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 Based on the bio-psycho-social model of functioning and health of International Classification of Functioning, Disability and Health (ICF) framework, this paper systematically analyzes rehabilitation-related policy documents of the World Health Organization (WHO) to explore the theoretical and policy principles, service systems, priority development areas, and main policy and technical measures for speech and language rehabilitation for children with hearing impairment.
Methods Under literature research and policy analysis methods, this paper systematically reviewed the functioning and health framework of ICF, relevant WHO policy reports and American Speech and Hearing Association technical documents, analyzed the current status and needs of rehabilitation services in China, and proposed a theoretical framework, priority areas, and main policy and technical measures for constructing an ICF-based speech and language rehabilitation service system for children with hearing impairment.
Results There were eight major principles for the development of speech and language rehabilitation for children with hearing impairment: child-centered and respect for individual differences, life-cycle support and promoting continuous development, evidence-based practice, multidisciplinary collaboration, building family participation support networks, promoting integrated education and social participation, focusing on cultural sensitivity, and technology-empowered rehabilitation innovation. Five service systems were elaborated, including comprehensive early screening, diagnosis, and intervention system; family and social support system; multidisciplinary team services system; comprehensive, multi-level speech and language rehabilitation service system; and digitally empowered services to build new rehabilitation service models. The priority development areas, and main policy and technical measures for speech and language rehabilitation for children with hearing impairment were also discussed.
Conclusion Based on the bio-psycho-social model of functioning and health of ICF, comprehensive, personalized, continuous, high-quality and universally accessible speech and language rehabilitation services can be developed by implementing measures, such as strengthening policy support, improving service systems, cultivating multidisciplinary professionals, promoting digital empowerment technologies and enhancing support system, to promote the overall development, social participation and quality of life for children with hearing impairment.

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 systematically review the effect of high blood flow restriction training (BFRT) on patients after anterior cruciate ligament reconstruction (ACLR).
Methods Relevant literature was searched in PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, Wanfang data, and VIP databases using subject term search methods from the inception to May 1st, 2024. The methodological quality of the included literatures was assessed using Physiotherapy Evidence Database (PEDro) scale, and relevant data were extracted for systematic review.
Results A total of seven articles were finally included, involving 183 subjects from six countries. The intervention sites were mainly hospital rehabilitation departments and rehabilitation centers. The publication dates ranged from 2016 to 2023. In BFRT group, lower limbs were compressed during conventional rehabilitation training, with intermittent of 0.5 to 2 minutes or without deflation. BFRT would increase muscle strength, muscle hypertrophy, and improved knee joint function. Total duration of intervention and training intensity affected the improvement.
Conclusion High BFRT can improve the condition of the muscles around the knee joint and promote functional recovery after ACLR. To ensure the safety and effectiveness of the training, low-intensity strength training should be employed, with 15 to 30 repetitions per set, four to five sets per session, two to three sessions per week, and a total training duration of at least three weeks.

Objective To explore the effect of task-oriented training of intelligent mirror gloves combined with low-frequency repetitive transcranial magnetic stimulation (rTMS) on hand function recovery in stroke patients.
Methods From October 1st, 2022 to June 30th, 2023, 136 stroke patients in Northern Jiangsu People's Hospital were randomly divided into control group, mirror group, rTMS group and combination group, with 34 patients in each group. All the groups received routine rehabilitation treatment. In addition, the mirror group received task-oriented training of intelligent mirror gloves, rTMS group received low-frequency rTMS, and the combination group received task-oriented training combined with low-frequency rTMS, for four weeks. The Fugl-Meyer Assessment-Upper Extremities (FMA-UE) score, Wolf Motor Function Test (WMFT) score, and surface electromyographic root mean square (RMS) of forearm extensor and flexor muscle groups on the affected/healthy side before and after treatment were compared. And the differences of transcranial magnetic stimulation-motor-evoked potentials (MEP) between rTMS group and combination group before and after treatment were also compared.
Results Four cases in the control group, seven in the mirror group, five in rTMS group and six in the combination group dropped off. The intra-group effect (F > 996.656, P < 0.001), inter-group effect (F > 20.333, P < 0.001) and interaction effect (F > 72.796, P < 0.001) were significant in the scores of FMA-UE and WMFT, and the RMS ratio of forearm extensor and flexor muscle groups among four groups, in which the combination group was the best. After treatment, the amplitude of MEP increased in rTMS group and combination group (|t| > 3.842, P < 0.05), and was higher in the combination group than in rTMS group (t = -3.060, P < 0.01).
Conclusion The task-oriented training of intelligent mirror gloves combined with low-frequency rTMS could effectively promote the recovery of hand function in stroke patients.

