Objective To evaluate the benefits of physical activity on the physical health, mental health and health behaviors related to physical activity in obese and overweight children and adolescents.

Methods Following the PRISMA guidelines, a systematic search was conducted in Web of Science, PubMed, Scopus, PsycINFO, Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals, related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents. They were assessed using AMSTAR 2 tool to ensure that the methodological quality was medium to high.

Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included. Six studies were of high quality, and two were of moderate quality. In terms of physical health, combined aerobic and resistance exercise interventions demonstrated the most significant improvements in reducing body mass index (BMI) and body fat percentage. Moderate-to-high-intensity exercise performed three times per week, at least 60 minutes per session, over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and overweight children while improving cardiorespiratory endurance and muscular strength. In terms of mental health, physical activity was positive in reducing depression and anxiety, and improving self-esteem in children and adolescents. Activities such as dance, outdoor adventure programs and team sports notably enhanced social skills and emotional well-being. For neurodevelopmental disorders, low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities. In terms of health-related behaviors, physical activity interventions promoted the development of exercise habits, improved social interaction skills, increased physical activity participation, reduced sedentary behavior, and enhanced health and physical activity knowledge. In terms of multi-modal interventions, programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interventions. Health-promoting schools (HPS) approach, integrating school, family and community involvement, effectively increased students' physical activity levels, reduced obesity rates, and improved mental health outcomes.

Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents. Moderate-to-high-intensity aerobic and resistance training, dance, and outdoor activities are effective interventions for improving body composition and mental health. Multi-modal interventions and HPS strategies can yield sustained health benefits.

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 systematically review the evidence from systematic reviews on the effect of exercise on internet behavioral addictions.
Methods Systematic reviews on exercise for internet behavioral addictions were searched in Web of Science, Scopus, EBSCO, PsycINFO, PubMed, Cochrane Library, Embase and CNKI, from January, 2015 to January, 2025. In accordance with the PRISMA guidelines, the evidences about exercise on internet behavioral addiction, as well as the health benefits, were reported.
Results Eleven English reviews were included, from China, Malaysia, Indonesia and Australia, involving 31 672 internet behavioral addiction aged ten to 30 years, covering internet addiction, mobile phone addiction and gaming addiction. The included literatures were all systematic reviews mainly from journals in psychology, psychiatry, public health, etc. Interventions included aerobic exercise, strength training, functional training, skill-based training and structured combination exercise, with programs ranging from 30 to 120 minutes per session, one to six times per week, for six to 24 weeks. Exercise significantly improved mental health, behavioral health, physical health and cognitive function. Moderate-intensity structured combination exercise (≥ 60 minutes persession, ≥ 3 times per week, ≥ 8 weeks) showed the best outcomes, especially for gaming addiction. Exercise combined with psychological therapy was more effective for severe addiction.
Conclusion Exercise is effective on internet behavioral addictions, and moderate-intensity structured combination exercise is the most effective. It is recommended to use structured combination exercise for gaming addiction and combined exercise-psychological therapy for severe addiction.

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 high-definition transcranial direct current stimulation (HD-tDCS) combined with upper limb robot on upper limb dysfunction in patients with ischemic stroke.

Methods From January, 2023 to March, 2024, 56 inpatients with upper limb dysfunction after ischemic stroke were selected from Zhejiang Rehabilitation Medical Center, and divided into control group (n = 28) and experimental group (n = 28) randomly. All the patients received comprehensive treatment and upper limb robot training, while the control group received sham HD-tDCS and the experimental group received HD-tDCS, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Wolf Motor Function Test (WMFT) and modified Barthel Index (MBI) before and after treatment. The cortical amplitude, cortical latency and central motor conduction time (CMCT) of transcranial magnetic stimulation motor-evoked potential (MEP) were recorded, and a correlation analysis was conducted.

