Objective To create an evidence-based expert consensus on airway function rehabilitation and management post tracheostomy in neurocritical patients.

Methods The lists of problems and recommendations were defined using Delphi method, and the evidence quality and recommendation strength were evaluated using GRADE, and the results were reported based on RIGHT.

Results The comprehensive rehabilitation of airway function for neurocritical patients with tracheotomy in the setting of clinical rehabilitation would be conducted by a multidisciplinary team, including rehabilitation physicians, rehabilitation therapists, nurses, etc. A total of 17 recommendations were finally formulated on four major issues, including the airway function rehabilitation, airway management, pre-decannulation assessment and decannulation, and the monitoring after decannulation and rehabilitation management.

Conclusions The expert consensus on the airway function rehabilitation and the management after tracheostomy in neurocritical patients in the setting of clinical rehabilitation has been created, which may be helpful for the quality and safety of rehabilitation for the airway function in neurocritical patients with tracheostomy.

Objective To systematically analyze the effect of virtual reality (VR) and augmented reality (AR) on cognition, emotion and adaptive behavior in children and adolescents with autism spectrum disorder (ASD).
Methods The randomized controlled trials (RCT) about the effect of VR or AR interventions on cognition, emotion and adaptive behavior in children and adolescents with ASD were retrieved from databases of PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP and Wanfang data from January, 2008 to August, 2024, and a systematic review was conducted.
Results Nine RCT from China, Italy, Spain, Iran and the United Kingdom, involving a total of 384 participants, were included, published between 2016 and 2024. Participants aged two to 15 years. The approaches included VR immersive headsets, Xbox 360 Kinect game consoles, CAVE-style immersive virtual environments and AR; covered daily life scenario experiences, cognitive and social scenario training, and emotion recognition tasks. Outcome measures involved cognitive function, emotional function, attention, memory, basic interpersonal communication and adaptive behavior. Interventions typically lasted 15 to 60 minutes a time, one to three times a week, for three to 24 weeks. VR-based training improved overall cognition, emotion recognition, emotional control and expression, basic interpersonal communication and adaptive behavior; while AR-based training improved executive function, spatial orientation, task focus and memory.
Conclusion VR and AR are effective on overall cognitive function, emotional function, attention, memory, basic interpersonal communication and adaptive behavior in ASD children and adolescents.

Objective To investigate the effect of manual therapy based on surface electromyography on knee osteoarthritis (KOA) in the older people.
Methods A total of 106 outpatient with unilateral KOA were selected from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, from August, 2023 to June, 2024, and were randomly divided into control group (n = 53) and experimental group (n = 53). The control group accepted routine manual therapy, and the experimental group accepted manual therapy based on the analysis of average electromyography (AEMG). They were assessed with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS) for pain, Tinetti Balance and Gait Score, and 6-minute walk test (6-MWT) distances before and after treatment.
Results One case dropped down in each group. Before treatment, AEMG decreased in the rectus femoris, medial femoris and medial head of gastrocnemius on the affected side in the experimental group (|Z| > 8.647, P < 0.001), and it increased in the lateral femoris, semitendinosus and biceps femoris (|Z| > 4.808, P < 0.001). The scores of WOMAC, VAS, Tinetti Balance and Gait Score, and distances of 6-MWT improved in both groups after treatment (|t| > 3.987, P < 0.001), and improved more in the experimental group than in the control group, except the VAS score (|t| > 2.213, P < 0.05).
Conclusion Manual therapy focusing on activation of rectus femoris, medial femoris and medial head of gastrocnemius, inhibition of the lateral femoris, semitendinosus and biceps femoris, and releasing the tension of the medial and lateral collateral ligaments, according to the results of surface electromyography, can alleviate the pain of the KOA in the older people and improve the mobility of the knee.

Objective To analyze the current status, research hotspots, and development trends of transcranial ultrasound stimulation (TUS) in neurorehabilitation.

Methods Relevant literature on the application of TUS in neurological rehabilitation was retrieved from CNKI, Wanfang data, and Web of Science Core Collection, covering publications from inception to December 31, 2023. VOSviewer 1.6.20 and CiteSpace 6.2.R1 were used for visualized analysis.

