World Health Organization survey on the level of integration of traditional Chinese medicine in Chinese health system rehabilitation services.

Background: To meet the growing global demand for rehabilitation services, the World Health Organization (WHO) launched Rehabilitation 2030. This study was commissioned by the WHO to investigate the integration degree of traditional Chinese medicine (TCM) in Chinese health system rehabilitation services and the demand for TCM rehabilitation in China. Methods: Twenty TCM rehabilitation experts and relevant government administrators were invited to complete the questionnaire between September 2019 and January 2022. The development of traditional, complementary, and integrative medicine (TCI) rehabilitation in China was assessed primarily based on six different health system components. Results: 26 policies, regulations, and national strategic plans related to TCI rehabilitation were issued by relevant government departments since 2002; notably, 14 policies related to TCI rehabilitation development were intensively introduced from 2016 to 2021. These policies cover the three main areas of financing, infrastructure development, and service delivery. The National Administration of Traditional Chinese Medicine's investment in TCM clinical capacity infrastructure and scientific research in 2019-2021 increased by 66% compared to 2010-2012, and the average number of TCM hospitals with rehabilitation departments in 2020 increased by 6.5% compared to 2018. The proportion of community health service centers providing TCM services in primary medical and health institutions has increased by 30.8% over the past 10 years. Conclusion: Long-term continuous policies, substantial financial investment, and expansion of the scope of TCI rehabilitation services in primary care institutions have effectively contributed to the rapid development of TCI rehabilitation. However, human resources and financing mechanisms for TCI rehabilitation need further improvement.

Communication and cooperation within a stroke rehabilitation team: a qualitative research / 中国康复理论与实践

ObjectiveTo explore the obstacles and causes of communication and cooperation among doctors, nurses and rehabilitation therapists in a stroke rehabilitation team. MethodsFrom July to October, 2022, twelve rehabilitation evaluation meetings were observed using ethnographic research, based on Shared Mental Model theory. Semi-structured interviews were held with five doctors, ten nurses and four rehabilitation therapists. ResultsFour themes and nine sub-themes were presented, namely equipment (poor interoperability of information system, limited knowledge of rehabilitation equipment for doctors and nurses), task (members were under time pressure to attend meeting, imperfect inter-discipline communication system), team interaction (insufficient information sharing, unfamiliar with roles/responsibilities, misunderstanding between specialties) and team member (less participation of nurses, limited multidisciplinary knowledge). ConclusionThe communication and cooperation among stroke rehabilitation team members is limited by many factors, such as equipment, task, team interaction and team members. It is suggested to improve interoperability of information systems, create a supportive environment, know each other's roles/responsibilities, strengthen interdisciplinary crossover, pay attention to and support the cultivation of nurses' ability, to promote efficient communication and cooperation among team members.

Interpretable evaluation for the Brunnstrom recovery stage of the lower limb based on wearable sensors.

With the increasing number of stroke patients, there is an urgent need for an accessible, scientific, and reliable evaluation method for stroke rehabilitation. Although many rehabilitation stage evaluation methods based on the wearable sensors and machine learning algorithm have been developed, the interpretable evaluation of the Brunnstrom recovery stage of the lower limb (BRS-L) is still lacking. The paper propose an interpretable BRS-L evaluation method based on wearable sensors. We collected lower limb motion data and plantar pressure data of 20 hemiplegic patients and 10 healthy individuals using seven Inertial Measurement Units (IMUs) and two plantar pressure insoles. Then we extracted gait features from the motion data and pressure data. By using feature selection based on feature importance, we improved the interpretability of the machine learning-based evaluation method. Several machine learning models are evaluated on the dataset, the results show that k-Nearest Neighbor has the best prediction performance and achieves 94.2% accuracy with an input of 18 features. Our method provides a feasible solution for precise rehabilitation and home-based rehabilitation of hemiplegic patients.

