The outbreak of the novel coronavirus pneumonia (NCP), an acute infectious respiratory disease in Wuhan, China in December 2019, which was officially named COVID-19 by WHO, has caused enormous burden on society and health services. To ensure safe rehabilitation practice during the epidemic, the Chinese Association of Rehabilitation Medicine formed an expert group to develop a consensus statement for rehabilitation practice. The consensus statement provides guidance on: (1) safeguarding medical staff, patients, caregivers and visitors; and (2) timing and methods of effective rehabilitation interventions for treatment of COVID-19 patients. It also emphasizes that non-COVID-19 patients still require rehabilitation intervention during the epidemic outbreak, bearing in mind the safety of staff and patients and making adaptations according to the individual conditions and the patients′ actual environment. This expert consensus statement applies to departments of rehabilitation medicine and related disciplines in general hospitals as well as to specialized rehabilitation facilities, and it provides valuable reference for rehabilitation professionals working with infectious respiratory diseases in the future.

Objective:To explore any effect of electroacupuncture (EA) at the Zusanli point on the scorch death of duodenal cells in rats with functional dyspepsia (FD) and possible mechanisms.Methods:Twenty-four 7-day-old Sprague-Dawley rats were randomly divided into a blank group, a model group and an EA group, each of 8. FD was induced in both the model and EA group rats using iodoacetamide gavage with tail-clip stimulation. After successful modeling the EA group was given acupuncture at the Zusanli point and then connected with a Korean acupuncture point nerve stimulator for 2 weeks. The other 2 groups were not given any intervention. The rats′ body weight was recorded before and after the modeling, as well as 7 and 14 days later. The gastric emptying rate and the small intestine propulsion rate of the three groups were detected right after the EA intervention, and the serum expression levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured using enzyme-linked immunoassays. Real-time fluorescence quantitative polymerase chain reactions were used to detect the transcription levels of IL-1β and IL-6 in the rats′ duodenums, while western blotting was employed to assess the expression of caspase-1 P20 and dermatin D (GSDMD) in their duodenums.Results:After successful modeling, the average body weight of the rats in the model and EA groups was significantly different from that in blank group, and after 7 and 14 days the average body weight of the former groups was significantly different from that of the blank group, with significant differences between the two groups as well. After the EA intervention significant differences were observed in gastric reside and small intestine propulsion rate between the EA group and the model group, as well as between the model and the blank group. After the intervention, there were significant differences between the blank group and the other two groups in the average expression of IL-1β and IL-6 in serum, IL-1β and IL-6 mRNA in the duodenum, as well as the GSDMD and caspase-1 p20 proteins in the duodenum. There were significant differences between the model and EA groups in all of the above measurements.Conclusions:EA at the Zusanli point can significantly reduce the level of scorch death in the duodenum of FD rats, as well as relieve low-grade duodenal inflammation and the clinical symptoms of FD. Its mechanism may be related to the down-regulation of the expression of caspase-1 P20 and GSDMD-N protein, and of inflammatory factors such as IL-1β and IL-6, relieving low-grade duodenal inflammation.

Objective:To explore any effect of mechanical vibration on the expression of estrogen and brain-derived neurotrophic factor (BDNF) in ovariectomized rats with an osteoporotic fracture.Methods:Thirty 3-month-old female Wistar rats were divided randomly into a control group, an ovariectomy group and a vibration group, each of 10. Fractures were induced in the rats of all three groups. Twenty minutes of whole-body vertical vibration was applied to the vibration group at a frequency of 35Hz, 5 days a week for 6 weeks. After 2 and 6 weeks the fracture healing of each group was evaluated using X-rays, the levels of hippocampal estrogen were measured using enzyme-linked immunosorbent assays and fracture-end BDNF was quantified by immunoblotting.Results:After 2 and 6 weeks of vibration the average fracture healing in the vibration group was significantly greater than in the other 2 groups. The average estrogen content in the hippocampus of the vibration group was significantly higher than in the other 2 groups after both 2 and 6 weeks, while the average BDNF content in their fracture ends was significantly lower. The BDNF expression at the fracture end was significantly correlated with the fracture healing.Conclusion:Mechanical vibration can promote the expression of estrogen and BDNF in the hippocampus and accelerate fracture healing in osteoporotic rats.

Objective:To explore any effect of brain aging on the brain′s walking network and its mechanism.Methods:Twenty healthy elderly people and 22 healthy young adults formed an elderly group and a youth group. All were evaluated using the Mini-Mental State Examination (MMSE), the Timed Up and Go test (TUGT), the 10-metre walk test (10MWT), the functional near infrared spectroscopy walking synchrony test and GaitRite gait parameters. The intensity of functional connections and the gait parameters of the prefrontal cortex (PFC) and the primary motor cortex (MC) were compared between the two groups.Results:Compared with the youth group, the average cadence of the elderly group was significantly faster. The FC value of the RPFC in the homologous ROI, as well as those of the RMC-RPFC and RPFC-LPFC in the heterologous ROI of the elderly group were significantly lower than in the youth group.Conclusions:Lower FC values in the RPFC and its associated brain regions in the elderly during normal walking may be what activates the brain′s walking network in the early stage of brain aging.