Results A total of 247 articles were included, with 124 in Chinese and 123 in English, showing an increasing trend in annual publications. The major contributors to English literature were China, the United States, Canada, France and South Korea. High-frequency Chinese keywords included transcranial ultrasound, neuromodulation, Parkinson's disease, stroke and clinical efficacy. The keyword clusters were transcranial ultrasound, neuromodulation, upper limb function and Parkinson's disease. Bursting keywords included rehabilitation, neural function, ultrasound therapy, closed-loop control and low intensity. High-frequency English keywords included focused ultrasound, deep brain stimulation, transcranial magnetic stimulation, blood-brain barrier and thalamotomy. Keyword clusters covered tissue plasminogen activator, ultrasonic imaging, transcranial magnetic stimulation, thalamotomy and ultrasound. Bursting keywords featured essential tremor, neurostimulation, direct current stimulation and transcranial ultrasound stimulation.

Conclusion Research on the application of TUS in neurorehabilitation is on the rise, focusing on its efficacy and safety in Parkinson's disease, essential tremor, and ischemic stroke. Future research needs to explore the mechanisms of TUS, optimize treatment plans, and promote the development of individualized therapies.

Objective To systematically evaluate the effect of speech and language therapies and educational interventions on children with intellectual and developmental disabilities (IDD).

Methods A systematic review was conducted by searching relevant literature in PubMed, PsycINFO, ERIC, Cochrane Library and Web of Science databases, ranging from January, 2018 to May, 2024.

Results A total of eight English articles were included, from six countries including the United States, France, Italy, Norway, Poland and New Zealand, involving 610 children with IDD, from journals about speech language pathology, Down syndrome research and speech language hearing research. The publication time was mainly from 2018 to 2023. The age of the subjects was two to twelve years, and the main health conditions included intellectual disability, autism and Down syndrome. The intervention methods included routine speech therapy (individualized therapy and group therapy), augmentative and alternative communication (device-assisted and sign language and picture cards), family-involved language training programs (parent training and family interaction), computer-assisted language learning (language learning software and telehealth), and play-based interventions (interactive games and structured games); 15 to 150 minutes a time, one to ten times a week, for ten to 144 weeks. The outcomes were reflected in five aspects: increasing the vocabulary in speaking; improving the language comprehension, symbol recognition and vocabulary comprehension; improving both expressive and receptive language skills; improving participation in game diversity and game participation levels, communication, social interaction and interaction skills; and improving overall language and non-verbal communication skills.

Conclusions Combining a variety of methods, such as individualized therapy, family participation, technologic assistance and interactive games, speech and language therapies and education are effective on spoken language production, language comprehension, speech production, social interaction and communication skills for children with IDD.

Objective To elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment.

Methods Based on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index.

Results This study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP.

Conclusion Structured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

Objective To investigate the effect of cognitive-motor dual-task training on balance and gait in patients within six months post stroke.
Methods From May, 2022 to April, 2023, 68 stroke patients in Beijing Puren Hospital were randomly divided into control group (n = 34) and experimental group (n = 34). Both groups received conventional rehabilitation training. The control group received single-task walking training, and the experimental group received cognitive-walking dual-task training, in addition, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE) before and after training, and measured static balance posture trajectory, stability limits, gait analysis with Pro-kin and OptoGait in both single-task and dual-task states.
Results After training, the scores of FMA-UE increased in both groups (|t| > 10.239, P < 0.001), and no difference was found between two groups (P > 0.05). In single-task state, all the parameters of balance improved in both groups after training (|t| > 2.934, P < 0.01), and the length of movement locus with eyes closed was longer in the experimental group than in the control group (t = 3.330, P = 0.001); all the parameters of gait improved in both groups after training (|t| > 6.823, P < 0.05), and the walk speed was better in the experimental group than in the control group (t = 2.355, P = 0.022). In dual-task state, all the parameters of balance improved in both groups after training (|t| > 2.472, P < 0.05), expect the length of trajectory with eyes open in the control group (P > 0.05), and no difference was found in other parameters between two groups (P > 0.05); and all the parameters of gait improved in both groups after training (|t| > 2.238, P < 0.05), and the stride length and walk speed were better in the experimental group than in the control group (t > 2.443, P < 0.05).
Conclusion Cognitive-motor dual-task training can effectively improve lower limb motor function, balance function and walking ability in convalescent stroke patients, and it is superior to single-task walking training in improving some gait parameters.

Objective To explore the effect of transcranial direct current stimulation (tDCS) based on music therapy on insomnia.

