Objective To compare problem-based learning (PBL) versus lecture-based learning (LBL) in the teaching of rehabilitation medicine in China.Methods All Chinese articles on PBL and LBL in teaching of rehabilitation medicine courses indexed in CBMdisc,Wanfang database,CNKI database,and Google academic search published prior to October 2017 were included.The methodological quality of the selected studies was assessed with'Cochrane Quality Evaluation Standard'.Meta analyses were performed using RevMan 5.3.Results After exclusion of non-eligible citations,a total of 18 documents involving 1943 subjects were satisfied the criteria and were included in this review.Meta-analyses revealed that PBL had a significant improvements on theoretical knowledge examination scores (MD=9.26,95％CI=5.24 to 13.29),practical skills examination scores (MD=12.11,95％CI=5.17 to 19.06),performance excellent rate (RR=3.90,95％CI=2.10 to 7.26),and patient satisfaction rate (RR=8.98,95％CI=4.23 to 19.07) (P＜0.05) among students compared with LBL in teaching of rehabilitation.Conclusion In this meta analysis,PBL is superior to LBL and worthy popularizing in teaching of rehabilitation.

Whole-body vibration (WBV) training is a kind of new technology on the practice of rehabilitation medicine and is used to improve muscle strength, mobility, balance, osteoporosis, sarcopenia, metabolic syndrome and osteoarthritis in aging adults. The definition, safety, effectiveness, and biomechanics of WBV training were reviewed in this paper.

Objective To evaluate the difference in isokinetic strength of the knee muscles between knee osteoarthritis (KOA) patients aged 80 years and over and matched healthy controls,and to establish the association of isokinetic strength with pain and functional status in patients with KOA.Methods The study enrolled 32 patients aged 80 and over diagnosed with unilateral knee OA and 10 matched controls.Pain was evaluated by the visual analogue scale (VAS),the pain intensity scale and the Lequesne index for patients with knee OA.Functional status was assessed by the Timed Up and Go Test (TUGT),the Five Times Sit to Stand Test (FTSST) and the Timed 10 Meter Walk Test (TWT).Muscle strength was measured using the isokinetic dynamometer Biodex System 4 Pro.Bilateral isokinetic (concentric) knee flexion and extension with the protocol of 60 degrees/sec,180 degrees/sec was also performed.Results The difference in two angular velocities of extensor and flexor peak torques between the knee OA group and the control group was statistically significant (t=2.747,P＜ 0.05).The extensor peak torque was negatively correlated with age,Liquesce index scores,FTSST,TUGT and TWT (r=-0.39～～-0.75,P＜0.05),but had no correlation with the VAS score or the Lequesne index pain score (r=-0.23～ 0.31,P＞0.05).The regression analysis results suggested that the extensor peak torque and the VAS score together were important predictors for the Liquesce index (adjusted R2 =0.41).Conclusions The degree of knee muscle damage is closely related to the functional performance of the muscles in knee OA patients aged 80 years or over.The strength of the quadriceps and the intensity of pain are important predictors of disability for those patients.

Whole-body vibration therapy (WBVT), in which energy produced by a forced oscillation is transferred to the muscle and bone of an individual from a mechanical vibration platform, has been proposed as an alternative or adjunctive intervention for osteoporosis. In this review, the safety, effectiveness and the biomechanics of WBVT for the prevention and treatment of osteoporosis were discussed.

Objective To explore the effect of different resistance amount on the reliability of the lumbar muscles' coordination test.Methods 30 young male adults participated the lumbar muscles' coordination test twice within 1 week by the same tester. In each test, the subjects took 5 kg, 10 kg and 15 kg of resistance randomly. The index included mean of concentric motion, deviation of concentric motion, mean of eccentric motion and deviation of eccentric motion. Intra-class correlation coefficient (ICC) for these 4 test results were applied to evaluate the reliability of those tests. Results The ICCs of the 4 test results were 0.303, 0.500, 0.358 and 0.360 respectively in the 5 kg of resistance group, 0.449, 0.382, 0.365 and 0.272 respectively in the 10 kg of resistance group, and 0.453, 0.442, 0.614 and 0.411 respectively in the 15 kg of resistance group. Conclusion The test-retest reliability can be satisfied in the lumbar muscles' coordination test with 15 kg of resistance.

