Objective To review the development of rehabilitation in China, summarize the development experience, and study the laws, regulations, policies, and plans for the development of rehabilitation and service. Methods We used literature and policy research methods to review the development of rehabilitation in China, summarize development experiences, and conduct systematic content analysis of relevant laws, regulations, policies and plans. Results The year 2021 marks the centennial of the founding of the Communist Party of China. This paper reviews the historical development and valuable experiences of China's rehabilitation undertakings, analyzes the background, main contents and significance of the laws and regulations related to China's rehabilitation undertakings, and focuses on the rehabilitation policies related to the "Healthy China 2030" Planning Outline and the Opinions on Accelerating the Development of Rehabilitation Medical Work. Conclusion The development of rehabilitation in China is an important part of the health service system. Based on the perspective of health services, the development of rehabilitation in China has improved the leadership and governance capacity of rehabilitation, established a funding mechanism for rehabilitation development, trained a large number of rehabilitation professionals and technicians, established a rehabilitation medical service system covering all three levels of medical services, and incorporated assistive technologies into the modern rehabilitation service system. A corresponding health information system has been established. The rehabilitation work has played an important role in achieving the goals of the "Health China 2030" program.

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.

To observe the effect of braces combined with insoles on scoliosis and walking performance in patients with adolescent idiopathic scoliosis (AIS).

From September, 2019 to September, 2020, 42 subjects with AIS were selected and randomly divided into brace group (n = 21) and brace combined with insole group (n = 21). Both groups received two-month routine rehabilitation, including braces for 22 to 23 hours a day and gymnastics for 30 minutes a day. The brace combined with insole group additionally wore insoles, at least eight hours a day for two months. Meanwhile, 32 even-aged adolescents were recruited as healthy controls. Firstly, gait and plantar pressure of 42 patients and 32 healthy adolescents were compared to find out abnormal indicators. Secondly, the scoliosis and above abnormal indicators were compared between the brace group and the brace combined with insole group

The center of pressure excursion index (CPEI) was higher in AIS group than in the healthy group (F = 3.120, P < 0.05), and there was no significant difference in walking speed, gait cycle and phase between two groups (P>0.05). An obvious imbalanced pressure was observed between the medial and lateral heel of the single foot and the bilateral foot in AIS patients (P < 0.05). After treatment, the Cobb's angle decreased in AIS patients (t > 7.552, P < 0.001), however, no difference was found between the brace group and the brace combined with insole group (t = 0.459, P > 0.05); the CPEI decreased (t = 2.209, P < 0.05), and the pressure in medial and lateral heel as well as the left and right foot tended to be balanced (t > 2.306, P < 0.05) in the brace combined with insole group, and were better than that of the brace group (|t| > 2.319, P < 0.05).

Plantar pressure distribution shows obvious local and global asymmetric changes in AIS patients. The efficacy of insoles on the scoliosis is limited, but the insole can effectively improve the abnormal biomechanics and balance the force.

The evaluation of balance includes clinical observation, scales and instrumental measures. Functional Reach Test is simple and can be carried out in both standing and sitting, but the error of reading the measuring ruler is large, which results in new moving rulers and inertial sensors. The factors influencing the results of Functional Reach Test are moving strategy, age, moving efficiency, goal orientation, single or double arms, human characteristics, number of experiments and others. In the future, combination of electromyogram and inertia sensor can be used to discuss the variety of muscles and the changes of muscle strength, and more influence factors for the test are needed to research.

Objective To design, fit and use a thoracic-weight-bearing socket and reciprocating gait prosthesis for amputee pelvis disarticulation.

Methods A case after pelvis disarticulation amputation was reported. The main weight of the socket bore on lower thorax, and the socket suspended with the pressure from anterior-posterior sides. Walking prosthesis was consisted of the socket, reciprocating hip joint, prosthetic knee joint and SACH foot. The prosthesis was adjusted alignment, and the patient was trained to walk with the prosthesis.

Results The patient could stand for four hours a time with the socket, and walk 200 meters in 30 minutes assisted with axillary crutches. The score of modified Barthel Index improved from 41.5 admitted to hospital to 93 (with socket) or 83 (with prosthesis) as discharged.

Conclusion Pelvis disarticulation amputees could stand up with socket with reasonable weight bearing and suspension and walk in reciprocating gait with reasonable components and joints, right alignment and gait training, to improve activities of daily living.