Methods From July, 2023 to April, 2024, 70 patients with insomnia in the Fourth Affiliated Hospital of Soochow University were randomly divided into control group (n = 35) and observation group (n = 35). Both groups accepted music therapy; moreover, the observation group accepted tDCS, and the control group accepted sham tDCS, for four weeks. They were assessed with Pittsburgh Sleep Quality Index (PSQI) total score and sub-score, Hamilton Depression Scale 17-item (HAMD-17), Hamilton Anxiety Scale (HAMA), Chinese version of Stress Perception Scale (CPSS); and the relative power of resting-state electroencephalography (EEG) and mean blood flow velocity (Vm) of each cerebral artery with transcranial Doppler were measured before and after treatment.

Results Five cases dropped down in the control group, and four in the observation group. PSQI total score and sub-score, HAMD-17 score, HAMA score and CPSS score (|t| > 3.503, P < 0.01) in the observation group decreased after treatment, and were less in the observation group than in the control group (|t| > 2.304, P < 0.05), except sleep duration, sleep efficiency and CPSS scores. The relative power of δ and θ increased in the observation group, and decreased in α, β and γ (|t| > 6.468, P < 0.001), and were better in the observation group than in the control group (|t| > 2.395, P < 0.05). The Vm of each artery increased in the observation group (|t| > 4.624, P < 0.001), and were more in the observation group than in the control group (|t| > 2.147, P < 0.05).

Conclusion tDCS based on music therapy may further improve sleep quality and EEG activity, increase cerebral blood flow velocity, and reduce adverse emotions in insomnia patients.

Objective To observe the effect of intelligent flexible ankle stretching training on lower extremity spasm in patients with spinal cord injury.

Methods From June, 2021 to May, 2024, 28 patients with spinal cord injury were randomly divided into control group (n = 14) and experimental group (n = 14). Both groups received conventional rehabilitation treatment. On this basis, the control group received manual extension treatment, and the experimental group received intelligent flexible ankle stretching system training, for eight weeks. The modified Ashworth Scale (MAS), ankle dorsiflexion angle, Clinical Spasticity Index (CSI), max root mean square (RMS_max) of surface electromyography of gastrocnemius medial head and vibration perception threshold (VPT) of great toe were compared.

Results After treatment, MAS (χ² = 10.378, P = 0.035), ankle dorsiflexion angle (Z = -3.306, P < 0.001), CSI (t = 4.101, P = 0.001) and RMS_max of gastrocnemius medial head (Z = -3.296, P < 0.001) improved in the experimental group, while MAS (χ² = 11.418, P = 0.022), ankle dorsiflexion angle (Z = -1.986, P = 0.047) and RMS_max of gastrocnemius medial head (Z = -2.297, P = 0.021) were better in the experimental group than in the control group. Although VPT was improved after treatment, no significant difference was found within and beteen groups (P > 0.05).

Conclusion The intelligent flexible ankle stretching training could improve the lower limb muscle spasticity in patients with spinal cord injury, and may be benefit for foot proprioception.

Objective To review the application of artificial intelligence (AI) in the identification, monitoring and intervention of sleep disorders in the elderly and the effect.

Methods A scoping review was conducted by searching relevant literature ahout the application of AI in the field of sleep disorders among the elderly from databases including PubMed, Web of Science, CNKI, and Wanfang data, covering literatures from the establishment to June, 2024.

Results A total of ten articles were included, originating from seven countries and involving 36 344 elderly participants. The publication dates ranged from 2020 to 2024. The study types included six cross-sectional studies, one prospective study, one self-controlled study and two randomized controlled trials. The articles mainly came from the fields of clinical medicine, sleep research, rehabilitation medicine and information engineering. AI was primarily used for monitoring the entire sleep process of the elderly, predicting and identifying sleep disorders, and interventions such as biofeedback, online consultations and cognitive-behavioral therapy based on mobile platforms.

Conclusions AI not only improves the accuracy of diagnosing sleep disorders, but also provides robust data support for clinical intervention. Online sleep interventions based on big data and intelligent algorithms can offer effective health management for the elderly.

Objective To systematically analyze the global policy framework, standard systems and application technology models of digital rehabilitation within the framework of the World Health Organization (WHO) Global Digital Health Strategy and propose policy recommendations for the future development of digital rehabilitation.