Objective To study the relationship among static and dynamic position sense of lower extremity, physical function, and static and dynamic balance in patients with knee osteoarthritis. Methods 32 patients with knee osteoarthritis were tested with Lequesne Index, static and dynamic position sense of lower extremity, and fall risk of static and dynamic balance, and analyzed with Pearson correlation coefficient. Results The medium-to-high-frequency in postural sway correlated with Lequesne Index (r=0.36, P<0.05) and fall risk index of static balance (r=0.85, P<0.001), but not with the fall risk index of dynamic balance (r=0.30, P>0.05). The reposition accuracy error of the unaffected/ mild-affected lower extremity and affected/severe-affected lower extremity correlated with Lequesne Index (r=0.33~0.39, P<0.05), the fall risk index of static (r=0.38~0.45, P<0.05) and dynamic balance (r=0.65~0.70, P<0.05). Conclusion Lower extremity dysfunction post knee osteoarthritis would result in poor proprioception that maintains balance.

Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including: up and down exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function using maximum walking speed (MWS),Berg balance scale (BBS),timed up to go test (TUGT) and Fugl-Meyer(FMA-L) at pre-treatment and post-treatment.The change of femoral artery blood flow velocity and lumen diameter on the affected lower limb were observed by color Doppler. Results There were no differences in the above scores,lumen diameter and blood flow velocity before treatment between the two groups (P＞ 0.05).After treatment,the scores of MWS (56.68 ± 6.57vs.45.61 ± 5.34),BBS(46.84 ± 4.05vs.29.84 ± 4.05),TUGT ( 14.55 ± 8.25vs.25.35 ± 8.70)were higher in mCIMT group than in NDT control group (t=15.09,17.38,15.25,all P=0.001)while no difference in FMA-L score between the two groups was found (35.24 ± 7.62 vs.31.32 ±3.28,t=19.99,P＞0.05).Lumen diameter of femoral artery [(9.05±1.15) mm vs.(8.05±0.68)mm,t=6.72,P=0.001] and blood flow velocity[(92.55±18.25)cm/s vs.(69.35 8.7)cm/s,t=6.83,P=0.001] were increased in mCIMT group as compared with NDT group. Conclusions The mCIMT therapy is better in improving the lower-extremity walking function and blood flow velocity of femoral artery.

Objective To determine the value of accommodation quotient (AQ) on dysphagia evaluation in the elderly. Methods 40 old cases with dysphagia were assessed with AQ, Kubota Water Swallow Test (WST) and Swallowing Evaluation (SE) before and after 3 weeks of treatment. The patients were divided into 2 groups based on the first AQ assessment: mild group (AQ=1.5~2.5) and serious group (AQ< 1.5). Results There was not significant difference in scores of WST between both groups (P>0.05) but SE (P<0.05). The AQ before treatment moderately correlated with the scores of WST and SE before treatment and improvement (P<0.001), and SE after treatment (P<0.001), but did not correlate with the score of WST after treatment (P>0.05). Conclusion The AQ may indicate the function of swallowing in the elderly, and predict the outcome of dysphagia.

Objective To explore the feature of balance function and falling risk in the elderly knee osteoarthritis patients with single knee pain or double knees pain. Methods 30 elderly knee osteoarthritis patients without pain, 30 with single knee pain and 32 with double knees pain were tested with timed up and go test (TUG), postural stability (PS), limits of stability (LOS) and dynamic fall index (DFI). Results There was significant difference in the elderly between no pain and single or double knee pain (P<0.05) in TUG, but not between the single knee pain and double knees pain (P>0.05). There was no significant difference in the elderly between single knee pain and no pain (P>0.05) in PS, but was between double knees pain and the other 2 groups (P<0.05). There was significant difference between no pain and single or double knee pain (P<0.05) in LOS, but not between single knee pain and double knees pain (P>0.05). There was significant difference between no pain and single or double knee pain (P<0.05) in DFI, and between single knee pain and double knees pain (P<0.05). Conclusion The elderly osteoarthritis patients with single knee pain are in high falling risk with their dynamic balance injury, while those with double knees pain are in higher falling risk with their static and dynamic balance injury.

Virtual reality (VR) offers the possibility of creating an interactive, motivating environment in which training intensity and feedback can be manipulated to provide individualized treatments or motor rehabilitation under a range of stimulus conditions that are not easily controllable and quantifiable in the real world, especially in elderly. This paper reviewed the studies illustrating the application, development and effectiveness of VR on rehabilitation in the elderly, that suggested VR may be useful to augment rehabilitation of a range of disabilities in elderly patients. The prospect of VR is discussed as well.