These policy documents included Making Every School a Health-promoting School: Implementation Guidelines, WHO Guidelines on School Health Services, and Making Every School a Health Promoting School Global Standards and Indicators, which construct a conceptual and policies framework for health-promoting schools. In perspective of health service system, this study systematically explored the policies, guidelines and standards of WHO and UNESCO on health-promoting schools and health services, as well as the role of health-promoting school component systems in promoting the health of children and how physical activity can be an important area of health-promoting schools. Results The Health Promoting Schools Initiative is an important area of research for the WHO health services. Making Every School a Health-promoting School: Implementation Guidelines primarily serves students aged five to 19, teachers and other staff in schools. WHO Guidelines on School Health Services cover a variety of activity types including health promotion, health education, preventive interventions, clinical assessment and health services management. Making Every School a Health Promoting School Global Standards and Indicators covers eight global criteria and thirteen specific areas in the areas of policy resources, curriculum and environment, and community engagement. Conclusion WHO and UNESCO have proposed a series of policies related to building health-promoting schools, which focus on child health and advocate the promotion of child and adolescent health, public health, education, social and economic development through schools to achieve the goal of safeguarding the health rights of children and adolescents and meeting health needs. Following the WHO Guidelines on School Health Services and Making Every School a Health Promoting School Global Standards and Indicators, it proposed to incorporate educational and physical education tools into the school health service system.
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@#Objective To systematically analyze the World Health Organization Rehabilitation Competency Framework (RCF) theoretical framework, methodology and its application in the field of rehabilitation.Methods We systematically analyzed RCF conceptual framework and key characteristics, and discussed how to apply the RCF in the fields of human resource planning, education program and curriculum system, and vocational competency standards and certification criteria for rehabilitation human resources.Results The RCF encompasses five domains, naming practice, professionalism, learning and development, management and leadership, and research. Rehabilitation professionals' performance is the result of the interaction of their core values and beliefs, competencies, activities, knowledge, and skills. The RCF can be used to plan rehabilitation human resources, establish competency-based rehabilitation education programs and curriculum systems, and develop competency certification standards and licensure accreditation standards.Conclusion This study analyzed background, content and implementation framework of RCF, and systematically discussed the theories and methods related to how to use the RCF to construct national rehabilitation human resources development plans, develop rehabilitation education programs and curriculum systems based on the RCF, and establish certification and assessment standards for rehabilitation human resources.