Application of brain-computer interface technology in stroke rehabilitation from 2021 to 2025:a bibliometric analysis
[Journal Article]JIANG Yi, LIANG Kang, CHU Jiahao et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To analyze the application trends and research hotspots of brain-computer interface(BCI)technology in stroke rehabilitation over the past five years. Methods Relevant literatures on the use of BCI in stroke rehabilitation published between January,2021 and August,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 was used for visualiza-tion analysis. Results A total of 458 papers were included.The annual number of publications remained at a high level.China was the leading country in publication output,with Fudan University and Aalborg University as the top institutions.The most prolific author was Mads R.Jochumsen,while G.Pfurtscheller had the highest citation frequency.The key-words and burst terms with the highest frequency in this field were brain-computer interface,motor imagery,up-per limb and deep learning. Conclusion Over the past five years,research on BCI in stroke rehabilitation has maintained a high publication volume.The research hotspots focus on innovations in BCI algorithm technology and multidimensional validation of neu-ral mechanisms and rehabilitation efficacy.

Effect of dual tasks with different cognitive loads on prefrontal lobe activation and static posture control in young men
[Journal Article]WU Mengyi, WANG Chong, WANG Pengfei et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To explore the effect of cognitive-motor dual tasks with different cognitive loads(none,simple and difficult)on activation of prefrontal cortex and static posture control in young man. Methods From June to July,2024,27 healthy male college students were recruited in Hebei Normal University.Static postural control parameters(C90 area),lower limb electromyography data(muscle energy proportion)and pre-frontal cortex hemodynamic signals of subjects under single task without cognitive load,dual-task with simple cognitive load,and dual-task with difficult cognitive load were collected using a balanced testing and training system,a wireless surface electromyography device,and functional near-infrared spectroscopy technology. Results The C90 areas of dual-tasks with simple and difficult cognitive load were smaller than that of the single task without cognitive load(P<0.05).The proportion of β band energy in the medial and lateral gastrocnemius mus-cles in the dual-task with simple cognitive load was greater than that in the single task without cognitive load(P<0.05),while the proportion of piper band energy in the lateral gastrocnemius muscle and tibialis anterior muscle was less(P<0.05).During dual-task with difficult cognitive load,the activation levels of bilateral ventro-lateral prefrontal cortex and right dorsolateral prefrontal cortex were higher than those in the single task without cognitive load(P<0.05). Conclusion Dual tasks with appopriate cognitive loads are effective on postural stability in young man.Simple cognitive load promote posture maintenance through optimizing the neuromuscular control of the lower limb muscle groups,while difficult cognitive load through activating the right prefrontal cortex involved in working memory and executive control,involving the neurocognitive compensatory.

Effect of exercise on respiratory function in Parkinson's disease:a meta-analysis

Abstract:Objective To systematically evaluate the effect of exercise interventions on respiratory function,cough ability and swal-lowing function in patients with Parkinson's disease,and to compare the efficacy of different types of exercise in-terventions. Methods After constructing a PICO framework,randomized controlled trials(RCT)investigating the effects of exercise on respiratory function in Parkinson's disease were retrieved from Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIP and CBM databases from the establishment of the databases to July 25th,2025.The risk of bias was assessed using the Cochrane Risk of Bias tool 5.1.0 and PEDro scale.RevMan 5.3 was used to create risk of bias graphs,and Stata 17.0 was used for meta-analysis. Results A total of eleven RCT involving 471 patients were included,with PEDro scale score of five to eight.Exercise in-terventions significantly improved forced vital capacity(FVC)(MD=0.42,95%CI 0.27 to 0.58,P<0.001),forced expiratory volume in first second(MD=0.32,95%CI 0.24 to 0.39,P<0.001),slow vital capacity(MD=0.80,95%CI 0.68 to 0.93,P<0.001),maximal inspiratory pressure(MD=11.53,95%CI 7.45 to 15.60,P<0.001),maximal expiratory pressure(MEP)(MD=16.75,95%CI 11.90 to 21.60,P<0.001),and peak expiratory flow(MD=55.77,95%CI 49.87 to 61.66,P<0.001)in patients with Parkinson's disease.Respiratory muscle training(RMT)significantly improved reflex peak cough flow(MD=3.51,95%CI 2.40 to 4.61,P<0.001)and voluntary peak cough flow(MD=3.09,95%CI 2.12 to 4.06,P<0.001).Subgroup analysis revealed that RMT was superior to non-ventilatory specific exercise(NVS)in improving MEP(P<0.05),whereas NVS was superi-or to RMT in improving FVC(P<0.05). Conclusion Exercise interventions can effectively improve respiratory function in patients with Parkinson's disease.NVS shows better efficacy in improving pulmonary function,while RMT can enhance cough ability,with more significant effect on respiratory muscle strength.