Results The scores of FMA-UE, WMFT and MBI, and MEP cortical amplitude, cortical latency and CMCT improved in both groups after treatment (t > 3.177, P < 0.01), and they were better in the experimental group than in the control group (t > 3.610, P < 0.01). The scores of FMA-UE and WMFT negatively correlated with MEP cortical latency and CMCT, and positively correlated with MEP cortical amplitude (|r| > 0.448, P < 0.001).

Conclusion HD-tDCS is effective on upper limb motor function and activities of daily living for patients with ischemic stroke, and can improve corticospinal motor conduction.

Objective To establish an educational intervention framework of electronic picture books for children with autism spectrum disorder (ASD) based on Creative Problem Solving (CPS) model, and observe the effect on social function.

Methods Electronic picture books were designed using CPS model, including the program of reading, interactive animation design and associated artistic activities. From March to June, 2023, 24 children with mild to moderate ASD were recruited from Maanshan Institute of Special Education, and randomly assigned into experimental group 1 (CPS-based cognitive picture book interventions, n = 8), experimental group 2 (CPS-based social picture book interventions, n = 8) and control group (Bloom's Taxonomy-based picture book interventions, n = 8), and received the interventions for four weeks, with a total of twelve times. They were assessed with speech, social, perceptual and health behavior using Autism Treatment Evaluation Checklist (ATEC) before and after treatment, and the differences were calculated.

Results There was a significant difference among the groups in the social and perceptual scores differences (F > 4.344, P < 0.05) and a near-significant difference in the health behaviour score difference (F = 2.921, P = 0.076). Post Hoc test showed that the differences in social scores were higher in both experimental groups than in the control group (P < 0.05); the difference in perceptual scores was significantly higher in experimental group 1 than in experimental group 2 (P < 0.01), but there was no significant difference with the control group (P > 0.05); the difference in health behavior scores was higher in experimental group 2 than in the control (P < 0.05), and the difference in experimental group 1 was slightly higher than in the control group (P = 0.072).

Conclusion Electronic picture book interventions based on the CPS model may be more effective in enhancing social, perceptual and health behavior in children with ASD, but there may be differences among models.

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 systematically evaluate robot-assisted gait training (RAGT) on motor function, ambulation and activities of daily living of patients after stroke and spinal cord injury (SCI), and to investigate the clinical value of different robotic technologies and control strategies.

Methods In accordance with PRISMA guidelines, relevant randomized controlled trials (RCTs) published between 2020 and 2024 were identified from databases including Scopus, Web of Science, PubMed, Cochrane Library and CNKI. The PEDro scale was used to assess methodological quality, and a comprehensive analysis was performed on the therapeutic effects of RAGT on walking ability, balance, lower limb muscle strength and functional independence.

Results Eight RCTs involving 702 participants were included, originating from countries such as China, Italy, India, Turkey and Poland. The population consisted of adult patients with various subtypes of stroke or SCI. These studies were published in journals across geriatric neuroscience, biosciences, medicine and sports science. Interventions involved three categories of lower limb exoskeleton including treadmill-based systems (end-effector and exoskeleton models), overground exoskeletons and specialized joint/platform-based robots. The training frequency was 20 to 45 minutes a time, once to twice a day, one to seven days a week, for a total of two to ten weeks. RAGT might significant improve gait parameters and lower limb muscle strength, though its impact on functional independence was heterogeneous. Adaptive control strategies (e.g., assist-as-needed) proved superior to fixed-parameter modes. Treadmill-based systems (e.g., Lokomat) were well-suited for early-stage rehabilitation, while overground exoskeletons (e.g., EKSO-GT) better facilitated adaptation to real-world environments.

Conclusion RAGT is an effective modality for improving gait and lower limb function of patients with stroke and SCI. The therapeutic outcome is contingent upon personalized setup of the exoskeleton and the implementation of adaptive control strategies. Different adaptive control modes have been developed for the three main types of lower limb exoskeleton. Rehabilitation training should consider the specific lower limb tasks with the robot's corresponding adaptive movement and control modes.

