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 effects of transcranial direct current stimulation (tDCS) on insomnia, anxiety and depression in patients with post-sroke insomnia (PSI).

Methods From January, 2020 to May, 2021, 44 patients with PSI from Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and experimental group (n = 22). On the basis of conventional treatment, the experimental group accepted tDCS, and the control group accepted sham stimulation for four weeks. Pittsburgh Sleep Quality Index (PSQI) and sleep monitoring system based on cardiopulmonary coupling technology were used to evaluate the sleep quality of the patients before and after treatment. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate mood.

Results Two cases dropped out in each group. After treatment, the scores of PSQI, HAMA and HAMD decreased in both groups (t > 8.575, P < 0.001), and the scores of PSQI and HAMA were better in the experimental group than in the control group (t > 2.811, P < 0.01), however, there was no significant difference in the scores of HAMD between two groups (t = 1.756, P > 0.05). After treatment, the sleep quality index, total sleep time, sleep latency, sleep efficiency and wake conversion times improved (|t| > 4.721, P < 0.001), and the rapid eye movement time prolonged in the experimental group (t = -2.851, P = 0.010); the sleep quality index, total sleep time, sleep efficiency and wake conversion times were better in the experimental group than in the control group (t > 2.190, P < 0.05), however, no significant difference was found in the sleep latency and rapid eye movement time between two groups (|t|< 1.073, P > 0.05).

Conclusion tDCS could improve the sleep quality and anxiety in PSI patients, and has little effect on sleep structure.

Objective To investigate the effect of multimodal mirror therapy on upper limb and hand function in stroke patients.

Methods From April, 2021 to August, 2022, 60 stroke patients from the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the patients accepted routine rehabilitation, while group B accepted mirror therapy, and group C accepted multimodal mirror therapy, in addition, for six weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Upper Extremity Function Test (UEFT) and modified Barthel Index (MBI), while the maximum grip strength and pinch strength of the affected hand were measured.

Results The FMA-UE score, UEFT score, maximum hand grip strength and pinch strength, and MBI scores improved in all groups after treatment (|t| > 7.878, P < 0.001), and it was the most in group C (F> 12.563, P< 0.001).

Conclusion Multimodal mirror therapy may further improve the upper limb motor function and hand function of stroke patients, as well as the strength of the affected hand and the activities of daily living.

Objective To explore the typical behavior characteristics of children with autism in symbolic play and the value of Symbolic Play Test (SPT) in the early identification of autism.

Methods From November, 2021 to September, 2022, a total of 260 children with language problems were collected from Department of Children's Health Care of Binzhou Medical University Hospital. A total of 193 children with autism were as observation group and 67 normal children were as control group. All children played symbolic games. The typical behavioral characteristics of children with autism in SPT were explored, and a reliability and validity analysis based on the results of SPT was conducted. They were assessed with the adaptive and personal social scores of Gesell Development Scale, and the correlation of the scores of Gesell Development Scale and the score of SPT was analyzed.

Results The Cronbach's α coefficient of SPT of children with autism was 0.835 to 0.935, and the total score of SPT, the scores of surrogate object, fictional attribute and fictional object were positively correlated with each other (r> 0.607, P< 0.001). The SPT scores decreased in the observation group (t> 9.615, P< 0.001), and SPT score positively correlated with adaptability and personal-social development quotient (r> 0.609, P< 0.001).

Conclusion Typical behavior of children with autism can be reflected in symbolic play, and SPT can provide clues for early identification of autism.

Objective To observe the effect of brain-computer interface (BCI) training based on motor imagery on hand function in hemiplegic patients with subacute stroke.

Methods From June, 2020 to December, 2021, 40 patients with hemiplegia in subacute stroke from Department of Rehabilitation Medicine, Fifth Affiliated Hospital of Zhengzhou University were divided into control group (n = 20) and experimental group (n = 20) using random number table. Both groups accepted medication and routine comprehensive rehabilitation, while the control group accepted hand rehabilitation robot training, and the experimental group accepted the robot training using motor imagery-based BCI, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index, modified Ashworth scale, and measured integrated electromyogram of the superficial finger flexors, finger extensors and short thumb extensors of the affected forearm during maximum isometric voluntary contraction with surface electromyography.

