Objective:To describe the characteristics and change trends of incidence, mortality and disease burden of acute myocardial infarction (AMI) in Qingdao from 2014 to 2020.Methods:We analyzed the incidence data of AMI retrieved from Qingdao Chronic Diseases Surveillance System. The average annual percent change (AAPC) of morbidity and mortality of AMI were evaluated by using Joinpoint log-linear regression model. Disability adjusted life year (DALY) was used to estimate disease burden of AMI in Qingdao.Results:A total of 70 491 AMI cases and 50 832 deaths of AMI occurred in Qingdao from 2014 to 2020. The age-standardized morbidity and mortality were 54.71/100 000 and 36.55/100 000, respectively. During 2014-2020, the AAPC of age-standardized morbidity was 2.86% (95% CI: 0.42%-5.35%), and 4.30% (95% CI: 1.24%-7.45%) in men and 0.78% (95% CI: -0.89%-2.47%) in women, respectively. The log-linear regression model showed that age-standardized morbidity in age groups 30-39, 40-49 years increased rapidly, with the AAPCs of 8.92% (95% CI: 2.23%-16.06%) and 6.32% (95% CI: 3.30%-9.44%), respectively. The trend was also observed in age groups 30-39, 40-49 and 50-59 years in men, with the AAPCs of 11.25% (95% CI: 3.54%-19.54%), 6.73% (95% CI: 2.63%-10.99%) and 6.72% (95% CI: 2.98%-10.60%), respectively. There was no significant change in age-standardized mortality. The DALY rate increased from 7.49/1 000 in 2014 to 8.61/1 000 in 2020, with the AAPC of 1.97% (95% CI: 0.36%-3.60%). Conclusions:The age-standardized morbidity of AMI in men increased in Qingdao, especially in those aged 30-49 years, while age-standardized mortality rate of AMI was relatively stable from 2014 to 2020. The burden of disease of AMI increased in both men and women.

Objective To verify the convergent validity,discriminant validity and concurrent validity of the Action Research Arm Test(ARAT)in patients with chronic stroke.Methods 30 cases with chronic stroke were assessed with ARAT,upper limb section at Fugl-Meyer Assessment and Motor Activity Log(MAL)on the same day.The validity was investigated using Spearman ρ and t test.Results The scores of the ARAT closely correlated with upper limb section at Fugl-Meyer Assessment(ρ=0.906,P<0.001).The upper limb section at Fugl-Meyer scores≥33 group achieved a significantly higher scores of the ARAT than the scores<33 group(t =6.614,P<0.001).The scores of the ARAT closely correlated with the amount of use(AOU)and quality of movement(QOM)of MAL(ρ=0.894 and 0.761,respectively,P<0.001).Conclusion The ARAT has been shown good convergent validity,discriminant validity and concurrent validity in people with stroke.

Objective To verify the inter-rater reliability,intra-rater reliability and internal reliability of the action research arm test(ARAT)in patients with chronic stroke.Methods 30 people with chronic stroke were tested with the ARAT by two experienced raters.The inter-rater reliability,intra-rater reliability and internal reliability were examined.Results The ARAT showed high inter-rater reliability and intra-rater reliability(ICC=0.992 and 0.987,respectively)and internal consistency(Cronbach's alpha coefficient=0.936).Conclusion The ARAT shows good inter-rater reliability,intra-rater reliability and internal reliability in assessing patients after stroke.

ObjectiveTo explore the efficacy of constraint-induced movement therapy (CIMT) on motor function of upper extremity of chronic stroke patients.MethodsFifteen chronic stroke patients with hemiparesis (course of diseases more than 13.5 months) were treated by CIMT, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training (by shaping) of the more affected extremity for 6 hours on the 10 workdays during that period. The therapeutic effect was evaluated with upper extremity function test (UEFT) and simple test for evaluating hand function (STEF).ResultsPatients showed a significant and very large degree of improvement after treatment on UEFT and STEF (ES, 0.8 and 0.5, respectively).ConclusionCIMT may be an efficacious method for improvement of the affected arm function of chronic stroke patients.

ObjectiveTo determine the efficacy of constraint-induced movement therapy(CIMT) on different severity of the motor deficit of upper extremity after stroke.Methods27 stroke patients who had upper-limb hemiparesis and learned nonuse were allocated either to the moderate group(n=12) or the severe group(n=15) according to severity of initial motor deficit of upper extremity by Upper Extremity Function Test(UEFT).The two group patients were given CIMT,involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training(by repetitive practice,shaping) of the more affected extremity for 6 hours on the 10 weekdays during that period.Outcome were measured with UEFT.ResultsThere was no significant difference in treatment gain on the UEFT between the moderate patients and the severe patients(P>0.05).However,the Effect Size for the severe patients(ES=2.2) was larger than for the moderate patients(ES=1.8) at the quality of movement(UEFT).ConclusionCIMT is an effective rehabilitation technique for different severity of the motor deficit of upper extremity after stroke,especially in severe stroke patients.

