ObjectiveTo explore the data standard system of electronic medical records in the field of rehabilitation, focusing on the terminology and coding standards, data structure, and key content categories of rehabilitation electronic medical records. MethodsBased on the Administrative Norms for the Application of Electronic Medical Records issued by the National Health Commission of China, the electronic medical record standard architecture issued by the International Organization for Standardization and Health Level Seven (HL7), the framework of the World Health Organization Family of International Classifications (WHO-FICs), Basic Architecture and Data Standards of Electronic Medical Records, Basic Data Set of Electronic Medical Records, and Specifications for Sharing Documents of Electronic Medical Records, the study constructed and organized the data structure, content, and data standards of rehabilitation electronic medical records. ResultsThe data structure of rehabilitation electronic medical records should strictly follow the structure of electronic medical records, including four levels (clinical document, document section, data set and data element) and four major content areas (basic information, diagnostic information, intervention information and cost information). Rehabilitation electronic medical records further integrated information related to rehabilitation needs and characteristics, emphasizing rehabilitation treatment, into clinical information. By fully applying the WHO-FICs reference classifications, rehabilitation electronic medical records could establish a standardized framework, diagnostic criteria, functional description tools, coding tools and terminology index tools for the coding, indexing, functional description, and analysis and interpretation of diseases and health problems. The study elaborated on the data structure and content categories of rehabilitation electronic medical records in four major categories, refined the granularity of reporting rehabilitation content in electronic medical records, and provided detailed data reporting guidance for rehabilitation electronic medical records. ConclusionThe standardization of rehabilitation electronic medical records is significant for improving the quality of rehabilitation medical services and promoting the rehabilitation process of patients. The development of rehabilitation electronic medical records must be based on the national and international standards. Under the general electronic medical records data structure and standards, a rehabilitation electronic medical records data system should be constructed which incorporates core data such as disease diagnosis, functional description and assessment, and rehabilitation interventions. The standardized rehabilitation electronic medical records scheme constructed in this study can support the improvement of standardization of rehabilitation electronic medical records data information.

ObjectiveTo analyze the data structure and standards of rehabilitation outpatient medical records, to provide data support for improving the quality of rehabilitation outpatient care and developing medical insurance payment policies. MethodsBased on the normative documents issued by the National Health Commission, Basic Standards for Medical Record Writing and Standards for Electronic Medical Record Sharing Documents, in accordance with the Quality Management Regulations for Outpatient (Emergency) Diagnosis and Treatment Information Pages (Trial), reference to the framework of the World Health Organization Family of International Classifications (WHO-FICs), the data framework and content of rehabilitation outpatient medical records were determined, and the data standards were discussed. ResultsThis study constructed a data framework for rehabilitation outpatient medical records, including four main components: patient basic information, visit process information, diagnosis and treatment information, and cost information. Three major reference classifications of WHO-FICs, International Classification of Diseases, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions,were used to establish diagnostic standards and standardized terminology, as well as coding disease diagnosis, functional description, functional assessment, and rehabilitation interventions, to improve the quality of data reporting, and level of quality control in rehabilitation. ConclusionThe structuring and standardization of rehabilitation outpatient medical records are the foundation for sharing of rehabilitation data. The using of the three major classifications of WHO-FICs is valuable for the terminology and coding of disease diagnosis, functional description and assessment, and intervention in rehabilitation outpatient medical records, which is significant for sharing and interconnectivity of rehabilitation outpatient data, as well as for optimizing the quality and safety of rehabilitation medical services.

ObjectiveTo explore the standardization of inpatient rehabilitation medical record summary sheet, encompassing its structure, content and data standards, to enhance the standardization level of inpatient rehabilitation medical record summary sheet, improve data reporting quality, and provide accurate data support for medical insurance payment, hospital performance evaluation, and rehabilitation discipline evaluation. MethodsBased on the relevant specifications of the National Health Commission's Basic Norms for Medical Record Writing, Specifications for Sharing Documents of Electronic Medical Records, and Quality Management and Control Indicators for Inpatient Medical Record Summary Sheet (2016 Edition), this study analyzed the structure and content of the inpatient rehabilitation medical record summary sheet. The study systematically applied the three major reference classifications of the World Health Organization Family of International Classifications, International Classification of Diseases (ICD-10/ICD-11, ICD-9-CM-3), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), for disease diagnosis, functional description and assessment, and rehabilitation intervention, forming a standardized terminology system and coding methods. ResultsThe inpatient rehabilitation medical record summary sheet covered four major sections: inpatient information, hospitalization information, diagnosis and treatment information, and cost information. ICD-10/ICD-11 were the standards and coding tools for admission and discharge diagnoses in the inpatient rehabilitation medical record summary sheet. The three functional assessment tools recommended by ICD-11, the 36-item version of World Health Organization Disability Assessment Schedule 2.0, Brief Model Disability Survey and Generic Functioning domains, as well as ICF, were used for rehabilitation functioning assessment and the coding of outcomes. ICHI Beta-3 and ICD-9-CM-3 were used for coding surgical procedures and operations in the medical record summary sheet, and also for coding rehabilitation intervention items. ConclusionThe inpatient rehabilitation medical record summary sheet is a summary of the relevant content of the rehabilitation medical record and a tool for reporting inpatient rehabilitation data. It needs to be refined and optimized according to the characteristics of rehabilitation, with necessary data supplemented. The application of ICD-11/ICD-10, ICF and ICHI Beta-3/ICD-9-CM-3 classification standards would comprehensively promote the accuracy of inpatient diagnosis of diseases and functions. Based on ICD-11 and ICF, relevant functional assessment result data would be added, and ICHI Beta-3/ICD-9-CM-3 should be used to code rehabilitation interventions. Improving the quality of rehabilitation medical records and inpatient rehabilitation medical record summary sheet is an important part of rehabilitation quality control, and also lays an evidence-based data foundation for the analysis and application of inpatient rehabilitation medical record summary sheet.