Results Two patients in the control group and one in the experimental group dropped off. All the indexes improved in both groups after treatment (t > 2.322, Z > 2.631, P < 0.05), and they were better in the experimental group than in the control group (t > 2.227, Z > 2.078, P < 0.05), except the FMA-UE score of wrist.

Conclusion Motor imagery-based BCI training is more effective on hand function and activities of daily living in hemiplegic patients with subacute stroke.

Objective To analyze the typical performance of initiating and responding behaviors of turn-taking in operational games for autistic children with low language function in special education schools and to provide a reference for intervention of turn-taking behaviors in operational games.

Methods From November, 2021 to January, 2022, a total of 23 autistic children with low language function (language ability ≤ three years old) in Shanghai Putuo District Qixing School were selected. Their linguistic ability was evaluated. A behavioral assessment approach was used to evaluate the behavior of initiating and responding behaviors of turn-taking in three operational games. The typical errors in initiating behaviors were summarized as difficult to initiate, untimely initiation, no response and abnormal initiation. The typical errors in responding behaviors of turn-taking in operational games were summarized as difficult to respond, untimely response, no response and abnormal response.

Results There was no significant differences in the performance of initiating behaviors among three types of operational games (χ² = 11.106, P = 0.196), and there were significant differences in the performance of responding behaviors among operational games (χ² = 26.256, P = 0.001). The initiating behaviors were postively correlated with word comprehension (r = 0.420, P < 0.05), word naming (r = 0.510, P < 0.05), and sentence imitation (r= 0.505, P < 0.05). The responding behaviors were postively correlated with word comprehension (r = 0.546, P < 0.01), word naming (r= 0.728, P < 0.01), sentence comprehension (r = 0.668, P < 0.01) and sentence imitation (r = 0.656, P < 0.01).

Conclusion Autistic children with low language function showed different typical behaviors of initiating and responding behaviors of turn-taking in operational games. It is suggested that when designing training programs for turn-taking skills, targeted interventions should be made to address the typical types of errors in response and initiation turns, and individualized intervention programs should be designed to enhance children's communicative efficacy in play game and promote their language development and social participation.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on walking function of stroke patients at recovery stage. Methods From January, 2021 to January, 2022, 60 stroke inpatients at recovery stage from Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the groups accepted conventional rehabilitation therapy and lower limb robot-assisted training, while group B accepted pseudo-rTMS, and group C accepted high-frequency rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT) and gait analysis before and after treatment. Results The score of FMA-LE, TUGT, pace, stride width, stride, double support phase time, affected side support phase time, affected side swing phase time, healthy side support phase time and healthy side swing phase time improved after treatment in all the groups (|t| > 5.990, P < 0.001), and all the indexes improved the most in group C (F > 3.210, P < 0.05), except double support phase time. Conclusion High-frequency rTMS could facilitate the recovery of lower limb function and walking of stroke patients at recovery stage.

Objective To analyze the effect of physical activity on executive function of children and adolescents, and sort out the related factors.

Methods Articles about physical activity intervention for children and adolescents on executive function were retrieved from CNKI, Wanfang Data, Google Scholar, Wiley Online Library and PubMed, from January 1st, 2010 to June 30th, 2021. The articles were screened, evaluated and systematically reviewed.

Results A total of 21 articles were included, from eleven countries, including 13 randomized controlled trials, involving 2 496 subjects, aged five to 18 years. The articles were published from 2010 to 2019, with mean score of Physiotherapy Evidence Database scale as 5.57. The physical activity intervention mainly involved physical fitness, skills and sport games, with low to high intensity, eight to 120 minutes a time, one to five times a week, no more than ten months. Physical activity was indicated to improve the executive function, specifically inhibition control, working memory and cognitive flexibility, such as the improvement of the accuracy and reaction time of cognitive tasks, and activation of bilateral prefrontal cortex activity. Types, intensity, duration, frequency and cycle of physical activity, participant selection, and assessment tools were related to the effect of intervention.