Objective To describe the medical services, quality and safety of rehabilitation medicine departments in general hospitals and rehabilitation hospitals in 2020 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 2021, the relevant data from 9 138 hospitals, including traditional Chinese Medicine hospitals and integrated traditional Chinese and Western medicine hospitals in 2020. A total of 2 676 sampling hospitals were equipped with rehabilitation medicine wards. After cleaning, a total of 2 268 samples of hospitals were included for analysis. Then, the setting of wards of rehabilitation medicine departments in 6 336 hospitals that participated in the questionnaire of rehabilitation medicine departments from 2017 to 2020 was analyzed.

Results Among the 9 138 general hospitals surveyed this year, only 2 676 had rehabilitation wards, and three general hospitals administrated to National Health Commision had not yet set up wards. In general hospitals, the average number of physicians per bed in 57.92% hospitals, the average number of rehabilitation therapists per bed in 80.44% hospitals, and the average number of nurses per bed in 53.92% hospitals did not meet the national requirements, and the average number of rehabilitation medical personnel per bed in rehabilitation medicine departments in different regions was significantly different. The rates of early rehabilitation intervention were 13.20%, 18.90% and 29.25% 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 department of general hospital was 76.35%, and that of discharged patients from rehabilitation specialized hospital was 64.30%.

Conclusion Professional medical services and quality safety of rehabilitation medicine in China improve steadily, and the degree of homogenization is further strengthened. However, from the perspective of the current prominent problems, in 2020, most general hospitals in China have not configured the wards of rehabilitation medicine, and there are problems such as the total number of rehabilitation medical personnel in the country does not meet the requirements, uneven distribution, insufficient early intervention in rehabilitation, and room for improvement of rehabilitation treatment effect, which need continuous improvement.

Objective To observe the clinical effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile (DHIC).Methods From September, 2019 to December, 2021, 40 patients with DHIC in the Department of Urology of Beijing Bo'ai Hospital were selected and randomly divided into control group and experimental group, with 20 cases in each group. The control group took Silodosin only, and the experimental group took Mirabegron in addition, for four weeks. The urinary diary, residual urine volume, Overactive Bladder Symptom Score (OABSS) and quality of life (QOL) score were compared before and after treatment.Results A total of 18 patients in the control group and 19 in the experimental group finished the trial. After treatment, the number of night urination per day, the residual urine volume and QOL score improved in the control group (P<0.01); the number of urination per 24 hours, the number of night urination per day, the volume per urination, the residual urine volume, the daily urgency score, the OABSS score and QOL score improved in the experimental group (P<0.01). The number decrease of urination per 24 hours, the volume decrease of per urination, the daily urgency score decrease, the OABSS score decrease and QOL score decrease were more in the experimental group than in the control group (P<0.01). The adverse reactions included palpitations, increased heart rate, dyspareunia, increased blood pressure, gastric discomfort, postural hypotension, and retrograde ejaculation, and there was no significant difference between two groups (P > 0.05).Conclusion The efficacy of Mirabellone combined with Silodosin on DHIC is better than Silodosin only, and there was no significant increase in drug-related adverse effects.

Objective To analyze the clinical features related to erectile dysfunction for male patients with spinal cord injury.

Methods From December, 2019 to January, 2021, 28 male patients with spinal cord injury were detected the stiffness and periactivity index of penises during night sleep using RigiScan. The patients were grouped as presence or absence of bulbocavernous reflex, anal autonomic contraction, anal tactile sensation and anal pressure sensation, to compare the stiffness and periactivity index between the groups.

Results The stiffness and periactivity indexes were more in patients presenting bulbocavernosus reflex, anal autonomic contraction, anal tactile sensation and anal deep pressure sensation (|t| > 2.19, P < 0.05).

Conclusion Bulbocavernous reflex, anal autonomic contraction, anal tactile and anal deep pressure response may predict penile erectile function after spinal cord injury.

Flexible variable stiffness actuator is divided into four categories including elastic element, pneumatic element, electric-magnetic element and intelligent material. It is gradually applied in rehabilitation robot. It could adapt the change of patient's impedance in the upper and lower limb rehabilitation robots, ensure the safety of the wearer in the exoskeleton, and improve the biomimetics in the prosthesis. Variable stiffness driving mechanism for rehabilitation robot still has some disadvantages. It is proposed to have compact structure, low power consumption, good stiffness characteristics, high response rate and progressive output torque curve, etc.

To apply Star Excursion Balance Test (SEBT) in evaluating dynamic balance function in stroke patients.

