Abstract:Objective To evaluate the effect of intelligent work simulation training combined with activity pacing on occupation-re-lated physical functions in brain injury patients with headache.Methods A total of 89 brain injury patients with headache received treatment at Guangdong Work Injury Rehabilitation Hospital from January,2021 to December,2023.Two groups were randomly selected from 89 patients according to the therapeutic regimens adopted:control group(n=24)received only intelligent work simulation training,while the experimental group(n=24)received intelligent work simulation training combined with activity pac-ing.Before and 30 days after treatment,Visual Analogue Scale(VAS)was used to assess the degree of headache at rest and under simulated working conditions,while Montreal Cognitive Assessment(MoCA),Berg Balance Scale(BBS)and Functional Capacity Evaluation were applied to evaluate the occupation-related physical func-tions of the patients,respectively.They were assessed with Lam Assessment on Stages of Employment Readiness(LASER)30 days after treatment.The outcomes of return-to-work were recorded three months after treatment.Results After treatment,the score of VAS under simulated working conditions decreased in the experimental group(t=7.240,P<0.001),and was significantly lower than that in the control group(t=-5.656,P<0.001);the scores of BBS,manual material handling and work endurance improved in both groups(|t|>3.491,P<0.01),and they were better in the experimental group than in the control group(|t|>2.256,P<0.05);and the performance of standing-squatting posture transition,1-minute walking distance and 1-minute stair climbing improved in both groups(|t|>2.095,P<0.05),without significant differences between the two groups(|t|<1.966,P>0.05).The employment willingness and return-to-work outcomes were better in the experimental group than in the control group(χ²>8.254,P<0.05).Conclusion The combination of activity pacing can alleviate headache under working conditions for brain injury patients with headache,further improve the complex specific occupation-related physical functions,and lead to higher employment willingness and return-to-work rate.

Abstract:Objective To analyze the research status,hotspots and development trends of the application of airway clearance tech-niques(ACT)in critical care rehabilitation.Methods Relevant literatures up to December 31st,2024 were retrieved from the Web of Science Core Collection data-base.CiteSpace VI 6.2.R3 and VOSviewer 1.6.19 were used to perform bibliometric analysis,including annual publication volume,countries,institutions,authors,journals,keywords and co-cited references.Results A total of 2 189 publications were included,showing an overall stable output trend over time.The United States was the country with the highest publication,the University of Toronto was the most productive institution,and Pelosi Paolo was the most prolific author.The hottest keywords included mechanical ventilation and acute respi-ratory distress syndrome.The bursting keywords were electrical impedance tomography and mechanical insuffla-tion-exsufflation.Conclusion ACT have been widely used in critical care rehabilitation in recent years,especially for the management of airway clearance in patients with respiratory failure and lung injury.It may focus on the use of mechanical insuf-flation-exsufflation,and assistive technologies such as electrical impedance tomography and driving pressure de-tection to guide treatment for patients with airway clearance disorders in the future.

Abstract:Objective To explore the legitimacy and particularity of conducting rehabilitation research for children with disabilities,and analyze the core cruxes in the ethical review of such children's participation in rehabilitation research proj-ects.Methods From the theoretical perspectives of policies and regulations as well as the basic principles of medical ethics,the legitimacy and necessity of children with disabilities participating in rehabilitation research were clarified.Based on the particularities of children with disabilities in terms of physiological characteristics,psychological traits and cognitive abilities,the core challenges in the ethical review of rehabilitation research for this group were systematically sorted out,including inadequate assessment and prevention of research risks,difficulties in informed consent decision-making,neglect of children's subjectivity,lack of safeguards for special groups and hidden risks in the research implementation process.Targeted analyses were then conducted in combination with the key points of ethical review.Results Rehabilitation research for children with disabilities aligns with the demand for safeguarding the health rights and interests of special groups and thus has sufficient legitimacy.However,the particularities of children with dis-abilities in cognitive abilities,independent decision-making and rights protection expose the ethical review of such research to numerous core challenges,which call for corresponding countermeasures.Conclusion The ethical review of rehabilitation research for children with disabilities must fully balance research legiti-macy with the particularities of participants.It is necessary to unify research scientificity with ethical rationality and promote the standardized and orderly development of research in this field through multiple measures:im-proving the institutional system of ethical review and strengthening top-level design;focusing on core challenges such as establishing a research risk assessment and prevention mechanism,optimizing the mechanisms for in-formed consent and the protection of children with disabilities'subjectivity,and enhancing the prevention of hid-den risks and the construction of research teams;and raising the capacity of ethical review and strengthening the supervision of the research process.