Objective To develop a Chinese expert consensus on comprehensive rehabilitation and non-invasive neuromodulation awakening therapy for patients with prolonged disorders of consciousness (pDoC) using an evidence-based approach.
Methods A core working group for the consensus was established. Combining the latest domestic and international advancements with clinical practice experience, preliminary recommended opinions were formulated focusing on two core topics: comprehensive rehabilitation and non-invasive neuromodulation for pDoC patients. After two rounds of online and offline expert consultation and discussion, all the final recommended opinions received up to more than 70% of agreement.
Results The development of rehabilitation strategies for pDoC patients should be in team-work, led by rehabilitation physicians, involving physical therapists, occupational therapists, speech therapists, nurses, neurologists, internists, nutritionists, social workers, and other professionals. Ten consensus opinions and six recommended treatment parameters were developed for comprehensive rehabilitation and non-invasive neuromodulation for pDoC patients.
Conclusion The expert consensus on comprehensive rehabilitation and non-invasive neuromodulation for pDoC patients provides a standardized guidance to promote the standardized management of clinical rehabilitation, and provide references for developing individualized rehabilitation strategies.

Objective To review the interoceptive assessment tools in terms of structure, content and psychometric properties, based on the framework of the International Classification of Functioning, Disability and Health (ICF).

Methods The literature on interoceptive evaluation tools was retrieved from databases of CNKI, PubMed, Medline and EBSCO. The principal structures and contents of the assessment tools were analyzed based on the ICF framework, and the quality of the psychometric properties were appraised using COSMIN.

Results A total of 13 interoceptive assessment tools were ultimately included, involving 16 literature references. There were five interoceptive sensitivity tools, four accuracy tools and four awareness tools. In terms of content, interoceptive sensitivity tools involved 33 categories of body functions, six categories of activities and participation, and one of environmental factors; while interoceptive accuracy tools only involved seven categories of body function, and two of activities and participation items; interoceptive awareness tools involved 30 categories of body function, four categories of activities and participation, and three of environmental factors. In terms of psychometric properties, Body Perception Questionnaire-Short Form (BPQ-SF) was the sensitivity tool with the best reliability and validity (qualified rate of 7/8), followed by Interoceptive Sensitivity Questionnaire (ISQ) (qualified rate of 6/8). Most of the accuracy tools adopted standardized measurement methods, but lacked sufficient reliability and validity verification. The awareness tools were good in reliability and validity (qualified rate above 5/8), especially Multidimensional Assessment of Interoceptive Awareness (MAIA-1) and Body Awareness Questionnaire (BAQ) (qualified rate of 8/8).

Conclusion BPQ-SF and ISQ are recommended for interoceptive sensitivity assessment, Water-loading Test and Heart-beat Tracking Task for interoceptive accuracy assessment, and MAIA-1 and BAQ for interoceptive awareness assessment.

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 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 develop an expert consensus on telerehabilitation management for stroke patients using evidence-based methods.

Methods The Delphi method was adopted to form a list of questions and recommended opinions. The GRADE system was used to assess the quality of evidence and the strength of recommendations. The results of the expert consensus were reported in accordance with the RIGHT checklist.

Results A telerehabilitation medical team composed of rehabilitation physicians, physical therapists, occupational therapists, speech therapists, psychological therapists and rehabilitation specialist nurses, etc., would provide services for the stroke patients if outpatient rehabilitation and short-term inpatient rehabilitation could not fully meet the needs. A total of 17 consensus opinions were formed covering four domains: overview, scope of application, implementation and management.

Conclusion Expert consensus has been reached on issues related to the standardized implementation of telerehabilitation for stroke patients, which is conducive to improving the quality and safety.

Objective To analyze the data structure and standards of rehabilitation outpatient medical records, to provide data support for improving the quality of rehabilitation outpatient care and developing medical insurance payment policies.