Advance in Rehabilitation Evaluation for Knee Osteoarthritis (review) / 中国康复理论与实践

Rehabilitation is an essential treatment for knee osteoarthritis. Rehabilitation evaluation is the foundation of rehabilitation treatment. The items of rehabilitation evaluation for knee osteoarthritis include pain, proprioception, range of motion, muscle force, balance, gait, quality of life, and so on. When evaluating the patient's pain, researchers should not only focus on Visual Analogue Score (VAS) outcomes, but also consider the patient's body function and activity level, and whether there is neuropathic pain. Furthermore, isokinetic dynamometer can not only be used for quantitative assessment for muscle strength, but also for the quantitative evaluation for patient's proprioception. Moreover, Community Balance and Mobility Scale has no ceiling and floor effects which also is a reliable and useful tool for assessing the balance function in patients with knee osteoarthritis, compared with Berg Balance Scale. The evaluation for body structure in patients with knee osteoarthritis mainly includes the radiological examination and physical examination. There are a lot of scales to evaluate the quality of life in patients with knee osteoarthritis, and Osteoarthritis of Knee and Hip Quality of Life fits most. Further researches and promotion of evaluation tools for knee osteoarthritis are needed in the future.

Intra- and Inter-rater Reliability of A Novel Hand-held MyotonPRO Device for Achilles Tendon Properties in Healthy Subjects / 中国康复理论与实践

Objective To evaluate the intra-and inter-rater reliability of MyotonPRO for Achilles tendon properties measured. Methods Twenty healthy subjects were recruited to measure Achilles tendon properties using a novel hand-held Myoton-PRO device by two testers, one of the testers re-tested five days later. The reliability was assessed using in-tra-class correlation coefficient (ICC) and Bland-Altman analysis, and minimum detectable changes (MDC) was calculated. The Achilles tendon properties of the dominant or non-dominant leg was compared. The correlation between body mass and Achilles tendon properties was examined. Results The intra-rater reliabilities of Achilles tendon properties were ICCleft=0.884 and ICCright=0.904; the inter-rater reli-abilities were ICCleft=0.883 and ICCright=0.945. The MDC was 36.64 N/m. Bland-Altman plots showed good agreement. There was no significant difference in Achilles tendon properties between dominant and non-domi-nant legs (t<1.236, P>0.05). The body mass positively correlated with Achilles tendon properties (r>0.477, P<0.05). Conclusion The intra-and inter-rater reliabilities of MyotonPRO were good in measuring Achilles tendon properties in healthy subjects. No significant difference was found between dominant and non-dominant legs. The body mass positively correlated with Achilles tendon properties in healthy subjects.

Factors Related to Stiffness of Gastrocnemius Muscle:Study with MyotonPRO / 中国康复理论与实践

Objective To explore the impact of gender and body mass on stiffness of the medial and lateral head of gastrocnemius muscle. Methods Forty healthy subjects were recruited to measure the stiffness of medial and lateral head of gastrocnemius mus-cle,using a novel hand-held device MyotonPRO.The relationships between gender,weight and muscle stiffness were examined. Results The stiffness of medial and lateral head of gastrocnemius muscle was more in males than in females(t>2.523, P<0.01),and was positively correlated with body mass(r>0.322,P<0.05).There was no significant difference in the stiffness between dominant and non-dominant legs for medial and lateral head of gastrocnemius muscle(t<0.851,P>0.05). Conclusion Gender and body mass ralate with the stiffness of medial and lateral head of the gastrocnemius muscle in healthy subjects,and the stiffness of both left and right sides is symmetrical in healthy subjects.

Inertial Sensing Based Assessment Methods to Quantify the Effectiveness of Post-Stroke Rehabilitation.

In clinical settings, traditional stroke rehabilitation evaluation methods are subjectively scored by occupational therapists, and the assessment results vary individually. To address this issue, this study aims to develop a stroke rehabilitation assessment system by using inertial measurement units. The inertial signals from the upper extremities were acquired, from which three quantitative indicators were extracted to reflect rehabilitation performance during stroke patients' movement examination, i.e., shoulder flexion. Both healthy adults and stroke patients were recruited to correlate the proposed quantitative evaluation indices and traditional rehab assessment scales. Especially, as a unique feature of the study the weight for each of three evaluation indicators was estimated by the least squares method. The quantitative results demonstrate the proposed method accurately reflects patients' recovery from pre-rehabilitation, and confirm the feasibility of applying inertial signals to evaluate rehab performance through feature extraction. The implemented assessment scheme appears to have the potential to overcome some shortcomings of traditional assessment methods and indicates rehab performance correctly.

