Objective To explore the effect of case-based learning(CBL)combined with PICOS(population,interventions,compari-sons,outcomes,study design)framework in undergraduate occupational therapy(OT)education. Methods A total of 43 junior students majoring in OT from School of Rehabilitation Medicine,Nanjing Medical Univer-sity,were taught the core courses of OT using CBL combined with PICOS framework,from February,2023 to June,2024.The Evidence-based Practice Competency Assessment Scale was used to investigate the students at the beginning and the end of the semester,respectively. Results At the end of the semester,students'self-assessments improved in areas such as the quality evaluation of litera-ture,identifying the best scientific evidence,evaluating the quality of papers,conducting practical analysis of re-search,applying PICOS to formulate clinical questions,assessing the primary association measurement methods of research results,understanding different levels of evidence,and familiarity with commonly used evidence-based practice databases(χ2>4.778,P<0.05).Self-assessment regarding uncertainty about the decision-making process or the different recommendation strengths for health interventions(χ2=7.938,P<0.01)was lower.Atti-tudes toward evidence-based practice,skill levels,and knowledge all improved. Conclusion The combined application of CBL and PICOS framework could improve the effect of undergraduate OT ed-ucation and enhance the evidence-based practice ability of OT students.

Objective:To observe the impact of core stability training in the sling exercise therapy pattern on the balance of stroke survivors.Methods:Sixty stroke survivors were randomly divided into a control group ( n=30) and an experimental group ( n=30). In addition to routine rehabilitation training, the control group received traditional core stability training, while the experimental group underwent core stability training applying the sling exercise therapy pattern. Before and after 4 weeks of training, the standing balance of both groups was evaluated using the Prokin balance trainer, with the length and area of motion recorded when performing the balance test with the eyes open and closed. Surface electromyography was used to record the average EMG (AEMG) values of the bilateral erector spinae and multifidus muscles during the balance testing. Results:After the 4 weeks of training the length and the area of progression of the center of the pressure were both significantly smaller for both groups than before the training with the eyes both open and closed. The average length and area in the experimental group were significantly less than among the controls. The AEMG values recorded during the balance tests were significantly higher than those before the intervention for both groups, with the multifidus muscle averages on the affected side significantly greater in the experimental group than among the controls when performing the balance test with the eyes closed.Conclusion:Core stability training in the sling exercise therapy pattern is superior to conventional core stability training because it can better improve the balance of stroke survivors.

ObjectiveTo investigate the current situation of personality traits and job satisfaction of pediatric therapists in Jiangsu province, and to explore the correlation between them and the related factors of job satisfaction. MethodsFrom June, 2021 to February, 2022, random cluster sampling method was adopted after field investigating several pediatric hospitals and institutions in Jiangsu. Online questionnaires were sent out to pediatric therapists in different settings in eleven cities in Jiangsu. The questionnaires included Minnesota Satisfaction Questionnaire (MSQ), Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC) and self-made scale of demographic characteristics and working status. ResultsAll of the questionaires were taken back, in which 165 were valid (83.33%). Among the three dimensions of psychoticism, extraversion and neuroticism, the intermediate type accounted for 66.06%, 38.79% and 40.00%, respectively. The overall satisfaction of job was (3.80±0.55), the internal satisfaction was (3.88±0.53), and the external satisfaction was (3.59±0.69). There was significant difference in the satisfaction among different types of work institution, monthly incomes, levels of parental support and neuroticism (P < 0.05). Multiple linear regression showed that the internal satisfaction and overall satisfaction were related with neuroticism, monthly income and parental support (P < 0.05), while external satisfaction was related with the neuroticism and parental support (P < 0.05). The level of neuroticism was negatively correlated with the internal satisfaction, the external satisfaction and overall satisfaction (|r| > 0.337, P < 0.001), and the level of extraversion was postively correlated with the external satisfaction (r = 0.155, P < 0.05). ConclusionThe job satisfaction of pediatric therapists is fine in Jiangsu, and is ralated with the level of neuroticism, the monthly income and the level of parental support. The levels of neuroticism and extraversion correlate with the job satisfaction.