Effect of bilateral upper limb training after priming upper limb robot training on upper limb function in stroke patients with severe hemiplegia
[Journal Article]HE Aiqun, LI Jingbo, LIU Hai'ou et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To compare the effect between unilateral and bilateral upper limb training on motor function of severely hemi-plegic upper limbs in subacute stroke patients after priming robot-assisted training. Methods From September,2023 to December,2024,60 inpatients with hemiplegia after stroke were recruited from Guangdong Work Injury Rehabilitation Hospital,and randomly divided into control group(n=30)and experi-mental group(n=30).Both groups first received 30 minutes of upper limb robot-assisted training.Subsequently,the control group received movement-based unilateral upper limb training for 30 minutes,while the experimental group received activity-based bilateral upper limb training for 30 minutes,for three weeks.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity(FTHUE-HK)and modified Barthel Index(MBI)before and after treatment. Results The scores of FMA-UE,FTHUE-HK and MBI improved in both groups after treatment(t>4.020,P<0.01),and all the scores were better in the experimental group than in the control group(t>2.456,P<0.05). Conclusion Activity-based bilateral upper limb training after priming robot-assisted training is more effective on motor function of severely hemiplegic upper limbs in stroke patients.

Effect of transcranial direct current stimulation based on bimodal balance model on upper limb dysfunction after ischemic stroke
[Journal Article]TIAN Fubao, LI Hongyu, TIAN Yang et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To explore the clinical effect of transcranial direct current stimulation(tDCS)treatment strategy based on bi-modal balance model on upper limb dysfunction after ischemic stroke. Methods From October,2023 to December,2024,60 patients with ischemic stroke in General Hospital of Ningxia Medi-cal University were randomly divided into control group(n=30)and experimental group(n=30).Both groups received basic rehabilitation,the control group received tDCS based on the theory of interhemispheric competi-tion model,and the experimental group received tDCS based on the theory of bimodal equilibrium model,for four weeks.Before and after intervention,the effect of both groups was evaluated using Fugl-Meyer Assessment-Upper Extremities(FMA-UE),modified Ashworth Scale(MAS),Action Research Arm Test(ARAT)and modi-fied Barthel Index(MBI).Neurophysiological parameters such as cortical latency(CL)and central motor conduc-tion time(CMCT)were detected and correlated analysis was performed. Results Two cases in the control group and one in the experimental group dropped down.After intervention,the scores of FMA-UE,ARAT and MBI increased in both groups(|t|>13.748,P<0.001),and the above scores were higher in the experimental group than in the control group(|t|>2.321,P<0.05);the MAS grade of the elbow flexor muscle group improved in the experimental group(|Z|=2.095,P<0.05).The CL and CMCT in both groups de-creased(|t|>2.752,P<0.001),and they were better in the experimental group than in the control group(|t|>2.082,P<0.05).There was a correlation between FMA-UE and CMCT(r=-0.433,P<0.05). Conclusion tDCS based on bimodal balance model can improve upper limb dysfunction more effectively in patients with ischemic stroke.