Advance in Assessment of Upper Limb and Hand Motor Function in Patients after Stroke (review) / 中国康复理论与实践

Patients often suffered limb dysfunction after stroke. Upper limb and hand function recovered more slowly than lower limb, and became one of the research focuses in rehabilitation medicine. Timely and effective assessments were important to guide the rehabilita-tion treatment, evaluate the treatment efficacy and predict functional recovery of upper extremity and hand function. The assessment meth-ods of upper limb and hand motor function included subjective evaluations and objective evaluations. The former included different kinds of scales, which involved assessment focusing on muscle, motor pattern, change of upper limb and hand function. While the latter contained biomechanics, neuroelectrophysiology, functional magnetic resonance imaging, upper limb robotic evaluation system and so on. Scales were proved to have good reliability and validity. But they could not show patients' function accurately because of the subjectivity, and the data could not be kept. Evaluation system with computer was applied in clinical practice more and more widely. In this review, we summarized the assessments on upper limb and hand motor function in patients after stroke.

Walking Ability of Amputees with Unilateral Transfemoral Prosthesis / 中国康复理论与实践

@#Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Methods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significantly less in the patients than in the controls (P<0.05) in the indoor 6-minute walking test, and the cycle of gait and energy expenditure were significantly more (P<0.05); single support time, double and single/double support time were different (P<0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (P>0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P<0.05). There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test between amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expenditure of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait, and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.

Advance in Assessment of Upper Limb and Hand Motor Function in Patients after Stroke (review) / 中国康复理论与实践

@#Patients often suffered limb dysfunction after stroke. Upper limb and hand function recovered more slowly than lower limb, and became one of the research focuses in rehabilitation medicine. Timely and effective assessments were important to guide the rehabilitation treatment, evaluate the treatment efficacy and predict functional recovery of upper extremity and hand function. The assessment methods of upper limb and hand motor function included subjective evaluations and objective evaluations. The former included different kinds of scales, which involved assessment focusing on muscle, motor pattern, change of upper limb and hand function. While the latter contained biomechanics, neuroelectrophysiology, functional magnetic resonance imaging, upper limb robotic evaluation system and so on. Scales were proved to have good reliability and validity. But they could not show patients' function accurately because of the subjectivity, and the data could not be kept. Evaluation system with computer was applied in clinical practice more and more widely. In this review, we summarized the assessments on upper limb and hand motor function in patients after stroke.

Development of Upper Extremity Evaluation Devices (review) / 中国康复理论与实践

This paper discussed the application of upper extremity rehabilitation devices in rehabilitation evaluation after stroke, fo-cused on some typical kinds of upper extremity rehabilitation systems. It was analyzed that the way to obtain multiple parameter and evalua-tion indices during the progress of upper extremity rehabilitation evaluation, and viewed the development and application of upper extremity rehabilitation evaluation technology.

The reliability of knee joint position testing using a dynamometer / 中华物理医学与康复杂志

Objective To determine the intra-and inter-tester reliability of a dynamometer in assessment of knee joint position senses (JPS).Methods Sixteen healthy volunteers (intra-rater N =6,inter-rater N =10) were examined with regard to intra-and inter-tester reliability of knee JPS by using Biodex System 3 dynamometer,measured by passive replication test,with subjects passively returning to the initial positions at 30°,45° and 60° knee flexion.The absolute error (AE) angle was recorded.Both intra-and inter-tester reliability studies involved two testers.Results The intra-tester reliability of the AE were moderate reliable at 30°,45°and 60° knee flexion,and the values of intra-class correlation coefficients (ICC) were 0.728,0.780 and 0.807,respectively.The values of Pearson's correlation coefficients for inter-tester reliability were 0.676,0.610 and 0.705,respectively (P ＜ 0.05).There was no significant difference between the AE values of dominance and non-dominant knees,test and retest,and in the AE values of 30°,45°and 60° knee flexion (P ＞ 0.05).The 95％ confidence upper limits of all subjects' AE values were less than 3°.Conclusion The major findings of this study suggest that the test-retest reliability of the knee JPS were moderate using Biodex System 3 dynamometer,and selecting a target angle of passive replication test can achieve the same purpose in 30° to 60°knee flexion.The clinical significance should be taken into consideration when the AE changes were greater than 3 degrees.

Efficacy of Rehabilitation on Acalculia after Acquired Brain Injury / 中国康复理论与实践

@#Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.