Objective To observe the effect of therapeutic listening on social interaction function in children with autism spectrum(ASD)disorder. Methods From January,2022 to January,2023,40 ASD children in Beijing Bo'ai Hospital were randomly divided into group A(n = 20)and group B(n = 20).Both groups received routine rehabilitation and occupational therapy,while group B received therapeutic listening as occupational therapy,for eight weeks.They were assessed with Pediatric Evaluation of Disability Inventory(PEDI),Childhood Autism Rating Scale(CARS),Autism Behavior Checklist(ABC),Peabody Developmental Motor Scales 2(PDMS-2)and Canadian Occupational Performance Measure(COPM)before and after treatment. Results All the indexes improved in both groups after treatment(|t|>3.194,P<0.01),and they were better in group A than in group B(|t|>2.122,P<0.05),except the score of ABC. Conclusion Combination of therapeutic listening is more effective on sensory processing and social interaction in ASD children.

ObjectiveTo explore the neuromuscular control mechanism of training strategies based on mirror neuron system (MNS): action observation (AO), action execution (AE) and action imitation (AO+AE) using functional Near Infrared Spectroscopy (fNIRS) and surface electromyography (sEMG). MethodsFrom July, 2022 to February, 2023, 64 healthy adults were asked to finish four tasks: watching landscape video (control), watching landscape video and acting right wrist and hand extension (AE), watching right wrist and hand extension video (AO), and watching right wrist and hand extension video and acting right wrist and hand extension (AO+AE). A block design was adopted, five times a task in a block, eight cycles, random orders in videos and tasks. The activation of each channel and regions of interest (ROI, namely BA40, BA44, BA45, BA46, BA6 and BA7) in left MNS regions was detected with fNIRS synchronously, as well as the average electromyography (AEMG) of extensor digitorum and extensor carpi radialis with sEMG. ResultsCompared with the control condition, MNS activated in AO, AE and AO+AE conditions, and the intensities mildly increased in turn. Compared with the control condition, 15 channels activated in AO condition, 15 channels activated in AE condition, and all 20 channels activated in AO+AE condition; and the activation intensities of most channels were AO+AE > AE > AO. Four ROI, BA40, BA46, BA6 and BA7, activated in AO condition, all the six ROI activated in AE and AO+AE conditions, and the activation intensities of most ROI were AO+AE > AE > AO. The standardized AEMG of extensor digitorum and extensor carpi radialis were higher in AO+AE condition than in AE condition (|t| > 4.24, P < 0.001). ConclusionMNS has been activated during action observation, execution and imitation, and the ranges and intensities of activation increase in turn. The target muscles activate more during imitation than during execution. Synchronous application of fNIRS and sEMG is feasible in the study of neural mechanism of rehabilitation strategies based on mirror neuron theory.

ObjectiveTo observe the effect of repetitive facilitative exercise (RFE) on the hand function of stroke patients with hemiplegia during recovery period. MethodsFrom January to December, 2022, 80 stroke patients with hemiplegia following hand dysfunction during recovery period in Beijing Bo'ai Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, the control group added functional occupational therapy, and the experimental group added RFE, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF) and modified Barthel Index (MBI) before and after treatment. ResultsOne case dropped down in the experimental group. After treatment, all the scores increased in both groups (|t| > 12.698, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.302, P < 0.05). ConclusionRFE could promote the recovery of hand function and activities of daily living in patients with hemiplegia during stroke recovery period.