Abstract:Objective To explore the impact of depressive state on cognitive function,sleep quality,balance function and quality of life in hospitalized Parkinson's disease patients.Methods A total of 55 inpatients with Parkinson's disease were recruited from Sichuan Bayi Rehabilitation Center be-tween January,2023 and May,2025.Based on the scores of Hamilton Depression Scale(HAMD),they were di-vided into depressive group(n=39)and non-depressive group(n=16).The depressive group was further subdi-vided into mild cognitive impairment(MCI)subgroup(n=13)and moderate-to-severe cognitive impairment sub-group(n=26)according to the scores of Montreal Cognitive Assessment(MoCA).The Pittsburgh Sleep Quality Index(PSQI),Berg Balance Scale(BBS),modified Rivermead Mobility Index(MRMI),and 36-Item Short Form Survey(SF-36)were used to evaluate functional performance across various dimensions.Results The PSQI score was higher in the depressive group than in the non-depressive group(β=-0.341,P<0.001),while the scores for physical component summary-related dimensions(physical function,role physical and gener-al health)and mental component summary-related dimensions(vitality and social function)of SF-36 were lower(β>0.279,P<0.05).The HAMD score of the depressive group was correlated with PSQI scores and most SF-36 dimension scores(|r|>0.329,P<0.05).The BBS score was lower in the moderate-to-severe cognitive impair-ment subgroup than in the mild cognitive impairment subgroup(F=9.224,P=0.004).Conclusion Depression is closely associated with impairment in sleep,balance function and quality of life in Parkinson's disease patients.

Abstract:Objective To explore the key factors influencing the supply of rehabilitation professionals in China's Disabled Persons'Federation system and their action paths.Methods The Health Resource Density Indices were calculated to evaluate the supply level of rehabilitation profession-als in the Disabled Persons'Federation system of various regions in China in 2023.The configuration of factors,such as the number of rehabilitation institutions,rehabilitation expenses for persons with disabilities,the number of universities offering rehabilitation-related programs,the number of persons with disabilities,the number of persons with disabilities participating in social insurance,and the number of persons receiving basic rehabilita-tion services,were analyzed using fuzzy-set qualitative comparative analysis.Results In 2023,the Health Resource Density Indices of the eastern,central,western and northeastern regions of China were 25.039,12.337,7.681 and 9.721,respectively.Shanghai(57.746)and Shandong(52.977)were the highest,while Tibet(0.175),Qinghai(2.215)and Xinjiang(2.798)were obviously lower.Three pathways of high supply level configurations(overall consistency=0.909,overall coverage=0.527)and two pathways of low supply lev-el configurations(overall consistency=0.937,overall coverage=0.498)were identified.Conclusion The supply levels of rehabilitation professionals in China's Disabled Persons'Federation system are the high-est in the eastern region overall,moderate in the central region,and low in the western and northeastern regions.Multiple factors synergistically affect the supply levels of rehabilitation professionals,among which the number of rehabilitation institutions is a direct determinant;the synergistic combination of various factors facilitates the achievement of high-level supply of rehabilitation professionals.

Abstract:Objective To develop a scientific,targeted,practical and operable internship system for undergraduate programs in sports rehabilitation,under the framework of the World Health Organization rehabilitation competency frame-work(RCF),and in alignment with the Healthy China 2030 strategic plan and the Ministry of Education's Nation-al Standards for Teaching Quality of Undergraduate Programs in Physical Education,to meet the needs of the modern era and advance of sports rehabilitation.Methods Led by Sports Rehabilitation Group,Committee of Rehabilitation Medicine Education,Chinese Association of Rehabilitation Medicine,the data on curriculum settings,teaching resources,faculty strength and internship pro-grams were collected from multiple universities nationwide offering undergraduate sports rehabilitation pro-grams;meanwhile,acceptance capacity,post settings and supervisor allocation of internship institutions were sur-veyed.After gaining a comprehensive understanding of the current status,issues and stakeholder feedback,the competency requirements for sports rehabilitation professionals were analyzed using the principles and methodol-ogies of RCF.A comprehensive internship system for undergraduate programs in sports rehabilitation was then constructed.Results The undergraduate internship system for sports rehabilitation covered seven dimensions of internship:objec-tives,schedule,conditions,content,outcome requirements,assessment and evaluation system,and management mechanism.It is developed based on five core domains of RCF:practice,professionalism,learning and develop-ment,management and leadership,and research.Conclusion From the perspective of RCF,this system standardizes internship processes,strengthens students'profession-al operational skills and promotes the close integration of sports rehabilitation professional education with social needs,cultivating professionals adapted to the Integration of Sports and Medicine model.