Characteristics of brain functional network based on electroencephalogram in post-stroke aphasia patients based on functional connectivity
[Journal Article]ZHANG Zihan, ZHANG Jiacheng, LIU Jinghe et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To analyze the characteristics of brain functional networks in patients with post-stroke aphasia(PSA)during a Chinese word-picture matching task. Methods A total of 18 PSA patients in Dongzhimen Hospital from January,2018 to December,2021 were enrolled as PSA group,and nine healthy controls matched for sex,age and education were included as the control group.The Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE)and task-state electroencephalogram(EEG)data based on a Chinese word-picture matching paradigm were collected.Source-space reconstruction was applied to EEG signals to construct functional connectivity matrices.Graph-theoretical analysis was used to com-pute global network properties,and network-based statistics were used to identify subnetwork differences be-tween groups.Correlations between global network properties and CRRCAE subscales were further analyzed. Results The global properties of each frequency band were higher in the control group(unmatched)than in PSA group and the control group(matched)(P<0.01).Subnetworks connections enhanced in the alpha band in the frontal,temporal,parietal,occipital lobes and limbic system(23 nodes,31 edges,P<0.05),and weakened connections in the frontal,temporal,limbic system and basal ganglia(20 nodes,26 edges,P<0.01)in PSA group;in the beta band,subnetwork connections enhanced in the frontal,temporal lobes,basal ganglia and limbic system(15 nodes,23 edges,P<0.01);in the theta band,subnetwork connections weakened in the left frontal and temporal lobes(10 nodes,11 edges,P<0.05),and enhanced in the right frontal and temporal lobes(7 nodes,7 edges,P<0.05).Under the matched condition,the global properties of the alpha and beta bands in PSA group were positive-ly correlated with reading(r=0.511 to 0.650,all P<0.05),and the local efficiency and average clustering coeffi-cient of the theta band were negatively correlated with repetition(r=-0.500 to-0.505,all P<0.05);under the unmatched condition,the local efficiency and average clustering coefficient of the alpha and beta bands in PSA group were positively correlated with reading(r=0.522 to 0.642,all P<0.05),and the global efficiency and lo-cal efficiency of the alpha band were positively correlated with auditory comprehension(r=0.486 to 0.496,all P<0.05).The comparison between the task state and the resting state further revealed that compensatory connec-tion enhanced in the alpha band in the frontal lobe and limbic system(6 nodes,5 edges,P<0.05)and in the beta band in the frontal,temporal,parietal,occipital lobes and limbic system(38 nodes,52 edges,P<0.01)in PSA pa-tients. Conclusion The core network damage characteristics of PSA patients are abnormally decreased global properties across multiple frequency bands and frequency-specific abnormal network reorganization,suggesting the overall brain network efficiency decline coexists with local compensation.This provides an objective basis for the neuroelec-trophysiological evaluation and targeted intervention of PSA.

Effect of life reconstruction training on anxiety and depression among individuals with chronic spinal cord injury and their caregivers
[Journal Article]XIE Haixia, HU Xinxing, ZHAI Hua et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To explore the effect of life reconstruction training on anxiety and depression among individuals with chronic spinal cord injury(SCI)and their caregivers,and to analyze the influencing factors. Methods A total of 216 SCI patients and 79 caregivers who participated in life reconstruction training were recruited from the Hope House for SCI individuals in Shanghai Yangzhi Rehabilitation Hospital from May,2017 to Octo-ber,2019.They were assessed with Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)be-fore and after intervention. Results After intervention,the scores of SAS and SDS decreased(P<0.05)in both SCI patients and their caregivers.SAS scores were more likely to reduce in SCI patients who suffered anxiety at admission(OR=2.315,95%CI 1.328 to 4.033,P=0.003)and their caregivers(OR=3.632,95%CI 1.270 to 10.390,P=0.016),as well as non-agricultural-registered SCI patients(OR=1.908,95%CI 1.074 to 3.391,P=0.028).Being unmarried,having an injury duration≥21 years,injury due to disease,and having depression at admission significantly promoted the reduction in SDS scores among SCI patients(P<0.05).Caregivers with a junior-high-school education or less were more likely to experience reductions in scores of SAS and SDS compared with those with higher education(P<0.05).Caregivers with five to 15 years of caregiving experience achieved more anxiety reduction(OR=7.155,95%CI 1.806 to 28.342,P=0.005). Conclusion Life reconstruction training is effective on anxiety and depression among individuals with chronic SCI and their caregivers.It is recommended to prioritize anxiety interventions for patients with rural household registra-tion in China,along with depression management for the married/divorced/widowed individuals,with<21 years since injury,and trauma-induced lesions.For caregivers,it is needed to focus to anxiety and depression in better-educated individuals,as well as anxiety in those with either<5 or≥15 years of caregiving experience.