Conclusion Physical activity can improve the inhibition control, working memory and cognitive flexibility of children and adolescents. The main factors related to the intervention effect are the physical activity elements, the participant's factors and the experimental design factors.

Objective To analyze the content and psychological measurement indicators of the commonly used motor function assessment tools for children and adolescents, based on the theory and method of International Classification of Function, Disability and Health-Children and Youth Version (ICF-CY). Methods Based on the ICF-CY classification framework and coding system, four commonly used functional evaluation tools for children and adolescents were selected, and their motor function measurement methods and psychological measurement indicators were analyzed by applying ICF coding rules and matching principles. Results Finally, nine English articles and two Chinese articles were included, from four countries including South Korea, Spain, China and Brazil. They were mainly published in the journals of clinical medicine, neuroscience, public health, rehabilitation science and other fields from 2011 to 2021. The age of the subjects was 0 to 16 years old involving 987 subjects; the health condition included spastic cerebral palsy, neurodevelopmental disorder, etc. Among the eleven articles included, six articles used Gross Motor Function Measure (GMFM-88), two articles used Fine Motor Function Measure Scale (FMFM), two articles used Peabody Developmental Motor Scales Second Edition (PDMS-2), and two articles used Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS), and three articles used Pediatric Evaluation of Disability Inventory (PEDI). The measurement methods were objective evaluation, subjective evaluation, and subjective observation, etc. The number of measurements was two to six. The measurement indicators of motor function mainly involved two levels. The first was the physical activity level, including gross movement, fine movement and motor control ability. The second was the functional level of activities, mainly including activities of daily living and functional independence. Conclusion Based on ICF-CY, the evaluation of children's motor function and activity and participation was mainly divided into two levels. At the body function level, the main evaluation indicators included b730, b760, b770, etc. At the level of activities and participation, the main evaluation indicators were d410, d440, d445, etc. GMFM-88 focuses on the evaluation of children's body movement and activity functions, such as sitting, standing, lying, walking and running, mainly involving b760, d410, d455, etc. FMFM focused on autonomous movement, motor motivation and motor coordination, and was mainly used to assess the functional status of upper limbs of children with cerebral palsy aged 0 to 3 years, mainly involving b760, d155, d440, etc. PDMS-2 payed more attention to evaluating the overall motor development level and motor function status of children and adolescents, mainly involving b750, b760, d415, etc. PEDI-FSS move partition focused on children's actual motor function performance in activities of daily living, and evaluated the application and practicability of children's motor function in activities of daily living, mainly involving b760, d410, d450, etc. In terms of measurement methods, the measurement of motor function mainly included objective evaluation and subjective evaluation; the measurement of activity function mainly included objective evaluation and subjective observation. These assessment tools have established norms varies with different age groups according to the movement development. Evaluators need accept professional training before using the above assessment tools to improve the reliability, validity and adaptability of the assessment.

Objective To investigate the features of surface electromyography (sEMG) signals of elbow and shoulder muscle groups during maximal isometric contraction of elbow joint, and flexion and extension exercises of elbow joint after elbow fracture surgery.

Methods From August, 2021 to April, 2022, 15 convalescent patients after elbow fracture surgery (patient group) and 11 healthy controls (control group) were collected. sEMG signals of biceps brachii, triceps brachii, brachioradialis brachii, upper trapezius, anterior deltoid, middle deltoid and posterior deltoid were recorded during maximal isometric contraction, and flexion and extension exercises of the elbow joint. Root mean square (RMS) value, co-synergy contraction ratio (CSR), co-activation radio (CR), and target muscle activation percentage during flexion and extension were calculated.