Abstract:Objective To analyze and review relevant literatures in the field of rehabilitation ethics research in China,and explore the main research topics and development trends.Methods Using CNKI database as the data source,VOSviewer was applied to visualize the author collaboration net-work,and BERTopic modeling technology was employed to perform topic identification,topic clustering and top-ic trend analysis on 106 included articles.Results Currently,the volume of publications on rehabilitation ethics researches in China showed an upward trend.Eight relatively close-knit author collaboration clusters were formed.The BERTopic modeling identified 14 distinct topics,which were clustered into three major topic groups.Researches focused on three main areas:supportive social care,whole-cycle rehabilitation ethics and ethical issues in rehabilitation technology.Conclusion Rehabilitation ethics researches in China is overall in a preliminary stage of development and has not yet formed a nationwide,and closely interconnected academic community.Intelligent rehabilitation ethics and ethics in integrated medical and elderly care rehabilitation represent emerging research hotspots.The scope of research exhibits a significant shift from ethical discussions concerning specific groups with functional impairments to-wards the construction of a systematic social support and rights protection framework.

Abstract:Objective To investigate the effect of personalized home-based rehabilitation under a digital health model on Parkinson's disease.Methods From January,2022 to December,2023,100 patients with Parkinson's disease who participated in the digital health model program at the Affiliated Hospital of Xuzhou Medical University were enrolled and randomly divid-ed into control group(n=50)and experimental group(n=50).The control group received conventional treat-ment,while the experimental group additionally received a home-based rehabilitation management plan with per-sonalized rehabilitation treatment.Before and six months after intervention,the Unified Parkinson's Disease Rat-ing Scale Part Ⅲ(UPDRS-Ⅲ),Part Ⅳ(UPDRS-Ⅳ),Hoehn-Yahr(H-Y)stage,daily levodopa equivalent dose,Parkinson's Disease Questionnaire-39(PDQ-39),Patient Health Questionnaire-9(PHQ-9)and Generalized Anxi-ety Disorder-7(GAD-7)were used for assessment.The time of exercise,systolic blood pressure and diastolic blood pressure were recorded before and after intervention.Results After intervention,the most indices improved in both groups,and the total scores of UPDRS-Ⅲ,UPDRS-Ⅳ and PDQ-39,as well as the dimension scores of activities of daily living,mental health and physical discomfort of PDQ-39 were better in the experimental group than in the control group (|t|>4.503,|Z|>2.161,P<0.05). The time of exercise,PHQ-9 score,GAD-7 score,systolic blood pressure and diastolic blood pressure improved more in the experimental group than in the control group (|t|>2.178,P<0.05).Conclusion Personalized home-based rehabilitation is more effective on Parkinsonian symptoms,quality of life and gen-eral health conditions.

Abstract:Objective To explore the ethical challenges in the development of rehabilitation medicine in the new era,and construct a scientific and systematic rehabilitation ethics management system.Methods Using a combination of theoretical analysis and case study,this paper started with the definition of the scope of rehabilitation ethics management,and expounded the historical background,core connotations,practical dilem-mas and countermeasures of rehabilitation ethics management.Taking the practices of the China Rehabilitation Research Center in multi-level ethics education,professional ethical review,multidisciplinary ethics consultation and social cooperation as examples,this study investigated the significance and practical pathways of improving rehabilitation ethics management.Results and Conclusion Constructing a rehabilitation ethics management system meeting the needs of the new era is a core guarantee for the healthy development of rehabilitation medicine.Through practical measures such as strengthening ethical education,enhancing review capabilities,improving the protection of vulnerable popula-tions,advancing ethical governance of new technologies and ensuring the equitable distribution of resources,the ethical foundation for the high-quality development of rehabilitation medicine will be consolidated.