Expert consensus on telerehabilitation management for stroke patients in China
[Journal Article]Multidisciplinary Rehabilitation Diagnosis and Treatment Working Committee of Chinese Association of Rehabili-tation Medicine, Neurorehabilitation Professional Group,Neurology Branch of Chinese Medical Association, China Rehabilitation Research Center-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract: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 consen-sus were reported in accordance with the RIGHT checklist. Results A telerehabilitation medical team composed of rehabilitation physicians,physical therapists,occupational thera-pists,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,im-plementation 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.

Comparison of different virtual reality technologies on motor function in Parkinson's disease:a network meta-analysis
[Journal Article]ZHANG Hao, XU Chuanlei, WEI Zhenxing et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To systematically compare the efficacy of different virtual reality(VR)technologies on motor dysfunction in patients with Parkinson's disease(PD)through a network meta-analysis(NMA). Methods Following the PRISMA-NMA guidelines,randomized controlled trials(RCT)that compared the effect of at least two interventions on motor function in patients with PD were searched in PubMed,Embase,Cochrane Li-brary,Web of Science,CNKI,Wanfang data and VIP.The interventions included immersive virtual reality(IVR),non-immersive virtual reality(VRT),augmented reality(AR),treatment as usual(TAU)and active control(AC).The primary outcomes included Unified Parkinson's Disease Rating Scale Part Ⅲ(UPDRS-Ⅲ),Berg Balance Scale(BBS)and Timed Up and Go Test(TUGT).A frequentist-based random-effects model was used to conduct NMA,and the surface under the cumulative ranking curve(SUCRA)was used to rank the interventions. Results A total of 20 RCT involving 890 patients were included.IVR performed best in improving the score of UPDRS-Ⅲ(SUCRA=97.7%)and was significantly superior to TAU(SMD=-0.82,95%CI-1.28 to-0.37).IVR showed the highest probability of being the best option for the score of BBS(SUCRA=85.2%)and was signifi-cantly superior to TAU(SMD=3.94,95%CI 1.08 to 6.80).IVR performed best in the outcome of TUGT(SU-CRA=95.1%)and was significantly superior to VRT(SMD=1.06,95%CI 0.40 to 1.72),AR(SMD=-1.09,95%CI-1.98 to-0.19)and TAU(SMD=-1.38,95%CI-1.95 to-0.82).However,subgroup analysis revealed that the efficacy advantage of IVR was mainly confirmed in short-term(four to six weeks)interventions,while the evidence for long-term efficacy was currently very limited. Conclusion The efficacy of interventions on motor rehabilitation in patients with PD appears to be positively correlated with the technology's level of immersion.As the most immersive technology,IVR is the optimal choice for im-proving overall motor function,balance and mobility in patients with PD.VRT and AR serve as effective adju-vants and are superior to TAU.

Application of quantitative electroencephalography in digital screening for mild cognitive impairment
[Journal Article]GU Jianpeng, SONG Yulei, YIN Haiyan et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To explore the quantitative electroencephalography(qEEG)characteristics of the prefrontal cortex in patients with mild cognitive impairment(MCI)during digital screening tasks for MCI screening. Methods A total of 592 MCI patients(MCI group)and 317 normal cognitively elderly individuals(control group)were recruited from 40 communities in Nanjing,Jiangsu Province,from July to August,2024.All participants were as-sessed using Montreal Cognitive Assessment-Beijing Version(MoCA-BJ).Prefrontal EEG data were collected using a portable EEG device,and power spectral analysis was performed via Fast Fourier Transform.An XG-Boost algorithm was employed to construct an MCI identification model based on qEEG power features,and the model's performance was evaluated using receiver operating characteristic(ROC)curve. Results Compared with the control group,prefrontal δ,α,and β band power increased during screening tasks in MCI group(P<0.05);δ power was negatively correlated with MoCA-BJ total scores,and visuospatial/executive func-tion,attention and delayed recall scores(r=-0.269,-0.169,-0.133,-0.171,P<0.001);α power was negative-ly correlated with MoCA-BJ total scores,attention and delayed recall scores(r=-0.113,-0.075,-0.091,P<0.05).The XGBoost model based on δ and α power was excellent in MCI identification,with an area under the curve of 0.91,accuracy of 0.81,precision of 0.89,F1 score of 0.84,recall of 0.80,and specificity of 0.81. Conclusion MCI patients exhibit increased power in the prefrontal δ and α frequency bands during digital screening tasks,which is associated with cognitive decline.An XGBoost model based on qEEG power features can enable early prediction of MCI.