Results In flexion and extension of elbow joint during maximal isometric contraction, the maximum strength of biceps brachii and triceps brachii were lower in the patient group than in the control group (|t| > 4.109, P < 0.01), and the RMS value of triceps brachii was lower in the patient group than in the control group (t = -7.695, P < 0.001). During maximal isometric extension of elbow joint, the CR of biceps brachii and brachioradialis brachii were more in the the patient group than in the control group (t> 2.326, P < 0.05); during maximal isometric flexion of elbow joint, the CSR of upper trapezius was more in the patient group than in the control group (t = 2.232, P< 0.05). During the extension exercise, the activation level of triceps brachii was more in the patient group than in the control group (t = 3.336, P < 0.05); during flexion exercise, the activation level of biceps brachii and triceps brachii was more in the patient group than in the control group (t >2.339, P < 0.05).

Conclusion There is abnormal contraction pattern of elbow and shoulder muscle groups in patients with elbow fracture after operation, which includes obvious co-contraction pattern of elbow flexor muscle group, insufficient activation of elbow extensor muscle and the compensatory contraction pattern of perishoulder muscle group. sEMG has great potential in quantitative evaluation of motor function after elbow fracture.

Objective To explore the effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients.

Methods From October, 2020 to September, 2022, 54 stroke patients were randomly divided into control group (n= 18), external diaphragm pacing group (n= 18) and combined treatment group (n= 18). All the groups received breathing training, while the external diaphragm pacing group received external diaphragm pacing therapy, and the combined treatment group received external diaphragm pacing and abdominal functional electrical stimulation therapy, for two weeks. They were measured forced vital capacity (FVC), forced expiratory volume in first second (FEV₁), ratio of forced expiratory volume in first second in forced vital capacity (FEV₁/FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with pulmonary function instrument; measured diaphragmatic excursion (DE) and diaphragmatic thickness (DT) with ultrasound, before and after treatment.

Results Three cases in the control group, two cases in the external diaphragm pacing group and one case in the combined treatment group dropped off. The FVC, FEV₁, PEF, MIP, MEP and DE improved in all the groups (|t| > 3.366, P< 0.01) after treatment; and the FVC, FEV₁, MIP and DE increased more in the combined treatment group and the external diaphragm pacing group than in the control group (P< 0.05); the FVC and FEV₁ increased more in the combined treatment group than in the external diaphragm pacing group (P< 0.05).

Conclusion External diaphragm pacing therapy may improve ventilation and inspiratory muscle strength, and increase diaphragm movement for stroke patients; while the ventilation improved more after combining with abdominal functional electrical stimulation.

Objective To develop a scale for assessment of communication functions in children's daily life.

Methods Based on the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) communication function-related categories, test items applicable to children's communication function were developed through a structured interview method and linguistic analysis. Delphi method was used to evaluate and select the items. The items were tested by item analysis and exploratory factor analysis to construct the scale structure. The internal consistency reliability, split-half reliability, structural validity, and criterion-related validity of the scales were tested by 168 children through internet.

Results A children's communication function scale consisting of 42 items was developed, involving four subtests, including preverbal communication (8 items), simple oral communication (5 items), comprehensive oral communication (20 items), and pictorial symbolic communication (9 items). The scale was tested with moderately difficult and high discrimination (0.328 to 0.936). The scale had good internal consistency reliability (0.897 to 0.979) and split-half reliability (0.851 to 0.952), as well as structural validity (r = 0.536 to 0.836). The total scale score was correlated with the Peabody Picture Vocabulary Test-Revised validity scale (r= 0.787, P< 0.05).

Conclusion The ICF-CY-based scale of communication functions in children's daily life consisted of 42 items in four subtests. It has shown good consistency reliability, split half reliability, construct validity and criterion-related validity.

Objective To construct the mental health benefits of physical activity of Tai Chi and framework for college students based on International Classification of Functioning, Disability, and Health (ICF), and to systematically review the effect of physical activity of Tai Chi on anxiety, depression and sleep quality of college students.

Methods Relevant literatures about the health outcomes on anxiety, depression and sleep quality of college students participating in physical activity of Tai Chi were retrieved from databases of Web of Science, PubMed, Medline, Scopus, CNKI, Wanfang data, from the establishment to November 10th, 2022, and screened and reviewed.