Abstract:Objective To investigate the effect of noisy galvanic vestibular stimulation(nGVS)on postural control,paraspinal mus-cle activation and cortical activation of patients with adolescent idiopathic scoliosis(AIS)during quiet standing.Methods A total of 30 eligible participants with AIS were recruited from the First Affiliated Hospital of Sun Yat-Sen Uni-versity between December,2023 and June,2025,and finished upright standing tasks on both stable and unstable surfaces under nGVS,sham and no stimulation conditions.They were synchronously measured sway area(SA),medial-lateral and anterior-posterior sway length(SLML and SLAP)and velocity(VML and VAP)of center of pressure(COP)with three-dimensional force platform;the root mean square(RMS)of the bilateral paraspinal muscles at upper end vertebra,apical vertebra and lower end vertebra levels were measured with wireless surface electromy-ography,and convex/concave activation ratio was calculated;and cortical activation of bilateral dorsolateral pre-frontal cortex(DLPFC),supplementary motor area,premotor cortex,primary somatosensory cortex and primary motor cortex were measured with functional near-infrared spectroscopy.Results Compared to the sham and no stimulation conditions,nGVS significantly reduced SA(F=4.645,P=0.006,η²p=0.138),SLML(F=7.651,P=0.001,η²p=0.209)and VML(F=5.035,P=0.010,η²p=0.148);increased the RMS of paraspinal muscles on the concave side of the apical vertebra(F=6.486,P=0.003,η²p=0.183),and de-creased its convex/concave activation ratio(F=4.028,P=0.023,η²p=0.122),and enhanced activation of bilater-al DLPFC(F>6.718,P<0.01,η²p>0.188).The mediation analysis confirmed a significant path of nGVS-DLP-FC-convex/concave activation ratio-COP displacement(P<0.05).Conclusion nGVS may improve postural control in patients with AIS by enhancing DLPFC activation and ameliorating paraspinal muscle imbalance.

Abstract:Objective To observe the effect of cardiopulmonary rehabilitation exercise on exercise tolerance and quality of life in old patients with chronic obstructive pulmonary disease and chronic heart failure(COPD-CHF).Methods A total of 100 old inpatients with COPD-CHF were recruited from the First Affiliated Hospital of Qiqihar Med-ical University between March,2023 and January,2024.They were randomly divided into control group(n=50)and rehabilitation group(n=50).After discharge,both groups received routine medication treatment,while the rehabilitation group additionally underwent cardiopulmonary rehabilitation exercise,for three months.Before and after intervention,left ventricular ejection fraction(LVEF)was measured with cardiac color Doppler ultra-sound,and pulmonary function was evaluated with cardiopulmonary exercise testing;while they were assessed with the 6-minute walk distance(6MWD),COPD Assessment Test(CAT)and Minnesota Living with Heart Fail-ure Questionnaire(MLHFQ).Results Four patients dropped out from each group.Anaerobic threshold,maximum oxygen uptake,maximum voluntary ventilation,LVEF and 6MWD increased in the rehabilitation group after intervention,(t>8.328,P<0.001),and they were better than those in the control group(t>6.717,P<0.001);while the scores of CAT and MLHFQ de-creased in the rehabilitation group(t>12.070,P<0.001),and they were better than those in the control group(t>8.297,P<0.001).Conclusion Cardiopulmonary rehabilitation exercise can improve cardiopulmonary function,exercise tolerance and quality of life in old patients with COPD-CHF.

Abstract:Objective To compare ankle sensorimotor function and postural control ability between patients with chronic ankle insta-bility(CAI)and healthy controls,and to further explore their relationship.Methods From March to June,2025,40 patients with CAI(observation group)and 40 healthy controls(control group)were recruited at Shanghai University of Sport.Peak muscle strength,position sense and force sense were mea-sured using the CON-TREX isokinetic muscle strength test system.Computerized dynamic posturography single-leg standing and Y-balance tests were used to assess static and dynamic postural control abilities.Correlation analysis was performed to examine the relationship between sensorimotor function and postural control ability in the observation group.Results The joint position sense and force sense errors were higher in the observation group than in the control group in all four movement directions(plantarflexion,dorsiflexion,inversion and eversion)(t>2.047,P<0.05).The me-diolateral center-of-pressure velocity(COPV)under eyes-open conditions,as well as anteroposterior and medio-lateral COPV under eyes-closed conditions were higher(t>2.609,P<0.01),and the Y-balance test reach dis-tances in all directions were lower(|t|>2.187,P<0.05)in the observation group than in the control group.Corre-lation analyses demonstrated significant positive associations of plantarflexion and eversion joint position sense errors,and plantarflexion force sense error,to COPV in the anteroposterior and mediolateral directions under cer-tain conditions(eyes open/eyes closed)(r=0.318 to 0.508,P<0.05).Significant negative associations were found from plantarflexion and eversion joint position sense errors,as well as plantarflexion,dorsiflexion and eversion force sense errors,to Y-balance test reach distances in certain directions(r=-0.313 to-0.433,P<0.05).Furthermore,peak plantarflexor and dorsiflexor strength showed significant positive associations with Y-balance test reach distances in certain directions(r=0.316 to 0.470,P<0.05).Conclusion Patients with CAI exhibit diminished ankle position and force sense,which correlate with deficits in static and dynamic postural control abilities,suggesting that position and force sense deficits may be important factors limiting the corection of normal postural control after CAI.