A Scale of Vocational Rehabilitation for Adult with Intellectual Disability / 中国康复理论与实践

@#Objective To establish a scale of vocational rehabilitation for adult with intellectual disability.MethodsDelphi method was applied to comply the scale which was divided into four dimensions including life satisfaction, life skills, social interaction ability and personality to evaluate vocational rehabilitation for adult with intellectual disability.ResultsFor the test-retest reliability, the coefficient was 0.735 for the total scale, 0.869 for life satisfaction, 0.621 for life skills, 0.611 for social skills, and 0.505 for ability to work. The coefficien of the scale (all versions) in all dimensions and total scores were between 0.635～0.938.ConclusionThe scale has good reliability and validity to evaluate the effect of vocational rehabilitation of adult with intellectual disability.

Disuse Syndrome after Subarachnoid Hemorrhage: A Rehabilitation Evaluation Discussion / 中国康复理论与实践

@#This article introduced the form of the rehabilitation evaluation discussion, which was moderated by the rehabilitation doctors, together with relevant therapists and nurses, aiming to discuss the obstacles and the rehabilitation plan for a difficult patient. This case showed the importance of early rehabilitation after stroke.

Application of Intelligent Device for Energy Expenditure and Activity in Evaluation of Protrusion of Intervertebral Disc / 中国康复理论与实践

@#Objective To apply the Intelligent Device for Energy Expenditure and Activity(IDEEA)system to evaluate the locomotion of patients with protrusion of intervertebral disc(PID)quantitatively and dynamically.Methods 8 patients with PID and 9 volunteers as controls performed a series of daily activities in their nature environment.They were monitored with IDEEA.Results The velocity of flexion forward,time flexion forward,time stand up,time sit down of the patients were significant different to the controls(P<0.05),and the walking speed of the former was slower(P<0.05)than the latter's.Conclusion Physical performance of the PID patients was significantly reduced.The IDEEA can be a good tool to evaluate their ability of locomotion in their daily living.

Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai / 中国康复理论与实践

@#Objective To create the evaluation index system of rehabilitation service for all disabled in Shanghai.MethodsCompositive quantitative and qualitative research methods,such as literature review,focus-group discussion,questionnaire survey,specialist consultation were carried in the study.ResultsThe Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai finally comes into being includes 8 first-degree index,32 second-degree indexes and 100 third-degree index.ConclusionThe evaluation index system would be provided with directive significance to the goal of 'rehabilitation service for all disabled persons'.

Introduction of Rivermead Behavioural Memory Test Second Edition / 中国康复理论与实践

@#The authors introduce the items,scores,reliability,validity,the differences between the Rivermead Behavioural Memory Test Second Edition(RBMT-Ⅱ) and RBMT-Ⅰand characteristics of the RBMT-Ⅱ(2003).RBMT-Ⅱ is more practicable in clinical than general standard memory tests,it is good for clinical rehabilitation.

Study on Reform and Construction of Teaching of Rehabilitation Evaluation Course in Higher Vocational Colleges / 中国康复理论与实践

@#Rehabilitation evaluation was an important special basic course of healing cure specialty in the higher vocational college. It was a key to improve teaching quality of training students' occupation capacity. The establishment of aim, class teaching contents and outline, the preparation of teaching data, the innovation of teaching methods and measures, the reinforcement of practical teaching, and etc. were discussed in this paper. Considerations and experiences on the practical teaching reform and construction of rehabilitation evaluation courses were put forward in the higher vocational colleges.

Quantitive Study on the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai / 中国康复理论与实践

@#Objective To create the target value of third-degree index and the weight coefficient of evaluation index system of rehabilitation service for all disabled in Shanghai. Methods Compositive quantitative and qualitative research methods, such as document analysis, Delphi method, questionnaire survey, specialist consultation were carried in the study. Results The enthusiasm coefficient of specialist in three times were 100%, 100%, 92.3% respectively, the degree of specialist authority was 0.84, the coordination coefficient of specialist for the first-and second-index were 0.79 and 0.72 respectively. The weight of the more important first-degree index namely community rehabilitation, outlay support, organization network and policy environment were 0.1836, 0.1781, 0.1360 and 0.1274.Conclusion The enthusiasm, authority and coordination of specialist of this evaluation index system are high. The index weight can offer evaluation basement.