ObjectiveTo investigate the mood states, cognitive performance and the factors related to cognitive function of patients with complete spinal cord injury. MethodsA total of 60 male patients with complete spinal cord injury (SCI) admitted to Beijing Bo'ai Hospital from November, 2020 to March, 2022 were selected as SCI group, and 30 healthy males were selected as the control group. They were assessed with Montreal Cognitive Assessment Beijing Version (MoCA), Digital Span Test (DST) of Wechsler Memory Scale, Symbol Digit Modalities Test-Oral Version (SDMT), Rey-Osterrieth Complex Figure Test-30 min recall (CFT), Stroop Color-Word Test Chinese Version (CWT), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). ResultsCompared with the control group, the SDMT and CFT scores were significantly lower (t > 3.052，P < 0.01); the reflect and square root transformation of MoCA score, the square root transformation of Stroop interference effects time consuming, HAMA score and HAMD score were higher (|t| > 2.542, |Z| > 7.676, P < 0.05) in SCI group. Multiple linear regression analysis indicated that age, education level, HAMD score and sleep disorder were significantly correlated with the scores of cognitive function in SCI group. ConclusionThere are more intensive anxiety and depression in patients with complete SCI. The patients with complete SCI present cognitive impairment, especially in information processing speed, visuospatial ability and visual memory, and executive function. Age, education level, depression and sleep disorder are the related factors of cognitive impairment in patients with complete SCI.

ObjectiveTo investigate the effects of cathodic transcranial direct current stimulation (ctDCS) on upper limb and finger dysfunction after right brain injury (RBI). MethodsFrom October, 2020 to May, 2022, 40 RBI patients in Beijing Bo'ai Hospital were randomly divided into control group and experimental group, with 20 patients in each group. All the patients accepted conventional drug treatment, conventional rehabilitation treatment and functional occupational therapy. The cathode electrode was placed in the M1 area of the uninjured side of brain, then the control group received sham stimulation and the experimental group received stimulation, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and -Finger, and the modified Barthel Index (MBI) before and after treatment. ResultsAfter treatment, the scores of FMA-UE, FMA-Finger and MBI improved in the two groups (t > 5.627, P < 0.001), and improved more in the experimental group than in the control group (t > 2.161, P < 0.05). ConclusionctDCS can effectively improve the motor function of upper limbs and fingers of RBI patients, and improve the ability of activities of daily living.

ObjectiveTo explore the effects of upper limb exergames on cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment. MethodsFrom August, 2020 to November, 2021, 50 troke patients with mild cognitive impairment in Beijing Bo'ai Hospital were randomly allocated to control group (n = 25) and experimental group (n = 25). Both groups received traditional occupational therapy. Additional functional occupational therapy was provided to the control group, and upper limb exergames were provided to the experimental group, for four weeks. They were assessed with Montreal Cognitive Assessment (MoCA), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after the treatment. ResultsAfter treatment, the scores of MoCA, FMA-UE and MBI improved in both groups (|t| > 3.354, |Z| > 4.379, P < 0.01), and the scores increased in five MoCA cognitive domains in the control group (except map naming and abstract thinking) (|Z| > 2.000, P < 0.05) and in six MoCA cognitive domains in the experimental group (except map naming) (|Z| > 2.646, P < 0.01). After treatment, the scores of MoCA, MoCA five cognitive domains (except map naming and abstract thinking) and FMA-UE were better in the experiment group than in the control group(|Z| > 1.982, t = 3.565, P < 0.05). ConclusionUpper limb exergames can facilitate the recovery of cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.

ObjectiveTo observe the differences of brain functioning between dominant and non-dominant hemispheres during rehabilitation for subacute stroke based on functional near-infrared spectroscopy (fNIRS). MethodsFrom September, 2019 to June, 2020, ten subacute stroke inpatients with left hemiplegia (non-dominant hemisphere group) and 16 with right hemiplegia (dominant hemisphere group) from Beijing Bo'ai Hospital received the same unilateral task-oriented occupational therapy for upper limbs, for four weeks. They were assessed with Action Research Arm Test, Fugl-Meyer Assessment-Upper Extremities and grip strength before and after treatment, and scanned with fNIRS to the β value of bilateral sensorimotor cortex, premotor cortex and prefrontal cortex according to the changes of oxyhemoglobin concentration. ResultsAll the indexes of assessment improved in the both groups after treatment (|t| > 3.253, P < 0.05), while the scores of Action Research Arm Test and grip strength improved more in the dominant hemisphere group than in the non-dominant hemisphere group (|t| > 2.154, P < 0.05). For the β value of fNIRS, there was no main effect on time, region and groups (F < 0.542, P > 0.05), and the interactive effect between region and group was significant (F = 4.226, P < 0.01): In the dominant hemisphere group, the β value was higher in the ipsilateral premotor cortex than in the contralateral cortex (P = 0.030), and it was less in the contralateral prefrontal cortex than in the ipsilateral sensorimotor cortex (P = 0.024), ipsilateral premotor cortex (P = 0.003) and ipsilateral prefrontal cortex (P = 0.018). ConclusionFor the subacute stroke patients with right hemiplegia, the activation of brain regions is different between dominant and non-dominant hemispheres during the rehabilitation of upper limb and hand.