Evaluation of assistive device adaptation and analysis of influencing factors among people with dysfunction
[Journal Article]LIU Chen, DONG Liquan, YAN Mei et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To investigate the current status of assistive device adaptation among people with dysfunction in China,identi-fy unmet assistive needs for assistive products,and determine key factors influencing attitudes toward assistive device use. Methods Based on data from the Chinese segment of the Global Rapid Assistive Technology Assessment(rATA)survey,5 935 individuals with dysfunction from Beijing,Anhui,Fujian,Hubei,Sichuan and Shaanxi were included.The adaptation status of assistive devices was analyzed,and a theoretical framework was constructed using the tech-nology acceptance model.Multiple linear regression analysis was applied to identify factors influencing attitudes toward assistive device use. Results The utilization rate of rehabilitation assistive devices among people with dysfunction was 65.9%,with a notable prevalence of multiple functional impairments.Fit rate was the highest(68.44%)in individuals with visual im-pairments,while those with communication impairments had the lowest(1.52%).Fit rates were significantly low-er among rural residents and older adults.Overall satisfaction with assistive devices was relatively high(4.11±0.71).Accessibility of the home environment(B=0.396,P<0.001),accessibility of the public environment(B=0.204,P<0.001),functional utility of assistive devices(B=0.204,P<0.001),and distance to obtain the devices(B<-0.112,P<0.01)were key factors affecting satisfication toward assistive device use,while the source of payment showed no significant impact(P>0.05). Conclusion Significant structural imbalances and group disparities exist in the adaptation of assistive devices among people with dysfunction in China.The phenomenon of multiple functional impairments has not received suffi-cient attention,and there remains a substantial unmet need for assistive products among non-fitted groups.Al-though overall satisfaction with assistive devices is high,influencing factors are complex.Continuous improve-ment of accessibility in both private and public environments,promotion of personalized adaptation services,and optimization of assistive device service networks are essential to enhance adaptation accuracy,sustained use,and subjective well-being among people with dysfunction.

Characteritics of resting state brain functional activities in patients with hand dysfunction after ischemic stroke
[Journal Article]WANG Huihuang, LI Xuejing, LIU Fu et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.11

Abstract:Objective To explore the characteritics of spontaneous brain functional activities for patients with hand dysfunction after ischemic stroke using resting state functional magnetic resonance imaging(rs-fMRI). Methods From August,2024 to June,2025,23 patients with hand dysfunction after ischemic stroke were as patients group,and ten age-matched healthy adults were recruited as healthy control group.The patients group was as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Lindmark Scale.All subjects underwent rs-fMRI examinations,and the amplitude of low frequency fluctuations(ALFF),fractional amplitude of low frequency fluctuations(fALFF)and regional homogeneity(Re-Ho)were compared between two groups.The resting state functional network was constructed based on indepen-dent component analysis,and the functional connectivity(FC)were analyzed.The rs-fMRI indicators of the pa-tients and the clinical scale scores were analyzed. Results Compared with the healthy control group,the zALFF value decreased in the precentral gyrus(P<0.05,FWE corrected)in the patient group,as well as the values of zfALFF in Cerebelum-Crus2-R(P<0.05,FWE correct-ed),and ReHo values in the putamen(P<0.05,corrected by Alpha Sim).FC of the inferior frontal gyrus(IF-Goperc.R)in the executive control network enhanced(P<0.05,Alpha Sim corrected),while FC of the middle oc-cipital gyrus(MOG.L)in the dorsal attention network(DAN)weakened(P<0.05,Alpha Sim corrected).There was a positive correlation between FC of MOG.L in the patient's DAN and the scores of FMA-UE(r=0.439,P=0.036),WMFT(r=0.516,P=0.012),and modified Lindmark Scales(r=0.425,P=0.043). Conclusion The resting state spontaneous activity of some brain areas of the cerebrum,cerebellum and basal ganglia is reduced in patients with hand dysfunction after ischemic stroke,and some brain network connections are abnor-mal.FC of MOG.L may serve as an objective imaging marker for evaluating hand dysfunction.