From September, 2018 to November, 2019, 38 stroke hemiplegic patients of Brunnstrom IV and above who could walk independently were included. They completed SEBT by two testers; the anterior, posteromedial and posterolateral extension standardized distance of the affected leg support were recorded. One of the testers measured SEBT again the day after the next day. The intraclass correlation coefficient (ICC) was calculated. The limits of stability on different directions were measured with active balancer EAB-100 (EAB) and tested with Timed 'Up & Go' Test (TUGT) by the third tester. The correlation of SEBT to EAB and TUGT was analyzed with Pearson correlation coefficient.

ICCs of three directions was 0.892 to 0.951 between testers, and 0.888 to 0.963 of test-retest. The standardized distance of three directions of SEBT correlated with the anterior and lateral stability limits of EAB (r = 0.479 to 0.671, P < 0.05), as well as TUGT (r = -0.557~-0.633， P < 0.05).

SEBT is valid and reliable for evaluation of the dynamic balance for stroke patients of Brunnstrom IV and above who can walk independently.

Objective To explore the application and method of World Health Organization Rehabilitation Competency Framework (RCF) in rehabilitation human resource management, and provide theoretical and practical reference for rehabilitation human resource management.Methods Based on the International Standard Classification of Occupations issued by the International Labour Organization, the application scope of RCF was systematically analyzed. The theoretical framework of rehabilitation human resource management based on RCF was constructed in combination with competency-based human resource management framework. On this basis, taking rehabilitation nurses as an example, the corresponding management methods and paths are proposed from four aspects of human resource management, including career management, recruitment and selection, training and development, and performance appraisal and salary management.Results Based on RCF, the theoretical framework of human resource management for rehabilitation nursing positions was constructed, and the main contents and processes of human resource management based on RCF were clarified from four aspects: recruitment and selection, training and development, performance appraisal and salary management, and career management. Occupational competency of rehabilitation professionals in International Standard Classification of Occupations was analyzed by RCF.Conclusion The rehabilitation competency framework constructed by WHO can be used to supplement the responsibilities of rehabilitation-related professionals in the International Standard Classification of Occupations issued by the International Labour Organization. RCF serves as a tool for practice managers and rehabilitation professionals in identifying selection criteria, learning objectives, and professional title assessment criteria. It can also be used in recruitment and selection, training and development, performance appraisal, salary management and career management in the field of rehabilitation human resource management.

To explore the features and rehabilitation of Pusher syndrome (PS).

A female patient was reported and the literatures were reviewed.

The patient presented moderate ipsilateral, deep sensory disturbance, left spatial neglect and disuse. White matter degeneration was found. After four-week rehabilitation, the score of Scale for Contraversive Pushing decreased from 2.5 to 0.75, and her hand function recovered to assistant hand.

The degeneration of white matter develops rapidly in PS patient, while the recovery of motor function is relatively slow, and need longer and comprehensive rehabilitation, especially the exercise therapy and somatosensory stimulation.

Objective To systematically review the research progress of sensory integration therapy in the rehabilitation of children with cerebral palsy. Methods The literatures related to the application of sensory integration therapy in the rehabilitation of children with cerebral palsy was retrieved from Web of Sciences, PubMed, CNKI, Wanfang data, and VIP databases until November 27, 2021, using subject search. And the contents of the literatures were extracted to review the implementation plan of sensory integration therapy and the effectiveness of its application in the rehabilitation of children with cerebral palsy. Results Six literatures were included. The main focus was on the research of sensory integration therapy on postural control, gross motor function, intelligence level and cognitive function, and treatment modalities in children with cerebral palsy. Conclusion Sensory integration therapy is effective on motor function, posture control and intelligence in children with cerebral palsy. To maximize the effect of sensory integration therapy, a suitable rehabilitation treatment plan should be formulated according to the degree of sensory integration disorder and the age, gender and tolerance of children.

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.

To summarize the methods and results of human motion intention recognition based on the surface electromyography.

Literatures were retrieved and reviewed from the databases of PubMed, Web of Science, CNKI, Wanfang and VIP until December, 2020. The experimental researches about human motion intention recognition based on surface electromyography were summarized.

The methods of motion intention recognition were divided into three models: musculoskeletal model, traditional machine learning model and deep learning model.

It is difficult to fully estimate human motion intention using surface electromyography in a single way. More researches are needed to develop more accurate and real-time human motion intention recognition methods.