Abstract:Objective To investigate the current status of kinesiophobia in patients with pelvic floor dysfunction(PFD)after pelvic floor reconstruction and analyze its influencing factors.Methods From November,2024 to February,2025,a total of 161 postoperative patients who underwent pelvic floor re-construction for PFD in the First Affiliated Hospital of Chongqing Medical University and Women and Children's Hospital of Chongqing Medical University were selected.A questionnaire survey was conducted using the conve-nience sampling method.The questionnaires included a general information survey,disease and surgery-related information,postoperative-related information,Tampa Scale for Kinesiophobia-11(TSK-11)and General Self-Ef-ficacy Scale(GSES),and the influencing factors of kinesiophobia related to early postoperative ambulation were analyzed.Results The TSK-11 score was(29.88±3.07),in which 136 cases exhibited clinically significant fear of movement.Lo-gistic regression showed that each 1-point increase in pain score at 24 hours postoperatively(OR=1.622,95%CI 1.140 to 2.308,P=0.007),disease course of more than three years(OR=3.813,95%CI 1.090 to 13.340,P=0.036),and transvaginal surgery(OR=3.745,95%CI 1.236 to 11.347,P=0.020)were independent risk factors for postoperative kinesiophobia.In contrast,receiving guidance on early ambulation after surgery(OR=0.283,95%CI 0.087 to 0.923,P=0.036)and a high GSES score(OR=0.924,95%CI 0.868 to 0.984,P=0.014)were protective factors.Conclusion Incidence of kinesiophobia is high in patients with PFD after surgery.Postoperative pain,disease course,transvaginal surgery,receiving guidance on early ambulation after surgery,and self-efficacy were all associated with the occurrence of kinesiophobia.

Abstract:Objective To analyze the current situation and frontier trends of sarcopenia and pain comorbidity in the last decade.Methods Literatures on sarcopenia and pain were retrieved in the Web of Science Core Collection,from January,2015 to June,2025,and analyzed with CiteSpace 6.3.R1,in terms of countries,authors,institutions and keywords.Results Finally,618 English publications were enrolled,revealing a steady upward trajectory in annual publication out-put.Japan emerged as the leading contributor by publication volume,while the Hospital for Special Surgery(USA)ranked as the most productive institution.Andrew A Sama was identified as the most prolific author in this field.The top five high-frequency keywords included sarcopenia,older adults,quality of life,prevalence and low back pain.Co-occurrence network analysis yielded 13 distinct clusters,with prominent themes including ca-chexia,fat infiltration,surgical outcomes,paraspinal muscle and older adults,etc.Keywords with higher burst strength included risk factors and osteoporosis,while rheumatoid arthritis was an emerging burst term in recent years.Conclusion Global researches on sarcopenia and pain comorbidity have grown steadily.Hotspots focus on mechanisms,risk factors,diagnostic approaches and interventions,with older adults remaining the primary focus.Emerging di-rections may involve cachexia-related conditions,arthritis and technology-assisted interventions.Future work should clarify mechanistic links with pain-related comorbidities and develop risk prediction,stratification,and targeted intervention frameworks.