Objective:To explore the effect of Lokomat training on the walking ability of stroke survivors with lower limb spasm.Methods:Eighty stroke survivors with lower limb spasm were randomly divided into an observation group and a control group, each of 40. Their routine rehabilitation treatment included normal limb positioning, passive joint movement, turnover training and inclined bed standing training. In addition, the control group underwent flat-ground walking training, while the observation group was given Lokomat training 3 times a week for 8 weeks. Both groups were evaluated after 4 and 8 weeks of treatment in terms of their walking ability, degree of lower limb spasm, lower limb motor functioning, balance and ability in the activities of daily life.Results:After 4 and 8 weeks the number of patients walking independently was significantly greater in the observation group. Their average stride frequency, step length on the affected side, support phase time and proportion of weight borne on the affected side were all significantly better than the control group′s averages. At both time points significantly more patients of the observation group had normal lower limb muscle tone. The observation group′s average Fugl-Meyer score, Berg Balance Scale score and modified Barthel Index score had improved significantly compared with those before the treatment, and were significantly better than the control group′s averages at the same time point. After 8 weeks of treatment the average walking speed of the observation group was faster than that of the control group.Conclusions:Lokomat training can significantly improve the walking ability of stroke survivors with lower limb spasm in the short term. Longer-term training can consolidate the effect and further improve the walking speed, motor function in the lower limbs, balance and even facility in daily life activities, as well as relieving spasm.

Objective To observe among stroke survivors the timing of muscle activation at the stance phase during walking using the surface electromyography ( sEMG) combined with 3D gait analysis. Methods Twenty stroke survivors assessed as at Brunnstrom stages Ⅲ, Ⅳ and Ⅴ were assigned to groups designated Ⅲ, Ⅳ and V. sEMG and 3D gait analysis were used to assess the activation timing of the bilateral rectus femoris ( RF) and biceps femoris ( BF) , the tibialis anterior ( TA) and the gastrocnemius medialis ( GM) . The activation timing and the dura-tion of activation of the muscles were compared among the 3 groups, as well as with those of healthy muscles. Results The onset time of the RF on the affected side was significantly later than on the healthy side, while that of the GM was significant earlier. The durations of BF and GM activation on the affected side were significantly shorter than on the unaffected side in group III. The onset times of the TA and GM on the affected side were significantly ear-lier than on the healthy side in group IV, as was the onset time of the TA of the affected side in group V. The average RF and BF onset times on the affected side in group Ⅳ were significantly earlier than in group Ⅲ. The onset time of the TA on the unaffected side and the average BF onset time on the affected side in group Ⅴ were significantly later than in group IV. The onset time of the RF and TA on the unaffected side in group Ⅳ and the onset time of the GM on the affected side were significantly later than in group III, while the onset time of the BF and TA on the affected side was significantly earlier. The average duration of BF activation on the unaffected side in group Ⅳ was significant-ly shorter than that of group Ⅲ. The average duration of TA activation on the unaffected side in group Ⅴ was signifi-cantly shorter than that of group IV. The duration of RF activation on the affected side in group Ⅴ was significantly shorter than that in group Ⅲ, and the same was true of the RF, BF, TA and GM activation times on the healthy side. Conclusions There are significant differences in the onset and duration of muscle activation when stroke survivors at different stages of recovery walk. Some muscles are activated too early and others are over-activated. These abnormali-ties gradually disappear with the recovery of motor function.

Objective To observe the effect of core stability training on lumbar disc herniation using changes in surface-electromyography signals from the core muscles.Methods Sixty patients with lumbar disc herniation were equally divided into an experimental group who were given the core stability training in addition to their regular physical therapy and a control group given the regular physical therapy only.The total course of treatment was 8 weeks.Each patient was assessed before the experiment and after 4 and 8 weeks of the intervention using the numeric rating scales of the Japanese Orthopaedic Association,the Oswestry disability index and integrated electromyogram (iEMG),root mean square (RMS) and medium frequency (MF) of the electromyographic signals from the rectus abdominis,obliqus externus abdominis,erector spinae,lumbar multifidus and gluteus medius muscles.Results No significant differences between the two groups were observed in any of the measurements before or after four weeks of the treatment.After 4 and 8 weeks of treatment,both groups had significant improvements in all of the measurements compared with before the experiment.Between 4 and 8 weeks the experimental group showed significant improvement in all of the measurements which was not matched in the control group.By the end of the treatment,all of the measurements of the experimental group were,on average,significantly better than those of the control group.Conclusions Both core stability training and regular physical therapy have similar effects on patients with lumbar disc herniation in the short term.However,continued core stability training improves the ability of core muscles and relieves pain and dysfunction better than prolonged regular physical therapy.