Results Ten randomized controlled trials were included finally, from China and U.S.， involving 960 participants (aged 16.4 to 40 years). The main sources were from journals about physical activity and health, with publication dates from 2016 to 2021. The quality of the included literatures was evaluated using the Physical Therapy Evidence Database (PEDro) scale with a mean score of 6.3. The main mental health problems of college students mainly focused on depression, anxiety, high stress, and poor sleep quality. The physical activity of Tai Chi included 24 simplified Tai Chi and Chen style Tai Chi. The frequency of physical activity of Tai Chi was mainly 1 to 6 times a week, 45 to 90 minutes (60 minutes mostly) a time, for 4 to 18 weeks. The health benefits of Tai Chi on anxiety, depression, and sleep quality for college students in the ICF were mainly in the affective function (b152), psychomotor function (b147), energy and drive function (b130), and sleep function (b134). The beneficial outcomes of physical activity of Tai Chi involved reducing anxiety, alleviating depressive symptoms and reducing stress. Compared with physical activity of Tai Chi, physical activity of Tai Chi with the addition of a twenty-four-pattern Taijiquan theory course was more effective in improving depression levels in patients with mild and moderate depression. Tai Chi also can help to improve sleep quality, shorten the time to sleep, and reduce sleep disturbances and daytime dysfunction.

Conclusion A PICO framework of Tai Chi for the health benefits of college students has been constructed using ICF. Tai Chi engaged in by college students are mainly 24 simplified Tai Chi. The frequency of physical activity of Tai Chi is 45 to 90 minutes (60 minutes mostly) a time, 1 to 6 times a week, for 4 to 18 weeks. The physical activities of Tai Chi can benefit in reducing anxiety and depression of college students and improving the quality of sleep.

Objective To analyze the policy and methodological framework of monitoring and evaluation in the fields of World Health Organization (WHO) health service system, health-promoting schools, and physical activity, and to construct a policy framework and approach to monitor and evaluate the integration of physical activity into the health-promoting schools.

Methods Using the theory of WHO health service system components, the core policy documents of the WHO in the fields of health service, health-promoting schools, and physical activity were systematically analyzed, the relevant policy framework was constructed and the core elements were analyzed at macro, meso, and micro levels.

Results At the macro policy level, the policy framework, monitoring and evaluation framework, governance and monitoring capacity building were addressed. (1) Based on the theory of WHO's six building blocks of health services, the policy framework for monitoring and evaluation of physical activity integration into health-promoting schools was constructed to guide the development and application of information systems, monitoring indicator systems, and evaluation tools. (2) With reference to the generic monitoring and evaluation framework of the national health strategy (NHS), a monitoring and evaluation framework covering input and process indicators, output indicators, outcome indicators and impact indicators was constructed within framework of school health service system monitoring and physical activity monitoring. (3) School health governance and monitoring capacity should be enhanced, and national health-promoting school governance and monitoring capacity should be strengthened based on the National Health Service System monitoring platform strengthening strategy. At the meso level, it involved monitoring implementation programs, core content, and data platforms. (1) Building a national health-promoting school and physical activity monitoring system, and a monitoring and evaluation program emphasizing "health first", "student-centered", "whole-school participation", and "continuous improvement" as well as "school responsibility", "unified indicator system", and "multidimensional evaluation". (2) Referring to the health-promoting school, and incorporate physical activity into the health-promoting school monitoring system and the monitoring and evaluation data platform by referring to the global monitoring standards for health-promoting schools and physical activity. (3) Establishing a monitoring and evaluation mechanism that combines regular monitoring and periodic evaluation, online monitoring and fieldwork, quantitative analysis and qualitative analysis, and school evidence and expert evaluation to monitor and evaluate student physical activity policy-related implementation actions and student physical activity and health status from multiple levels and perspectives. (4) Strengthening the construction of school health information systems, strengthen school physical activity statistical surveys and research, strengthen physical education and health literacy monitoring, form a scientific database of exercise prescriptions, and adjust policy actions and service measures based on monitoring reports. (5) Establishing a synergistic mechanism for monitoring and evaluation. At the micro level, it involves monitoring and evaluation indicators, methods and tools. (1) Under the framework of WHO health service monitoring, health-promoting school monitoring and physical activity monitoring, developing monitoring and evaluation standards and indicator systems for physical activity integration into health-promoting schools and develop monitoring and evaluation tools and data platforms. (2) Constructing a scientific monitoring indicator system, including core indicators and extended indicators, and incorporate quality physical education and practice teaching monitoring. In the construction of the indicator system, input and process indicators include physical activity leadership and governance, financial resources, human resources, technology and equipment facilities, and information systems; output indicators focus on physical activity promotion-related indicators, including quality physical education and practice teaching, promotion and assurance of active travel, and physical activity interventions and services in the classroom, between classes, and after school; outcome indicators address physical activity coverage, levels, and effects; the impact indicators include health, functioning, well-being and quality of life, as well as environmental, social, economic, educational, sport and public health aspects. (3) In terms of monitoring and evaluation methods and tools, adopting the standardized tools recommended by WHO for monitoring and evaluation.