Objective To summarize the integrative rehabilitation treatment of traditional Chinese medicine (TCM) and Western medicine in hypertrophic olivary degeneration (HOD) secondary to the operation of brain stem cavernous malformation. Methods The clinical data of medication, rehabilitation and follow-up of a patient with HOD secondary to operation on brain stem cavernous malformation was retrospectively analyzed.Results Three months after operation, limb static and motor tremor, dysarthria, palate spasm, eye movement disorder and walking difficulty appeared. The patient was diagnosed as HOD according to clinical features and brain magnetic resonance imaging (MRI). He was treated with pertinence rehabilitation training combined with TCM including acupuncture and herbs. After integrative rehabilitation, he could stand and walk independently, the tremor was alleviated, the balance function improved, the activities of daily living improved, and the dosage of oral western medicine also decreased.Conclusion After intracranial surgery, secondary neurodegeneration and movement disorder may appear, and it could be improved by integrative rehabilitation treatment of TCM and Western medicine

Objective To review the pathogeny, clinical assessment and classification, and rehabilitation management of scapular dyskinesis.Methods The literatures in recent ten years were reviewed and summarized. Results and Conclusion The clinical assessment and classification of scapular dyskinesis had been summarized. Scapular dyskinesis is mainly secondary to rotator cuff injury, subacromial impingement syndrome, glenohumeral instability, injury of acromioclavicular joint, throwing shoulder and adhesive capsulitis, etc. Scapular exercise may be a supplement to routine rehabilitation management.

Objective To explore the correlation of upper arm circumference and calf circumference with muscle mass, and the screening effect and the cut-off values for low muscle mass and sarcopenia. Methods From March to August, 2020, a total of 831 community-dwelling old people (≥ 60 years old) were recruited by using convenience sampling. Muscle mass and other body composition indicators were tested by body composition tester. The upper arm circumference, calf circumference, grip strength and gait speed were measured at the same day. Pearson cofficient was used to analyze the correlation of upper arm circumference and calf circumference with muscle mass, and receiver operation characteristic (ROC) curve was used to analyze the diagnostic effect of upper arm circumference and calf circumference on low muscle mass and sarcopenia, and the Youden index (YI) was used to determine the cut-off values. Results Upper arm circumference and calf circumference were positively correlated with appendicular skeletal muscle mass (ASM) and skeletal mass index (SMI) (r = 0.6 to 0.8, P < 0.001). For diagnosing low muscle mass, the areas under the ROC curve (AUC) of upper arm circumference were 0.888 for male, 0.787 for female; and that of calf circumference were 0.933 for male, 0.854 for female, respectively. The cut-off values of upper arm circumference for low muscle mass were 26 cm for both male and female; and that of calf circumference were 34 cm for male and 33 cm for female, respectively. For diagnosing sarcopenia, the AUC of upper arm circumference was 0.902 for male, 0.744 for female; and that of calf circumference was 0.923 for male, 0.832 for female, respectively. The cut-off values of upper arm circumference and calf circumference for sarcopenia were 26 cm and 33 cm for both male and female. The AUC of combined diagnosis with age, upper arm circumference, calf circumference, grip strength and gait speed for low muscle mass and sarcopenia in males and females was all greater than 0.85. Conclusion In the community old adults, upper arm circumference and calf circumference are positively correlated with muscle mass, and both indices can be used to diagnose low muscle mass and sarcopenia. multi-indices combination can improve the diagnosis effect of upper arm circumference in females.

Objective To evaluate the accessibility construction status of road traffic sidewalks in Shanghai.Methods From July to September, 2019, 46 road traffic sidewalks in Shanghai were selected using a convenience sampling, and evaluation tools were designed based on the Codes for Accessibility Design (GB 50763-2012) and Standards for Design on Accessibility of Buildings and Facilities (DGJ08-103-2003). After field check and experience for the sidewalks, the compliance rates of evaluation dimensions and evaluation contents of sidewalks were analyzed using the descriptive analysis. The weights of each dimension were calculated using the principal component analysis to construct the sidewalk comprehensive barrier score model, and to compare the sidewalk comprehensive barrier scores in different areas of Shanghai. From September to November 2019, in-depth interviews were conducted with eleven persons with disabilities to understand the sidewalk barriers for them.Results The overall compliance rate of sidewalk accessibility was 4.35%. Among the evaluated contents, 93.5% sidewalks had a curb ramp, 91.3% had a height difference between the ramp and the carriageway, 26.1% were not paved with tactile ground surface indicators; 71.7% tactile ground surface indicators were blocked by poles, etc., and 84.8% were occupied by obstacles. The warning indicator was the greatest weight among the evaluated dimensions. The barrier of sidewalks was high (36.7%) and medium (20.0%) in the central area, which was higher than that in the sub-central area (both 6.3%) (P < 0.05). There were many obstacles during the experience of sidewalks using, resulting in less using of the barrier-free facilities.Conclusion Most of the sidewalks in Shanghai do not meet the standards of the Codes for Accessibility Design. It is urgent to construct and maintain the barrier-free facilities.