Objective To construct the competency and professional activities of pediatric rehabilitation therapists in China based on World Health Organization rehabilitation competency framework (RCF).
Methods Competencies, activities, and tasks in the field of pediatric rehabilitation were collected through literature, official websites and interviews with key informants using RCF. Competency requirements suitable for pediatric rehabilitation therapists were selected, competency dimensions and activities were adjusted based on the context of pediatric rehabilitation therapy. Similar content was integrated through thematic framework analysis and content analysis. Competencies were matched with typical professional activities. A competency framework and professional activities for Chinese pediatric rehabilitation therapists were developed, and the Delphi method was used to survey 22 experts, ultimately confirming competency dimensions and activity content.
Results The enthusiasm coefficient of experts was 88.00%, the authority coefficient was 0.84, and the expert opinions were more focused on importance. The CV values of all competency dimensions and activities were ≤ 0.25, and the W test was statistically significant (P < 0.05), indicating a high degree of coordination among experts. A competency framework for pediatric rehabilitation therapists in China, included 17 competency dimensions and 17 professional activities.
Conclusion To explore the competency of typical professions through RCF may enhance the application of research results in the field of rehabilitation, which provides a reference for clarifying the job content and cultivating the competency of Chinese pediatric rehabilitation therapists.

Objective To systematically evaluate the effect of exercise therapy on body structure, function, and activity and participation in patients with chronic nonspecific neck pain (CNSNP) based on the International Classification of Functioning, Disability and Health (ICF) framework.
Methods A PICO framework was constructed, and randomized controlled trials (RCTs) on the intervention of different types of exercise therapy for patients with CNSNP were retrieved from databases of CBM, Wanfang data, VIP, CNKI, Cochrane Library, Embase, PubMed and Web of Science, from the establishment to March, 2024. The quality of the literature was evaluated with Cochrane Risk of Bias Tool and Physiotherapy Evidence Database (PEDro) scale, and the evidence quality of the outcome indicators was evaluated using GRADE. Data were synthesized and analyzed using RevMan 5.3, and the risk of bias was evaluated using Stata 18.0.
Results A total of eleven RCTs involving 668 subjects were included. The scores of PEDro scale were five to eight. The types of interventions included muscle strength training, stability training, proprioception training, Yoga and Pilates. The control groups received placebo, physical factor therapy and health education. Exercise therapy could increase the craniovertebral angle (SMD = 0.84, 95%CI 0.42 to 1.26, P < 0.001), reduce the Visual Analogue Scale score (SMD = -2.05, 95%CI -2.58 to -1.52, P < 0.001), increase the pressure pain threshold (MD = 112.27, 95%CI 75.03 to 149.50, P < 0.001), increase the range of motion of cervical forward (SMD = 1.24, 95%CI 0.34 to 2.15, P = 0.007) and lateral (SMD = 1.52, 95%CI 0.40 to 2.65, P = 0.008) flexion, and improve the endurance of the deep cervical flexors (SMD = 1.02, 95%CI 0.10 to 1.94, P = 0.03) and position sense of the cervical spine (SMD = -1.00, 95%CI -1.47 to -0.53, P < 0.001); however, it was not significant in improving the range of motion of backward flexion (SMD = 0.85, 95%CI -1.04 to 2.75, P = 0.38) and rotation (SMD = 1.65, 95%CI -0.35 to 3.65, P = 0.11). Exercise therapy could also reduce the Neck Disability Index score (MD = -11.88, 95%CI -16.09 to -7.68, P < 0.001), and it was no significant in the Short-Form-36 score (MD = 19.04, 95%CI -3.00 to 41.08, P = 0.09).
Conclusion Exercise therapy can improve head posture, pain, motion of forward flexion and lateral flexion, endurance of the cervical flexors and joint position sense, and the overall function in patients with CNSNP. However, further researches are needed to verify the effects on cervical backward flexion and rotation, and quality of life.

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 analyze the hotspots and frontiers of researches related to pain in Parkinson's disease.
Methods The literatures on pain in Parkinson's disease were retrieved from CNKI, VIP, Wanfang data, CBM and Web of Science Core Collection from inception to November, 2023, and were analyzed with CiteSpace 6.1.R6.
Results A total of 926 literatures were included with 293 in Chinese and 633 in English, respectively. Chinese high-frequency keywords were quality of life, sleep disorders and depression, while English high-frequency keywords were nonmotor symptom, quality of life and levodopa. The latest bursting word in Chinese was pathogenesis, while the latest bursting words in English were exercise and management.
Conclusion Number of researches related to pain in Parkinson's disease is gradually rising, and the characteristics, pathogenesis, quality of life, rehabilitation interventions and clinical efficacy have become research hotspots. The mechanism of pain in Parkinson's disease and rehabilitation management program will be the main research topics in the future.

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 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 explore the effect of proprioceptive neuromuscular facilitation (PNF) on the knee abduction torque and vastus medialis-medial gastrocnemius (VM-MG) co-contraction index during walking among the old patients with medial compartment knee osteoarthritis.
Methods From March to May, 2022, 32 old patients with medial compartment knee osteoarthritis in communities in Ji'nan were enrolled and randomly allocated to control group (n = 16) and training group (n = 16). The training group received PNF and the control group received home-based exercise, for six weeks. The knee abduction torque and VM-MG co-contraction index were measured using an infrared motion capture system synchronized with 3D force plate and electromyography system before and after treatment.
Results Three cases in the control group and two cases in the training group dropped off. The first and the second peaks of knee abduction torque, and the VM-MG co-contraction index improved in the training group after treatment (|t| > 2.460, P < 0.05), and the first and the second peaks of knee abduction torque were better in the training group than in the control group (|t| > 2.454, P < 0.05).
Conclusion PNF may optimize the load distribution between the medial and lateral compartments of the knee in patients with knee osteoarthritis.