Methods Based on the policies on digital health and rehabilitation development issued by the WHO, focusing on the Global Digital Health Strategy, Rehabilitation 2030 Initiative, Rehabilitation in Health Systems, Rehabilitation in Health Systems: A Guide for Action, and World Report on Disability,a systematic review was conducted, to explore the policy architecture and core content of digital rehabilitation, the standard system for digitalizing rehabilitation, and key technological models for the development of digital rehabilitation.

Results In the context of global health and digital transformation, the development of digital rehabilitation services was an essential component of the global digital health strategy. Building a comprehensive policy framework and content system for digital rehabilitation was critical for strengthening rehabilitation data governance, enhancing data utilization efficiency, and ensuring data privacy and security. Empowering rehabilitation with digital technology was vital for improving the standardization, effectiveness, coverage, quality and safety of rehabilitation services. International digital rehabilitation policies primarily involved the following areas: policy and governance, digital standard systems, data privacy, security and ethics, digital talent cultivation and capacity building, and monitoring, evaluation and continuous improvement of digitally empowered rehabilitation services. The standard system for rehabilitation digitization covered the three major reference classifications of the WHO Family of International Classifications, including International Classification of Diseases Eleventh Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI), especially ICF. It also included international data interoperability standards, data security and privacy protection standards, data quality and certification standards, and health information standards, etc. The application technology models of digital rehabilitation primarily included data-driven service models, artificial intelligence -enabled models, and remote rehabilitation models combined with virtual reality, augmented reality technologies, and Internet of Things support.

Conclusion The establishment and implementation of comprehensive policies, standards and technological models for digital rehabilitation are crucial for driving the digital transformation and development of global rehabilitation services. Under the framework of the WHO Global Digital Health Strategy, it is necessary to build adaptive digital rehabilitation policy frameworks, and enhance digital governance capabilities and levels, establishing and improving digital rehabilitation standard systems, and promoting the interoperability and integration of rehabilitation data with other health big data. Meanwhile, it is essential to actively develop data-driven technological models for rehabilitation services to comprehensively improve the accessibility, availability, quality and safety of rehabilitation services.

Objective To explore the effect of visual deprivation training combined with proprioceptive training on balance function of hemiplegic patients after stroke.

Methods A total of 80 stroke patients with hemiplegia in Jiangsu Shengze Hospital were selected from May, 2022 to March, 2024, and randomly divided into control group (n= 20), proprioceptive training group (n= 20), visual deprivation group (n= 20) and combined group (n= 20). All the groups received routine rehabilitation training, while the proprioceptive training group added proprioceptive training, the visual deprivation group added balance training under visual deprivation, and the combined group added visual deprivation training and proprioceptive training, for four weeks. They were assessed with ProKin Balance Test and Training System, Berg Balance Scale (BBS), 10-metre walking test (10MWT), Fugl-Meyer Assessment-Lower Extremities (FMA-LE) and Functional Gait Assessment (FGA) before and after treatment.

Results The intra-group effect (F >96.618, P < 0.001) and interaction effect (F >5.444, P < 0.01) were significant in mean longitudinal velocity and mean horizontal velocity. The intra-group effect (F >177.671, P < 0.001), inter-group effect (F >3.761, P < 0.05) and interaction effect (F >7.555, P < 0.001) were significant in movement ellipse area and movement length both with eyes open and closed. The intra-group effect (F >221.902, P < 0.001) and interaction effect (F >7.586, P < 0.001) were significant in the time of 10MWT, and the scores of BBS, FMA-LE and FGA; and the inter-group effect were significant in FGA score (F =5.258, P < 0.01). Post Hoc test showed that all the indicators were better in the combined group and the visual deprivation group than in the control group (P < 0.05); as well as in the proprioceptive training group than in the control group (P < 0.05) except mean longitudinal velocity with eyes open, mean horizontal velocity with eyes closed, and movement length with eyes open; while all the indicators were better in the combined group than both in the visual deprivation group and the proprioceptive training group (P < 0.05); there was no significant difference between the visual deprivation group and the proprioceptive training group for all the indicators (P > 0.05).

Conclusion Both visual deprivation training and proprioceptive training can improve balance, lower limb motor function and walking of hemiplegic stroke patients, and the combination is more effective.

Objective To explore the standardization of inpatient rehabilitation medical record summary sheet, encompassing its structure, content and data standards, to enhance the standardization level of inpatient rehabilitation medical record summary sheet, improve data reporting quality, and provide accurate data support for medical insurance payment, hospital performance evaluation, and rehabilitation discipline evaluation.