Objective:To explore the relationship between executive function and gait in cases of mild amnestic cognitive impairment (aMCI).Methods:Twenty aMCI hospital patients formed an observation group, while 20 healthy counterparts were the control group. Both groups underwent the Tinetti test, followed by the " normal walking" single-task test and the " normal walking + Go/No-go" dual-task test. The pace, step width, stride length, Go/No-go task response time and accuracy rate were recorded.Results:In the single-task test, there was no significant difference in pace or stride width between the two groups, but the average stride length of the observation group (1.11±0.04)cm was significantly shorter than that of the control group. However, in the dual-task test, the average pace time (0.96±0.08)sec and stride length (1.02±0.06)cm of the observation group were significantly smaller than the control group′s averages, while their step width (0.11±0.02)cm was significantly wider. There was no significant difference between the two groups in the response time in a single (Go/No-go) task, but in the dual-task test, the observation group′s average time was significantly longer than the control group′s and the accuracy was significantly poorer. Both the error rate and the non-response rate were significantly higher than among the control group.Conclusions:Mild amnestic cognitive impairment reduces stride length and pace when walking and impairs executive function.

Objective:To explore the effects of intermittent oral-esophageal tube feeding (IOE) on cerebral hemorrhage (CH) survivors receiving a tracheotomy.Methods:A total of 126 CH patients undergoing tracheotomy were randomly divided into an IOE group ( n=65) and a nasogastric tube feeding (NGT) group ( n=61). The feeding continued for 4 weeks along with medication and thorough rehabilitation interventions (including hemiplegic limb training, swallowing training, and pulmonary function training). Before and after the treatment, the body mass index, hemoglobin, albumin, proalbumin, creatinine height index, extubation rate and intubation time of the tracheotomy, as well as the incidence of complications were evaluated for both groups. Both groups were also assessed using the clinical pulmonary infection scale (CPIS) and National Institutes of Health stroke scale (NIHSS). Results:After the 4 weeks the nutrition indexes, average extubation rate (90.76%) and intubation time [(15.96±3.86)d], CPIS score (3.00±1.69), NIHSS score (11.86±4.08) and the overall incidence of complications in the IOE group were all significantly better than the NGT group′s averages.Conclusions:Where feasible, intermittent oro-esophageal tube feeding is superior to nasogastric tube feeding of cerebral hemorrhage patients undergoing tracheotomy. It reduces the risk of pulmonary infection and other complications, resulting in early removal of the tracheotomy cannula and quicker recovery.

Objective:To explore any effect of 8 weeks of high-intensity interval training (HIIT) on glycemia and pancreatic β-cell function among persons with type 2 diabetes to provide data for optimizing their exercise protocol.Methods:Sixty patients with type 2 diabetes and without a habit of regular exercise were randomly divided into an exercise group ( n=30) and a control group ( n=30). Both groups maintained their daily living habits, except that the exercise group practiced HIIT on a power vehicle ergometer 3 times a week for 8 weeks. Before and after the intervention, the 2-hour oral glucose tolerance test (OGTT) was conducted to evaluate glycemia and pancreatic β-cell function. Body composition was also detected using dual-energy X-ray absorptiometry. Results:After the intervention a significant decrease was observed in the fasting blood glucose, mean blood glucose, glycosylated hemoglobin, blood glucose levels at the end of a 2h OGTT, blood glucose area under the curve and homeostatic model assessment of insulin resistance, as well as waist circumference and abdominal fat content of the exercise group. And there was a significant increase in the homeostatic model assessment of pancreatic β-cell function and disposition index among the exercise group. In the control group no significant differences were observed.Conclusion:Eight weeks of HIIT can improve glycemia and pancreatic β-cell function and reduce abdominal fat among persons with type 2 diabetes. It can be used as an effective rehabilitation protocol.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Objective:To determine the minimum clinically-important difference (MCID) in the rehabilitation effect among children with haemophilic knee joint contracture.Methods:The data describing 28 children with an average age of 13.89±3.00 years and haemophilic knee joint contracture who received no less than 10 sessions of physiotherapy in the Department of Rehabilitation Medicine at the Peking Union Medical College Hospital were analyzed. The therapeutic effect of the treatement was quantified in terms of Haemophilia Joint Health Scores (HJHSs) for their knees. The MCID after the therapy was evaluated using the mean change method, multivariate linear regression, receiver operating characteristics, and the distribution-based method.Results:The MCID for the improvement of knee HJHS was 5.13 by the mean change method, 4.31 by multivariate linear regression, 3.50 according to the ROC curve and 1.64 by the distribution-based method. Taking all of them into consideration, 4.31 was found to be an appropriate value.Conclusions:The MCID after physical therapy for the improvement in knee HJHS for a child with haemophilic knee contracture is 4.31. Improvements greater than 4.31 can be considered clinically significant.

Objective:To document the clinical efficacy of using electrical stimulation to guide acupuncture on the peroneal longus and the peroneal brevis of patients with functional ankle instability (FAI).Methods:Seventy FAI patients were randomly divided into an observation group and a control group, each of 35. Both groups received routine balance function training, proprioception training and manual activation of the peroneal muscles. The observation group also received acupuncture at the motor points of the peroneal longus and the peroneal brevis muscles under the guidance of electrical stimulation, once a day, for 3 weeks. Before and after the treatment, any curative effect was quantified using the CAIT ankle instability assessment questionnaire, electromyography (iEMG) of the peroneal longus and the peroneal brevis, as well as those muscles′ excitation times during simulated varus walking.Results:All of the measurements after the treatment were significantly better than before the treatment, with the improvements in the observation group significantly greater than in the control group.Conclusions:Acupuncture at the motor points of the peroneal longus and the peroneal brevis under the guidance of electrical stimulation can effectively activate the related muscles and relieve the symptoms of functional ankle instability.