Objective To explore the effects of continuous rehabilitation nursing on the postoperative functional recovery of patients with minimally invasive lumbar disc herniation.Methods Totally 115 postoperative patients with minimally invasive lumbar disc herniation who were admitted into the rehabilitation center of Shaoxing People′s Hospital of Zhejiang Province for rehabilitation exercise between March 2011 and March 2016 were selected by convenience sampling method and were divided into the control group (n=58) and the observation group (n=57) by random number table. Patients in two groups were given grade-one and grade-two rehabilitation nursing. After discharged from hospital,patients in the observation group were given continuous rehabilitation nursing in their family or community,while patients in the control group,whose continuous rehabilitation nursing was suspended,were required to do exercise at home. Then the scores of Oswstry disability index (ODI) and Japanese Orthopaedic Association score(JOA) before operation,one month after operation and three months after operation in two groups were observed,and the effects of their three-month′ nursing and treatment were compared.Results The ODI scores of the control group before operation,one month after operation and three months after operation were [(37.59±6.03),(8.31±2.75),(1.95±1.16)],and those of the observation group were [(38.61±5.69),(7.95±2.06),(1.18±0.85)] (t=0.882,0.641;P>0.05);the score of the observation group three months after operation was lower than that of the control group (t=16.571,P<0.01). The JOA scores of the control group before operation,one month after operation and three months after operation were [(11.43±2.17),(18.60±2.20),(21.87±2.07)],and those of the observation were [(10.79±2.02), (18.96±3.54),(27.14±2.36)] (t=1.697,0.434;P>0.05);the observation group′s score three months after operation was higher than that of the control group (t=161.998,P<0.01). As for the effects of two groups three months after treatment,the total efficacy of the observation group was higher than that of the control group (91.2% vs 74.1%) (Z=3.087,P<0.01).Conclusions Normalized continuous rehabilitation nursing can help to improve the lumbar and spinal cord functions of patients with minimally invasive lumbar disc herniation after operation and enhance their rehabilitation efficacy.

In this paper a new type of cerebral circulation is introduced, including the basic principal, parameter algorithms and equipment design. The analyzer is developed on the basis of previous cerebral circulation analyzer and combined with the latest development of hemodynamics. It has the advantages of previous analyzer and overcomes its shortcomings frequently encountered in clinical that unable to finish the analysis without detection of all the intracranial vessels. It provides new functional module and adds indices such as hydraulic power, carotidshear stress, comprehensive index etc. This analyzer can be used for cerebral circulation dynamic analysis and auxiliary diagnosis of cerebrovascular diseases.
Algorithms ; Cerebrovascular Circulation ; Cerebrovascular Disorders ; diagnosis ; Equipment Design ; Hemodynamics ; Humans

Objective To investigate pathophysiological changes in the multifidus muscles of patients with lumbar disc herniation.Methods Thirty-six patients with unilateral symptoms caused by lumbar disc herniation were enrolled.They were divided into a symptomatic side group and a contralateral side group according to whether their symptomatic (algetic) or contralateral side would be studied.The percentage area of pimelosis and the mean gross signal intensity of each multifidus were measured with magnetic resonance imaging (MRI)_ The amplitude and duration of motor unit potentials of each multifidus were recorded using electromyography (EMG) when the patients were performing isometric contraction.Results The bilateral multifidus muscles of 36 patients displayed various degrees of pimelosis on magnetic resonance images.The percentage of pimelosis cross-sectional area in the symptomatic side group was significantly higher than in the contralateral side group.[(44.20 ± 15.14)％ versus(37.31 ± 13.85)％,P ＜ 0.05] The mean value of the gross signal intensity was also significantly higher.Both the amplitudes and duration of the motor unit potentials recroded from the multifidus had increased and widened,but significantly more in the symptomatic side group than in the contralateral side group.Conclusions Both the imaging and electrophysiological data showed more significant changes on the symptomatic side in patients with unilateral symptoms caused by lumbar disc herniation.

In this paper a new type of cerebral circulation is introduced, including the basic principal, parameter algorithms and equipment design. The analyzer is developed on the basis of previous cerebral circulation analyzer and combined with the latest development of hemodynamics. It has the advantages of previous analyzer and overcomes its shortcomings frequently encountered in clinical that unable to finish the analysis without detection of al the intracranial vessels. It provides new functional module and adds indices such as hydraulic power, carotidshear stress, comprehensive index etc. This analyzer can be used for cerebral circulation dynamic analysis and auxiliary diagnosis of cerebrovascular diseases.