Methods Based on the relevant specifications of the National Health Commission's Basic Norms for Medical Record Writing, Specifications for Sharing Documents of Electronic Medical Records, and Quality Management and Control Indicators for Inpatient Medical Record Summary Sheet (2016 Edition), this study analyzed the structure and content of the inpatient rehabilitation medical record summary sheet. The study systematically applied the three major reference classifications of the World Health Organization Family of International Classifications, International Classification of Diseases (ICD-10/ICD-11, ICD-9-CM-3), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), for disease diagnosis, functional description and assessment, and rehabilitation intervention, forming a standardized terminology system and coding methods.

Results The inpatient rehabilitation medical record summary sheet covered four major sections: inpatient information, hospitalization information, diagnosis and treatment information, and cost information. ICD-10/ICD-11 were the standards and coding tools for admission and discharge diagnoses in the inpatient rehabilitation medical record summary sheet. The three functional assessment tools recommended by ICD-11, the 36-item version of World Health Organization Disability Assessment Schedule 2.0, Brief Model Disability Survey and Generic Functioning domains, as well as ICF, were used for rehabilitation functioning assessment and the coding of outcomes. ICHI Beta-3 and ICD-9-CM-3 were used for coding surgical procedures and operations in the medical record summary sheet, and also for coding rehabilitation intervention items.

Conclusion The inpatient rehabilitation medical record summary sheet is a summary of the relevant content of the rehabilitation medical record and a tool for reporting inpatient rehabilitation data. It needs to be refined and optimized according to the characteristics of rehabilitation, with necessary data supplemented. The application of ICD-11/ICD-10, ICF and ICHI Beta-3/ICD-9-CM-3 classification standards would comprehensively promote the accuracy of inpatient diagnosis of diseases and functions. Based on ICD-11 and ICF, relevant functional assessment result data would be added, and ICHI Beta-3/ICD-9-CM-3 should be used to code rehabilitation interventions. Improving the quality of rehabilitation medical records and inpatient rehabilitation medical record summary sheet is an important part of rehabilitation quality control, and also lays an evidence-based data foundation for the analysis and application of inpatient rehabilitation medical record summary sheet.

Objective To observe effect of repetitive transcranial magnetic stimulation (rTMS) combined with repetitive peripheral magnetic stimulation (rPMS) on upper extremities motor function in patients with cerebral hemorrhage, and its mechanism of brain function remodeling using functional magenetic resonance imaging (fMRI).
Methods From September, 2020 to November, 2021, 40 patients with cerebral hemorrhage were randomly divided into central group (n = 13), peripheral group (n = 13) and combination group (n = 14). All patients received routine medication and physical therapy. The central group received low-frequency rTMS at 1 Hz in M1 area of the contralateral brain, the peripheral group received rPMS in the Erb's point of affected side, and the the combination group received rTMS combined with rPMS, for three weeks. They were assessed with Fulg-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) before and after treatment, respectively. At the same time, resting-state fMRI (rs-fMRI) scanning was performed by using 3.0 T whole-body magnetic resonance imaging system, and the changes of functional connection between M1 area and other brain areas of the whole brain were observed. Spearman correlation analysis was used to explore the correlation between functional connectivity strength (FCS) differences in brain regions and FMA-UE score differences before and after treatment in the combination group.
Results The intra-group effect (F > 106.646, P < 0.001), inter-group effect (F > 4.296, P < 0.001) and interaction effect (F > 9.583, P < 0.001) were significant in the scores of FMA-UE and MBI among groups, while the combination group was the best. After treatment, the functional connectivity (FC) to regins of intrest (ROI) 1 (left/affected M1 area) enhanced in the right posterior central gyrus and the left superior temporal gyrus, and reduced in the left superior frontal gyrus and the right posterior cerebellum. The FC to ROI2 (right/unaffected M1 area) enhanced in the left anterior central gyrus, the left anterior cuneiform lobe and the left inferior frontal gyrus, and reduced in the left middle occipital gyrus and the right insula. Compared with the peripheral group, no enhanced FC was found to ROI1 in the combination group, and the FC reduced in the left middle occipital gyrus; no enhanced FC was found in ROI1, and FC reduced in the left anterior cuneiform lobe and the left thalamus. Compared with the central group, the FC to ROI1 enhanced in the right posterior central gyrus and the right superior marginal gyrus in the combination group, and reduced in the left cerebellar lobe and the right thalamus; the FC to ROI2 enhanced in the left central posterior gyrus and the right superior frontal gyrus, and reduced in the left inferior frontal gyrus and the right posterior cerebellum. The FCS difference in the right central posterior gyrus (r = 0.416, P = 0.013), left superior temporal gyrus (r = 0.658, P = 0.020), left central anterior gyrus (r = 0.695, P = 0.010), left inferior frontal gyrus (r = 0.537, P = 0.020), and left anterior cuneiform lobe (r = 0.613, P = 0.030) before and after treatment in the combined group was positively correlated with the difference of FMA-UE scores; the FCS difference in the left occipital gyrus (r = -0.554, P = 0.039) was negatively correlated with the difference of FMA-UE score.
Conclusion rTMS combined with rPMS can improve the motor function of upper extremities more effectively after cerebral hemorrhage, which may associate with low-frequency rTMS indirectly activating the motor cortex of the affected side and promoting the downward projection of corticospinal tract; the high frequency rPMS of the affected upper extremities enhancing the activation of SMC area by the ascending pathway; to reorganize important brain regions in sensorimotor network and default network.