ObjectiveTo discusse the relationship between static balance in laboratory approaches and dynamic balance in clinical assessment and identify the value of static and dynamic balance at functional outcome in hemiparetic stroke patients. MethodsNineteen stroke subjects were assessed in this study. The static balance was measured by postural sway test, the dynamic balance was measured by Berg balance scale(BBS)and Time up to go test(TUGT),the outcome was measured by FIM and 10m maximum walking speed(MWS). The level of association between the parameters of postural sway test and clinical variables were examined with Pearson's correlation coefficients. ResultsThe parameters of postural sway test was significantly negative related to BBS(r=-0.705--0.475,P<0.05);The parameters of postural sway close-eye test was significantly positive related to TUGT(r=0.508-0.583,P<0.05);The parameters of postural sway test was no related to FIM and MWS (r=-0.048--0.296;r=-0.404--0.01,P>0.05);BBS was significantly positive related to FIM and MWS(r=0.752;r=0.700,P<0.001). TUGT was significantly negative related to FIM and MWS(r=-0.600,P<0.01;r=-0.817,P<0.001).ConclusionClinical and laboratory balance assessments are related and that dynamic rather than static balance measures are valid indicators of functional outcome performance in hemiparetic stroke patients.

ObjectiveTo investigate the relationship between strength of the paretic lower limb and motor function, balance, walking speed, ability of daily living (ADL) in hemiparetic stroke patients.Methods85 stroke subjects, who were able to walk in the study, were evaluated in the strength of the paretic lower limb, motor function, balance, walking speed and ADL with Motricity Index, Fugl-Meyer Assessment, Berg Balance Scale, 10 m walking speed test and Functional Independence Measure (FIM). The levels of association between them were examined with Pearson's correlation coefficients and with multiple linear regression analyses by using the stepwise method. ResultsStrengths of the paretic lower limb were significantly positive related to motor function, balance, walking speed and ADL (r=0.592-0.811,P<0.001). The paretic ankle dorsiflexors, knee extensors, hip flexors were important clinical factor to consider in determining motor function(R2=0.377,P<0.001), balance(R2=0.321,P<0.001)and walking speed(R2=0.173,P<0.001), ADL(R2=0.42,P<0.001). ConclusionStrengths of the paretic lower limb of stroke patients may play an important role in their motor function, balance, walking speed and ADL.

ObjectiveTo evaluate the effect of the timed “up and go” test (TUGT) on measuring functional mobility of stroke patients.MethodsNinety hemiparetic stroke patients participated in this study. The balance, gait speed and disability of patients were measured by Berg balance scale (BBS), maximal gait speed and functional independence measure (FIM) to find out the critical value of TUGT.ResultsA good relationship existed among TUGT and the BBS,gait speed and FIM (r=-0.926—-0.674,P<0.001).The percentage of independent walking of stroke patients whose TUGT scores <10s or>20s were 100% and 8.3%. The optimal cut off values of TUGT to predict the independent walking of patients were 15.2s, and in stroke group sensitivity and specificity of TUGT were 89.4% and 79.1%.Conclusion TUGT is a reliable instrument with adequate concurrent validity to measure the functional mobility of stroke patients.

ObjectiveTo analyze the effect of temporal distance parameters on comfortable and maximal walking speed of hemiplegic stroke patients.MethodsThe comfortable and maximal walking speed of 85 hemiplegic stroke patients were tested by 10 m walking speed and temporal distance parameters of gait cycle were obtained. The effect of step length and walking rate on comfortable and maximal walking speed was analyzed.ResultsStep length and walking rate were significantly positive related to comfortable and maximal walking speed (r=0.849-0.915,P<0.001).The step regression analysis selected step length as a significant variable for comfortable and maximal walking speed (R2=0.835,R2=0.827,respectively). ConclusionThe important parameter that influences comfortable and maximal walking speed of hemiplegic stroke patients is step length.

ObjectiveTo observe the effect of language rehabilitation training on stroke patients with complete aphasia.Methods10 stroke patients with complete aphasia were treated with language rehabilitation training.ResultsAfter training, scores of hearing, naming, reciting, reading, and writing of patients were significant higher than that before training (P<0.05—0.01).Conclusion Language rehabilitation training plays an active role in rehabilitation of stroke patients with complete aphasia.