Effect of visual feedback balance training combined with digital treadmill intervention on walking function in pa-tients with ischemic stroke
[Journal Article]ZHAO Weijing, YOU Hong, TANG Zuohong et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To explore the effect of visual balance training combined with digital treadmill intervention on walking func-tion in patients with ischemic stroke. Methods From July,2023 to December,2024,90 patients with ischemic stroke in Gansu Provincial Hospital were ran-domly divided into control group(n=30),treadmill group(n=30)and combined group(n=30).All groups re-ceived routine rehabilitation treatment,while the treadmill group added digital treadmill training,and the com-bined group added visual feedback balance training and digital treadmill training,for four weeks.All groups were assessed with Berg Balance Scale(BBS),Pro-Kin visual feedback balance training system,Tinetti Performance-Oriented Mobility Assessment(POMA),digital treadmill system,Timed Up and Go Test(TUGT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE),Functional Ambulation Category(FAC)and modified Barthel Index(MBI)before and after intervention. Results The effects of intra-group(F>147.291,P<0.001),inter-group(F>4.919,P<0.05)and interaction(F>18.386,P<0.001)were all significant for the indicators including BBS score,length trajectory and elliptical area of eyes open or closed,POMA score,step length,hip and knee range of motion on the healthy and affected side,TUGT time,FMA-LE score,and MBI score.Post-hoc tests showed that after treatment,all the above indicators improved in each group(P<0.01),and they were the best in the combined group,followed by the treadmill group(P<0.05).After treatment,the FAC grades improved in all the groups(|Z|>1.971,P<0.05),and it was better in the combined group than in the control group(P<0.01). Conclusion Visual feedback balance training combined with digital treadmill intervention can improve balance function,walking ability and activities of daily living in patients with ischemic stroke,which is more effective than tread-mill training alone.

Cited:1
Effect of external attentional focus strategy on walking function after stroke
[Journal Article]WANG Yue, ZHANG Tong, LIU Huilin et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To explore the effect of external attentional focus strategy on walking function after stroke. Methods From July to December 2024,40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group(n=20)and experimental group(n=20).Both groups underwent conventional rehabilitation.On this basis,the control group received conventional walking training,while the experimental group received walk-ing training based on external attentional focus strategy,for three weeks.Before and after training,they were as-sessed with Gait Watch 3D gait analysis,Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE). Results After training,the step speed,step frequency,walking cycle,time of TUGT,and the scores of BBS and FMA-LE improved in both groups(|t|>3.098,P<0.01),and the step speed,step frequency,walking cycle and the score of FMA-LE improved more in the experimental group than in the control group(|t|>2.572,P<0.05). Conclusion External attentional focus strategy can improve the walking function of patients with stroke.

Spatiotemporal effect and mechanism of the integrated traditional Chinese and Western medicine brain-limb co-ordinated rehabilitation

Abstract:The theoretical framework of the integrated traditional Chinese medicine(TCM)and Western medicine brain-limb coor-dinated rehabilitation encompasses twelve intervention models,formed by combining four spatial combinations(brain-area Western medicine/TCM+upper/lower limb intervention of TCM/Western medicine)and three temporal sequences(brain-first,limb-first and simultaneous),exhibiting significant condition dependence(e.g.,types of disease,treatment course,baseline status)and population heterogeneity.Transcranial direct current stimulation combined with limb rehabil-itation can produce synergistic effects in some cases,but may also result in limited benefits or antagonistic effects.Cur-rently,there is a particular lack of clinical studies that systematically compare the effects of different temporal sequences(brain-first,limb-first,simultaneous).Functional near-infrared spectroscopy has been relatively maturely applied to re-veal the brain function regulation mechanisms underlying brain-limb coordinated rehabilitation.

Effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy on upper limb motor function after stroke
[Journal Article]YU Zifu, YANG Xiaoxia, ZHAO Xia et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To explore the effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation ther-apy on upper limb motor function in stroke patients. Methods From December,2022 to December,2023,144 stroke patients with upper limb motor dysfunction in the Affili-ated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control,intra-dermal-needle,scalp-acupuncture and acupuncture groups(36 cases repectively).All groups received convention-al treatment and upper limb rehabilitation training,the intradermal-needle group added intradermal-needle thera-py,the scalp-acupuncture group added scalp-acupuncture therapy,and the acupuncture group added both scalp-and intradermal-needle therapies,for four weeks.They were assessed with Fugl-Meyer Assessment-Upper Ex-tremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Barthel Index(MBI)before and after treatment.Twenty cases were selected randomly from each group,fractional anisotropy(FA)values and ratio of fractional anisotropy(rFA)of the lesion area and the posterior limb of the internal capsule were also measured with diffusion tensor imaging. Results Two cases dropped out in both the control group and the intradermal-needle group,while one case dropped out in both the scalp-acupuncture group and the acupuncture group.All groups showed significant improvement in FMA-UE,WMFT and MBI scores,as well as in the FA and rFA values of the lesion area and the posterior limb of the internal capsule(t>5.532,P<0.001)after treatment.The acupuncture group demonstrated the greatest pre-to post-treatment differences in FMA-UE scores,lesion-area FA and rFA values,and posterior-limb rFA val-ues compared with the other three groups(|Z|>3.256,P<0.05),and more WMFT and MBI improvements than those of the intradermal-needle group and the control group(|Z|>5.483,P<0.001).A significant interaction ef-fect was observed between intradermal and scalp acupuncture in improving FMA-UE scores(partial η²=0.035,P=0.029).The change in FMA-UE scores was positively correlated with the change in FA values of the posteri-or limb of the internal capsule(r>0.453,P<0.05)across four groups. Conclusion Scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy can more effec-tively improve upper-limb motor function in stroke patients,which may associate with the recovery of internal capsule.

Spontaneous brain activity changes in post-stroke aphasia and post-stroke depression:a meta-analysis of resting state functional magnetic resonance imaging
[Journal Article]CHEN Yuhang, YANG Yu'ai, LU Xuanyu et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity. Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta. Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05). Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.

Characteristics of electroencephalogram power spectrum in cerebral infarction of various sites and neurological deficit serverites
[Journal Article]ZHAO Xinying, YU Fuda, WANG Hui et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To investigate the characteristics of the relative electroencephalogram(EEG)power spectrum in cerebral in-farction patients with different lesion locations and neurological deficit severities. Methods From February,2024 to May,2025,70 patients with cerebral infarction who completed EEG examinations at Shijiazhuang People's Hospital were enrolled.They were divided into cortical group(n=19)and subcortical group(n=51)based on admission MRI/CT imaging,and divided into mild group(n=53)and moderate-to-se-vere group(n=17)according to the scores of National Institutes of Health Stroke Scale(NIHSS)and Barthel In-dex.All patients underwent 32-channel video-EEG monitoring.The power spectral density of α and θ waves,and the(δ+θ)/(α+β)ratio(DTABR)were analyzed in eight electrodes of F3,F4,P3,P4,T3,T4,O1 and O2. Results DTABR was higher in the cortical group than in the subcortical group across all eight electrodes(|Z|≥2.047,P<0.05),while the relative power decreased in α waves(|Z|≥1.968,P<0.05),and increased in θ waves(|Z|≥1.988,P<0.05)in the cortical group.DTABR was higher in the moderate-to-severe group than in the mild group(|Z|≥2.263,P<0.05). Conclusion Elevated DTABR suggests cortical involvement or more severe neurological impairment,and decreased αwave and increased θ wave activity are primarily observed in patients with cortical lesions,potentially serving as EEG indicators for identifying cortical involvement.