Objective To describe the medical services quality and safety of rehabilitation medicine departments in general hospitals and rehabilitation hospitals in 2022 from the aspects of structure, link and outcome quality.

Methods Through the National Clinical Improvement System of the National Health Commission, all secondary and above general hospitals and rehabilitation hospitals were investigated in 2022, the relevant data from 7 250 hospitals, including traditional Chinese medicine hospitals and integrated traditional Chinese and Western medicine hospitals in 2022. A total of 3 153 sampling hospitals that equipped with rehabilitation medicine wards were included for analysis.

Results Among the 7 250 general hospitals surveyed this year, only 3 277 equipped with rehabilitation wards. In general hospitals, the average number of physicians per bed in 56.46% hospitals, the average number of rehabilitation therapists per bed in 77.67% hospitals, and the average number of nurses per bed in 51.18% hospitals did not meet the national requirements. The rates of early rehabilitation intervention were 13.98%, 20.82% and 21.36% respectively in the department of orthopedics, department of neurology and department of intensive care in general hospitals. The average activity of daily living improvement rate of discharged patients from rehabilitation departments of general hospitals was 77.69%, and that of discharged patients from rehabilitation specialized hospitals was 66.78%.

Conclusion There are insufficient allocation of wards and facility scales in the department of rehabilitation medicine, a shortage of human resources for rehabilitation services, inadequate integration of rehabilitation services with clinical services, and there is still scope for enhancing the effect and efficiency of rehabilitation services. It is recommended to expand the scale of rehabilitation services and improve discipline construction; increase the quantity and quality of rehabilitation human resources; incorporate rehabilitation services into the health service system; establish and modify clinical rehabilitation guidelines and technical specifications; and construct a rehabilitation medical information platform.

Objective To explore the data standard system of electronic medical records in the field of rehabilitation, focusing on the terminology and coding standards, data structure, and key content categories of rehabilitation electronic medical records.

Methods Based on the Administrative Norms for the Application of Electronic Medical Records issued by the National Health Commission of China, the electronic medical record standard architecture issued by the International Organization for Standardization and Health Level Seven (HL7), the framework of the World Health Organization Family of International Classifications (WHO-FICs), Basic Architecture and Data Standards of Electronic Medical Records, Basic Data Set of Electronic Medical Records, and Specifications for Sharing Documents of Electronic Medical Records, the study constructed and organized the data structure, content, and data standards of rehabilitation electronic medical records.

Results The data structure of rehabilitation electronic medical records should strictly follow the structure of electronic medical records, including four levels (clinical document, document section, data set and data element) and four major content areas (basic information, diagnostic information, intervention information and cost information). Rehabilitation electronic medical records further integrated information related to rehabilitation needs and characteristics, emphasizing rehabilitation treatment, into clinical information. By fully applying the WHO-FICs reference classifications, rehabilitation electronic medical records could establish a standardized framework, diagnostic criteria, functional description tools, coding tools and terminology index tools for the coding, indexing, functional description, and analysis and interpretation of diseases and health problems. The study elaborated on the data structure and content categories of rehabilitation electronic medical records in four major categories, refined the granularity of reporting rehabilitation content in electronic medical records, and provided detailed data reporting guidance for rehabilitation electronic medical records.