Abstract:Objective To explore the effect of elbow-wrist functional orthosis on plantar pressure distribution and balance function in stroke patients with hemiplegia. Methods From June,2024 to April,2025,60 patients with post-stroke hemiplegia were recruited from Huashan Hospi-tal,Fudan University,and Shanghai Hebin Rehabilitation Hospital.They were randomly divided into control group(n=30)and intervention group(n=30).The control group received routine neurological rehabilitation,while the intervention group received additional training with an elbow-wrist functional orthosis on the affected side,for eight weeks.Before and after intervention,the Modified Ashworth Scale(MAS)of the elbow joint,plan-tar pressure symmetry index(SI),plantar contact area and mean plantar pressure were recorded,and balance and mobility were assessed using the Berg Balance Scale(BBS),Timed Up&Go Test(TUGT)and 10-Meter Walk Test(10MWT). Results Two cases dropped out in the control group.After treatment,MAS grades of the elbow joint,forefoot SI,affect-ed side plantar pressure area,BBS scores,TUGT and 10MWT of both groups improved(|Z|>3.969,|t|>3.528,P<0.01),while the hindfoot SI and average pressure of the affected foot improved in the intervention group(∣t∣>4.264,P<0.001).Except for TUGT and 10MWT,the intervention group was superior to the control group(∣Z∣>2.030,∣t∣>2.096,P<0.05). Conclusion The elbow-wrist functional orthosis can enhance balance function in stroke patients with hemiplegia by re-ducing upper-limb spasticity,optimizing center-of-gravity distribution,and improving postural control.

Abstract:Objective To explore an centralized clinical practice teaching model delivered via a summer short-term semester,and to examine its effectiveness on empathy and communication efficacy among undergraduate students majoring in re-habilitation therapy through a mixed-methods design. Methods From June to July,2025,forty second-year rehabilitation therapy undergraduates from Nanchang Medical Col-lege participated in a one-week immersive clinical practice during the summer short-term semester.An action re-search framework integrating a one-group pre-post experimental design and qualitative research methods were adopted.Quantitative data were collected using the Chinese-Adapted Jefferson Scale of Empathy-Medical Stu-dent Version(JSE-HP)to assess changes in empathy.Qualitative data were obtained through semi-structured fo-cus group interviews and structured reflective journals to investigate students'experiences and transformations in empathic cognition,emotional integration and professional identity. Results After the teaching intervention,students demonstrated significant improvements in the total score of JSE-HP and all subdimensions(perspective taking,compassionate care and standing in the patient's shoes)(t<-3.69,P<0.01).Qualitative analysis yielded three core themes:reconstruction of clinical reasoning paradigms,emotional-cognitive integration and elevation of professional identity. Conclusion Summer short-term semester clinical practice model,structured around"clinical immersion,narrative reflec-tion,interprofessional collaboration and formative assessment",effectively facilitates embodied cultivation of empathy.This model not only bridges the gap between theory and clinical practice,but also serves as an educa-tional catalyst for students'transformation from technical performers to humanistic caregivers.It aligns with the core concepts of the World Health Organization rehabilitation competency framework,offering a replicable and scalable approach to advancing systematic reform in medical humanities education.

Abstract:Objective To analyze the research status and development trends of non-pharmacological therapies for post-stroke spas-ticity(PSS)over the past two decades. Methods Relevant literatures on non-pharmacological rehabilitation of PSS published from January,2004 to June,2024 were retrieved from Web of Science Core Collection.CiteSpace 6.3.R6 and VOSviewer 1.6.18 were used for vi-sualization analysis. Results A total of 780 publications were included.The annual number of publications showed an overall upward trend.China,the USA,and Italy contributed the highest number of publications.The Hong Kong Polytechnic Universi-ty and researcher Noureddin Nakhostin Ansari were identified as the most influential institution and author,re-spectively.High-frequency keywords and cluster labels included electric stimulation,transcranial magnetic stimu-lation,robot and acupuncture. Conclusion Over the past 20 years,researches on non-pharmacological therapies for PSS have remained active,with hot-spots focusing on diverse interventions such as electrical stimulation,magnetic stimulation and robot-assisted therapy.