Effect of threshold inspiratory muscle training on pulmonary rehabilitation in postoperative lung cancer patients:a meta-analysis
[Journal Article]ZHAO Yingnan, ZHENG Xintong, LIU Junling et al.-Chinese Journal of Rehabilitation Theory and Practice2025, No.10

Abstract:Objective To systematically evaluate the effect of threshold inspiratory muscle training on pulmonary rehabilitation in postoperative lung cancer patients,with a focus on exploring the difference in efficacy under different interven-tion modes. Methods Randomized controlled trials on the effect of threshold inspiratory muscle training on pulmonary rehabilitation in postoperative lung cancer patients were retrieved from PubMed,Cochrane Library,Embase,Web of Science,CNKI,Wanfang data,VIP and China Biomedical Literature Database.Meanwhile,gray literature from ProQuest and clinicaltrials.gov was searched as supplements.The retrieval period was from the establishment of each data-base to May 9,2025.Cochrane 5.1.0 was used to evaluate the quality of literature,and a meta-analysis was per-formed using RevMan 5.4. Results Twelve studies involving 701 patients were included,all of which were of moderate to high quality.Threshold inspiratory muscle training could reduce the pulmonary complications of postoperative lung cancer patients(OR=0.45,95%CI 0.29 to 0.68,P<0.001),shorten the hospital stay(MD=-1.85,95%CI-3.29 to-0.42,P=0.010),improve the inspiratory muscle strength(MD=5.84,95%CI 0.96 to 10.71,P=0.020),enhance their ex-ercise endurance(SMD=0.40,95%CI 0.10 to 0.71,P=0.010),and did not increase the risk of pulmonary air leakage(OR=0.88,95%CI 0.47 to 1.63,P=0.680).Subgroup analysis revealed that shortening of hospital stay(MD=-2.98,95%CI-5.87 to-0.09,P=0.040)and the improvement in exercise endurance(SMD=0.57,95%CI 0.14 to 1.00,P=0.009)were significant only when threshold inspiratory muscle training was combined with aerobic exercise.However,standalone threshold inspiratory muscle training showed no statistical signifi-cance in these two outcomes. Conclusion Threshold inspiratory muscle training can effectively reduce postoperative pulmonary complications and im-prove inspiratory muscle strength in postoperative lung cancer patients with good safety.Threshold inspiratory muscle training could shorten hospital stay and improve exercise endurance only when combining with aerobic exercise.

Specific risk factors among initial swelling sites of breast cancer-related lymphedema

Abstract:Objective To explore the clinical characteristics and specific risk factors of breast cancer-related lymphedema(BCRL)patients with different initial swelling sites(chest wall,upper arm,forearm and hand). Methods A total of 130 BCRL inpatients in Jing'an District Centre Hospital of Shanghai from December,2015 to March,2024 were reviewed.The patients were grouped by initial swelling sites;baseline characteristics,treatment meth-ods,edema indicators and upper limb dysfunction were compared among groups. Results The sample size of the chest wall group was too small(n=2),so it was excluded from the statistical analysis.There was no significant difference in baseline characteristics,treatment methods,edema indicators or the upper limb dysfunction among the other three groups.Multivariate Logistic regression analysis showed that:age(OR=1.059,P=0.013)and edema onset time(OR=0.984,P=0.011)were the independent related factors for initial swelling in the upper arm,edema onset time(OR=1.014,P=0.011)was the independent risk factor for initial swelling in the forearm,and limitation of shoulder motion(OR=0.125,P=0.044)was the independent protec-tive factor for initial swelling in the hand. Conclusion Age,edema onset time and shoulder joint function of BCRL patients may affect the initial sites of swelling.The initial sites of swelling may indicate different etiologies of edema.