Conclusion Physical activity, as a health strategy, is important to build health-promoting schools and promoting students' physical development and health. This study constructed a policy framework and methodological system for monitoring and evaluation of physical activity integration into health-promoting schools based on the WHO health services framework. This monitoring and evaluation covered at the macro, meso and micro levels. At the macro level, the policy framework, monitoring and evaluation framework, and monitoring capacity were proposed; at the meso level, the implementation plan, core contents, and data platform were proposed; at the micro level, the monitoring framework and contents of physical activity integration into health-promoting schools were used as the basis to develop the related indicator system and implementation methods and tools.

Objective To explore the policy framework, core content, and curriculum implementation of physical activity and health-related curriculum in perspective of health-promoting school.

Methods Based on the policies related to health-promoting school and the World Health Organization (WHO) theory of health service system, content analysis was conducted on the core policy documents of WHO and UNESCO, and to construct the policy framework, core contents, and implementation pathways of physical activity and health-related curriculum in schools from the perspective of health-promoting school. The core policy documents included Making Every School a Health-Promoting School: Global Standards and Indicators; Making Every School a Health-Promoting School: Implementation Guidelines; and WHO Guidelines on School Health Services.

Results Policy framework, theoretical basis, core content, and implementation pathways of physical activity and health-related curriculum were established in perspectives of WHO policies of health-promoting school. The core content of physical activity and health-related curriculum in health-promoting school context were systematically analyzed in terms of school physical activity and health-related curriculum. The specific implementation path of physical activity and health-related curriculum in health-promoting school involved six aspects: curriculum objectives, curriculum content, curriculum approaches, curriculum evaluation, learning materials, and teacher training.

Conclusion Health promotion is an important part of health service system. Health-related curriculum in schools is the use of educational and health-related tools to provide health services to students in a school context. Physical activity and health-related curriculum is a comprehensive health service for students' physical and mental health development in a health-promoting school setting. The pathways and methods for constructing a physical activity and health-related curriculum in a health-promoting school perspective involve six main areas: curriculum objectives, curriculum content, curriculum approaches, curriculum evaluation, learning materials, and teacher training.

Objective To investigate the characteristics of spatial orientation language comprehension and expression behavior of children with autism.

Methods A three-ladder test was designed to test the comprehension and expression of "(go/come) to" sentences, including general subject-predicate sentences, conjunctive-predicate sentences with displacement purposes, and conjunctive-predicate sentences with displacement modes. March to June, 2022, the test was conducted on 17 children with autism from a special education school and 17 healthy children matched the scores of Peabody Picture Vocabulary Test-Chinese revised from a kindergarten. The typical errors were analyzed for children with autism.