Conclusion The standardization of rehabilitation electronic medical records is significant for improving the quality of rehabilitation medical services and promoting the rehabilitation process of patients. The development of rehabilitation electronic medical records must be based on the national and international standards. Under the general electronic medical records data structure and standards, a rehabilitation electronic medical records data system should be constructed which incorporates core data such as disease diagnosis, functional description and assessment, and rehabilitation interventions. The standardized rehabilitation electronic medical records scheme constructed in this study can support the improvement of standardization of rehabilitation electronic medical records data information.

Objective To investigate the effect of combination of rope-assisted proprioceptive neuromuscular facilitation (PNF) training and rope-assisted brain-computer interface (BCI) training on upper limb function in stroke patients with hemiplegia.

Methods From March, 2022 to February, 2023, 96 inpatients with stroke hemiplegia from the Second Affiliated Hospital of Guangxi Medical University were randomly divided into conventional group (n = 32), PNF group (n = 32) and combined group (n = 32). All the groups received routine rehabilitation treatment. The conventional group received upper limb PNF training, the PNF group received upper limb rope-assisted PNF training, and the combined group received both upper limb rope-assisted PNF training and upper limb rope-assisted BCI training, for four weeks. They were assessed with Functiongal Test for the Hemiplegic Upper Extremity-Hong Kong version (FTHUE-HK), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment.

Results The intra-group effect (F > 341.219, P < 0.001), inter-group effect (F > 21.705, P < 0.001) and interaction effect (F > 3.171, P < 0.05) were significant in the scores of FTHUE-HK and MBI. The intra-group effect (F =520.472, P < 0.001) and inter-group effect (F = 41.939, P < 0.001) were significant in the scores of FMA-UE, and the interaction effect was not (P > 0.05). After treatment, the FTHUE-HK, FMA-UE and MBI scores were the best in the combined group (P < 0.05).

Conclusions The combination of rope-assisted PNF training with rope-assisted BCI device training could further improve the motor function of the upper limbs in stroke patients with hemiplegia, and enhance their activities of daily living.

Objective To explore the effect of home exercise on pain, function and quality of life after operation for rotator cuff injury.

Methods From June, 2023 to June, 2024, 45 patients after operation for rotator cuff injury were selected from Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University and Xuzhou Central Hospital, and randomly divided into conventional group (n = 15), home-based group (n = 15) and combined group (n = 15). The conventional group received an eight-week routine rehabilitation program in hospital, the home-based group received an eight-week home exercise prescription training, and the combined group first received four weeks of routine rehabilitation in hospital, and followed by four weeks of home exercise prescription training. They were assessed with Visual Analogue Scale for pain (VAS), University of California at Los Angeles shoulder rating scale (UCLA), Constant-Murley Score (CMS), range of motion (ROM) of shoulder, and the Short-form of Health Survey-36 (SF-36) before treatment, and four and eight weeks after treatment.

Results VAS scores decreased in all the three groups four and eight weeks after treatment (Z > 2.964, P< 0.001), which was the most in the home-based group four weeks after treatment (|Z| > 2.531, P< 0.05). The main effect of time was significant in scores of UCLA, CMS, and physical health and mental health of SF-36 (F > 498.102, P< 0.001), which improved after treatment (P< 0.001). The main effect of group was significant in score of mental health of SF-36 (F = 7.408, P= 0.002), which was the most in the home-based group four and eight weeks after treatment (P< 0.01). The interaction was significant in score of physical health of SF-36 (F = 10.138, P< 0.001), which was the least in the home-based group four weeks after treatment (P< 0.05). The main effect of time was significant in every direction of ROM, which improved after treatment (P< 0.001). The interaction was significant in ROM of abduction and external rotation (F > 4.059, P< 0.01), and almost significant in ROM of flexion (F = 2.412, P= 0.055). However, ROM of flexion was less in the home-based group than in the combined group four weeks after treatment (P= 0.047), which was less in the home-based group than in the conventional group eight weeks after treatment (P= 0.042); ROM of abduction was the least in the home-based group four weeks after treatment (P< 0.01), which was less in the home-based group than in the combined group eight weeks after treatment (P= 0.046); ROM of external rotation was less in the home-based group than in the combined group four weeks after treatment (P= 0.022).

Conclusion Home exercise is effective on pain, function and quality of life in patients after operation for rotator cuff injury. There are benefits with both home exercise and institution-based rehabilitation, and almost the same in a whole eight weeks after treatment.