Abstract:Objective To investigate the association of physical activity and balance ability with disability,and to further examine the mediating role of balance ability in the relationship between physical activity and disability. Methods Based on data from 2021 to 2023 National Health and Nutrition Examination Survey(NHANES)cycle,a mul-tivariable Logistic regression model was constructed to evaluate the independent association of physical activity and balance ability with disability,with covariates adjusted in four steps.An interaction model was further devel-oped to assess the multiplicative interaction between physical activity and balance ability.Mediation analysis was performed using the Baron and Kenny three-step approach to examine the mediating role of balance ability,and the proportion of the mediation effect was calculated.The significance of the mediation effect was assessed using the Delta method,and robustness was verified through the Bootstrap method with a fixed random seed.Multiple sensitivity analyses were conducted to ensure the stability of the results. Results A total of 3 902 participants were included,with a prevalence of disability of 17.7%.Multivariable regression analysis showed that,after adjusting for all covariates,both light-intensity physical activity(LIPA)(OR=0.489,95%CI 0.380 to 0.629,P<0.001)and high-intensity physical activity(HIPA)(OR=0.493,95%CI 0.371 to 0.656,P<0.001)were significantly associated with a reduced risk of disability,whereas impaired balance ability was significantly associated with an increased risk(OR=1.579,95%CI 1.266 to 1.970,P<0.001).The interac-tion effect analysis showed that the interaction between physical activity and balance ability were not significant(P>0.05),however,the main effect of LIPA remained robust(β=-0.597,SE=0.221,OR=0.550,P=0.007),while impaired balance ability was significantly associated with an increased risk of disability(β=0.577,SE=0.231,OR=1.780,P=0.012).The mediation analysis further indicated that balance ability played a robust medi-ating role in the association between LIPA and disability,with a mediation proportion of 21.1%.The indirect ef-fect(a×b)was statistically significant(P<0.001),and the 95%confidence intervals derived from the bootstrap method did not include zero. Conclusion Physical activity and balance ability are significantly associated with disability,and balance ability may me-diate the relationship between physical activity and disability,highlighting its potential value in disability risk as-sessment and intervention strategies.

Abstract:Objective To investigate the present situation of input,output,outcome and impact of all registered community-based re-habilitation stations in Inner Mongolia in China,and analyze how the input predict the output,outcome and im-pact. Methods From March 1st to April 30th,2025,a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia,covering four dimensions:input,output,outcome and impact.A total of 1 365 questionnaires were distributed.The input included four items:laws and policies,human resources,equip-ment and facilities,and rehabilitation information management.The output included two items:technical paths and benefits/effectiveness.The outcome included three items:coverage rates,rehabilitation interventions and functional results.The impact included two items:health and sustainability.Each item contained several ques-tions,all of which were described in a positive way.Each question was scored from one to five.A lower score in-dicated that the situation of the community-based rehabilitation station was more in line with the content de-scribed in the question.Regression analysis was performed using the total score of each item of input dimension as independent variables,and the total scores of the output,outcome and impact dimensions as dependent vari-ables. Results A total of 1 262 valid questionnaires were collected.The mean values of input,output,outcome and impact of community-based rehabilitation stations were 1.827 to 1.904,with coefficient of variation of 45.892%to 49.239%.The regression analysis showed that,rehabilitation information management,human resources,and laws and policies significantly predicted the output dimension(R²=0.910,P<0.001).Meanwhile,all four items in the input dimension predicted both the outcome(R²=0.850,P<0.001)and impact dimensions(R²=0.833,P<0.001). Conclusion Input,output,outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions,although some imbalances were observed.Additionally,the in-put of community-based rehabilitation stations could significantly predict their output,outcome and impact.

Abstract:Objective To investigate the effect of lower extremity exoskeleton robots on balance and walking function of patients with post-stroke cerebellar ataxia. Methods A total of 60 patients with post-stroke cerebellar ataxia in Beijing Bo'ai Hospital from October,2022 to Octo-ber,2024 were selected,and randomly divided into control group(n=30)and exoskeleton group(n=30)ran-domly.Both groups were given conventional exercise training,including trunk control training,rotation axis training and Frenkel training;the exoskeleton group received additional training with lower limb exoskeleton ro-bots,for four weeks.Before and after treatment,the Gait Watch three-dimensional gait analyzer and the Holden Functional Ambulation Classification(HFAC)were used to evaluate the walking spatiotemporal parameters such as walking speed,walking frequency and step length deviation,as well as the walking ability.Berg Balance Scale(BBS)and the International Cooperative Ataxia Rating Scale(ICARS)were used to access the balance and ataxia functions,respectively. Results After treatment,the walking speed,walking frequency and step length deviation of both groups improved(|t|>19.676,P<0.001),the BBS score improved(|t|>29.032,P<0.001),and the ICARS scores decreased(t>33.192,P<0.001)in both groups,and they were better in the exoskeleton group than in the control group(|t|>2.284,P<0.05).There was no significant difference in the improvement rate of HFAC between two groups(P>0.05). Conclusion Lower extremity exoskeleton robots can effectively improve the balance and walking function of patients with post-stroke cerebellar ataxia.