Methods Based on the normative documents issued by the National Health Commission, Basic Standards for Medical Record Writing and Standards for Electronic Medical Record Sharing Documents, in accordance with the Quality Management Regulations for Outpatient (Emergency) Diagnosis and Treatment Information Pages (Trial), reference to the framework of the World Health Organization Family of International Classifications (WHO-FICs), the data framework and content of rehabilitation outpatient medical records were determined, and the data standards were discussed.

Results This study constructed a data framework for rehabilitation outpatient medical records, including four main components: patient basic information, visit process information, diagnosis and treatment information, and cost information. Three major reference classifications of WHO-FICs, International Classification of Diseases, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions,were used to establish diagnostic standards and standardized terminology, as well as coding disease diagnosis, functional description, functional assessment, and rehabilitation interventions, to improve the quality of data reporting, and level of quality control in rehabilitation.

Conclusion The structuring and standardization of rehabilitation outpatient medical records are the foundation for sharing of rehabilitation data. The using of the three major classifications of WHO-FICs is valuable for the terminology and coding of disease diagnosis, functional description and assessment, and intervention in rehabilitation outpatient medical records, which is significant for sharing and interconnectivity of rehabilitation outpatient data, as well as for optimizing the quality and safety of rehabilitation medical services.

Objective To investigate the effect of closed-chain exercise training on hemiplegic shoulder pain and shoulder joint stability in stroke patients, and to explore the relationship between hemiplegic shoulder pain and shoulder joint stability.

Methods A total of 52 stroke patients with hemiplegic shoulder pain in Jiangsu Province Hospital from October, 2020 to January, 2023 were selected, and were randomly divided into control group (n = 26) and experimental group (n = 26). Both groups received conventional rehabilitation therapy, while the experimental group additionally underwent closed-chain exercise training for shoulder joint. Pain severity and motor function were assessed using Visual Analog Scale (VAS) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after intervention. Musculoskeletal ultrasound was used to measure acromion-greater tuberosity distance (AGT), acromion-lesser tuberosity distance (ALT), acromiohumeral distance (AHD) and supraspinatus thickness (SST) to evaluate shoulder joint stability. Correlation analysis was conducted on the improvements in shoulder pain and shoulder joint stability in the experimental group.

Results Two cases in the control group and two in the experimental group dropped down. Both groups showed significant improvements in VAS and FMA-UE scores after intervention (|t| > 5.214, P < 0.001), and the scores improved more in the experimental group than in the control group (|t| > 2.087, P < 0.05). The experimental group also showed significant improvements in AGT, ALT, AHD and SST (|t| > 4.187, P < 0.001), with AGT, ALT and AHD being superior to those in the control group (|t| > 2.155, P < 0.05). The difference of VAS score in the experimental group was correlated with the difference of FMA-UE, AGT and ALT after intervention (r > 0.434, P < 0.05).

Conclusion Closed-chain shoulder exercise training can significantly improve shoulder joint stability while alleviating shoulder pain, and effectively enhancing upper limb function in stroke patients with hemiplegic shoulder pain. Hemiplegic shoulder pain is correlated with shoulder joint stability.

Objective To explore psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease (COPD) following dysphagia.

Methods From April to June, 2024, 13 elderly patients with COPD and dysphagia received treatment in Yixing No. 2 People's Hospital (Yixing Occupational Disease Institute) and Northern Jiangsu People's Hospital were interviewed. Nvivo 11.0 and content analysis were employed to analyze and summarize themes.

Results Two main themes were identified. The psychological experiences included fear of eating due to swallowing and choking, swallowing anxiety in social situations, concerns about malnutrition, and emotional loss related to family. The care needs included improvement in swallowing function, adjustment of food texture, assistance with disease adaptation and effective access to health education information.

Conclusion Healthcare professionals should thoroughly understand the psychological and needs of elderly patients with COPD-related dysphagia, and comprehensive nursing strategies should be developed and implemented to improve swallowing function and overall quality of life.