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 explore the factors affecting the fall risks in stroke patients, and predict the level of fall risk.
Methods A retrospective analysis was conducted. A total of 64 stroke patients in Huadong Hospital from July, 2022 to January, 2024 were enrolled. The patient's demographic data, functional indicators and walking indicator, including gender, age, height, weight, stroke type, course of disease, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), simplified Fugl-Meyer Assessment (FMA), Functional Reaching Test (FRT), Multi-Directional Reach Test (MDRT), Montreal Cognitive Assessment (MoCA) and Timed Up and Go Test were recorded. Using the risk level of falls in stroke patients as the dependent variable, first, a univariate analysis was conducted, and then discriminant analysis was followed to observe the risk factors for falls in stroke patients.
Results All the included stroke patients had an average age of approximately 66 years old, more males than females, and more cerebral infarction patients than cerebral hemorrhage patients. The average course of the disease was (4.50±6.02) months. There were 19, 26 and 19 stroke patients with mild, moderate and severe fall risk levels, respectively. One-way analysis of variance showed that the scores of WHODAS 2.0, FMA, FMA-Upper Extremities (FMA-UE), FMA-Lower Extremities (FMA-LE), FRT, MDRT-Forward (MDRT-F), MDRT-Right (MDRT-R) and MoCA were significantly differenct among stroke patients with different fall risk levels (F > 2.277, P < 0.05). Discriminant analysis showed that patients with different fall risk levels had different functional parameter equations, using the retrospective method, the accuracy rates of Fisher discriminant function and Bayes discriminant function were 75% and 78.1%, and the misjudgment rates were 25% and 21.9%, respectively.
Conclusion Activity and participation ability, upper and lower extremity motor function, stability limits of the forward and right direction and cognitive function are related factors to the risk level of falls. It could predicte the risk level of falls by establishing a discriminant function through functional indicators.

Objective To analyze the effect of adapted physical activity (APA) on physical function, motor skills, mental health and social participation in children with intellectual and developmental disabilities (IDD).
Methods Literature on the effect of APA on function and activity of children with IDD were searched in PubMed, Google Scholar, Cochrane Library and PsycINFO databases, from January, 2014 to May, 2024. The methodological quality was evaluated with Physiotherapy Evidence Database (PEDro) scale, and a systematic review was conducted.
Results A total of nine English articles were included, and the PEDro scale scored five to eight, with medium to high quality. Included literature was from seven countries, including China, Ukraine, Iran, the United States, Australia, Brazil and Turkey, involving 327 children with IDD. The articles were mainly from journals in the fields of intellectual disability research, health, sports and rehabilitation, and adapted physical education. They were publicated mainly between 2018 and 2022. The subjects were seven to 18 years old, covering a variety of IDD types, including intellectual disability, autism and attention deficit hyperactivity disorder. APA intervention involved a single approach and comprehensive approaches, the comprehensive approaches included various types of APA, sports behavior management and assistive technology application, etc., and the activity was designed by adapted physical education teachers or coaches based on the interests and physical activity needs of children with IDD. Specific intervention methods included adaptive ball games (football, gymnastics, basketball, tennis and table tennis, etc.), adaptive strength training (standing weightlifting and chest passing, etc.), executive function training (playing whack-a-mole, frisbee, hitting and throwing, etc.) and adaptive skiing, walking, balance exercises, etc., with an intervention frequency of two to three times a week, 30 to 70 minutes a time, low intensity to strenuous, lasting eight to 36 weeks. The functional and health benefits of different types of APA on children with IDD were reflected in four aspects. In terms of physical function, it could improve cardiopulmonary endurance (maximum oxygen uptake and heart rate recovery, etc.), enhance muscle strength and endurance (grip strength, push-ups and sit-ups, etc.), improve flexibility (rapid, accurate and coordinated movement changes, etc.) and flexibility (sitting body forward bending and shoulder joint range of motion, etc.), and improve balance and movement coordination (static/dynamic balance test and movement coordination assessment, etc.) and body composition (body mass index, body fat percentage and waist-to-hip ratio, etc.). In terms of motor skills and abilities, it could develop basic motor skills (walking, running, jumping, throwing and catching, etc.) and complex motor skills (ball games, gymnastics and dance, etc.), and improve athletic ability test scores. In terms of mental health, it helped to reduce anxiety and depression, improved self-esteem, and improved executive function. In terms of social participation, APA improved the physical activity participation, the frequency and quality of social interaction and quality of life.
Conclusion This study systematically reviewed the evidence for the effect of APA on the function, activity and participation of children with IDD. Diversified APA and adaptive physical education programs designed according to children's functional and developmental levels have significantly improved the physical function, motor skills, mental health and social participation of children with IDD, and promoted their overall development.

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.