Results The main effects of sentence ladders (F > 3.718, P < 0.05) and children groups (F > 8.782, P < 0.001) were significant on comprehension and expression of sentences, while the performance was poor for the complex sentences and for the children with autism. The common types of errors in expression were missing components, mixed sentences, autonomous sentences, inaccurate wording, inconsistent content, blending errors and non-response. The numbers and the distribution of error types were quite different from the children with autism to the healthy children.

Conclusion Children with autism are more difficult to understand and express "(go/come) to" sentences, mainly manifested in a higher error frequency and more kinds of error.

Objective To construct the physical activity intervention effect category and framework for college students with mental and behavioral health and functioning problems based on International Classification of Functioning, Disability, and Health (ICF).

Methods The typical mental and behavioral health and functioning condition of college students were systematically analyzed using ICF. Relevant literatures about the health and functioning outcomes of college students participating in physical activity were retrieved from the databases of PubMed, Web of Science, EBSCO, and CNKI, from the establishment to August 20th, 2022, and reviewed systematically.

Results Ten English literatures were included, involving ten randomized controlled trials with 848 participants aged 15 to 34 years from seven countries, mainly from the journals of rehabilitation science, sports rehabilitation, rehabilitation psychology and health psychology, and were mainly published after 2016. The typical mental and behavioral health and functioning problems of college students mainly focused on stress, anxiety, depression, sleep disorders, learning fatigue, mobile phone addiction, alcohol drinking disorder, sedentary behavior and physical inactivity. Physical activity interventions included Biodanza, Hatha Yoga, Tai Chi, basketball, Baduanjin, cycling, swimming, roller skating, baseball, skill training, stretching exercise, resistance training, and aerobic exercise, etc. The frequency of interventions was mainly a long-term (four to 14 weeks, one to three times per week) program of high-, moderate-, or low-intensity physical activity. The health outcomes included improving cognitive function, relieving stress, anxiety, depression and learning fatigue, reducing negative automatic thinking, enhancing mindfulness, reducing loneliness and deficiency, improving sleep quality, improving upper limb muscle endurance; promoting the development of exercise habits, increasing physical activity participation, improving activity performance and academic performance, reducing sedentary behavior, drinking behavior and problematic mobile phone use; increasing social interaction, improving health perception and psychosocial function, enriching and improving recreation and campus life, and improving the quality of interpersonal relationships, quality of life and well-being.

Conclusion A conceptual framework of physical activity participation of college students with mental and behavioral health and functioning problems is constructed using ICF. The typical mental and behavioral health and functioning problems of college students are mainly classified as mental health and functioning problems, behavioral health and functioning problems. The intervention types of physical activity are divided into physical fitness category, skill category, sports category and combination category. Health outcomes can be reflected in three dimensions: physical and mental health, activity and behavioral health, and overall functioning and quality of life.

Objective To explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions.

Methods From January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM.

Results A cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001).

Conclusion The occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.

Objective To explore the effects of upper limb exergames on cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.

Methods From August, 2020 to November, 2021, 50 troke patients with mild cognitive impairment in Beijing Bo'ai Hospital were randomly allocated to control group (n = 25) and experimental group (n = 25). Both groups received traditional occupational therapy. Additional functional occupational therapy was provided to the control group, and upper limb exergames were provided to the experimental group, for four weeks. They were assessed with Montreal Cognitive Assessment (MoCA), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after the treatment.

Results After treatment, the scores of MoCA, FMA-UE and MBI improved in both groups (|t| > 3.354, |Z| > 4.379, P < 0.01), and the scores increased in five MoCA cognitive domains in the control group (except map naming and abstract thinking) (|Z| > 2.000, P < 0.05) and in six MoCA cognitive domains in the experimental group (except map naming) (|Z| > 2.646, P < 0.01). After treatment, the scores of MoCA, MoCA five cognitive domains (except map naming and abstract thinking) and FMA-UE were better in the experiment group than in the control group(|Z| > 1.982, t = 3.565, P < 0.05).

Conclusion Upper limb exergames can facilitate the recovery of cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.