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Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.
ABSTRACT
Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.
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Objective:To analyze and compare the policies and theoretical fundamental, the categories and amount of activities, benefits and influential factors of international and national physical activity guidelines for children, to provide theoretical and method guidance for the development and implementation of relevant guidelines. Methods:Six guidelines of physical activity for children issued by the World Health Organization (WHO), China, United States, Australia and Canada (2 sets) were included, analyzed and coded using International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). The policy background, theories, evidence-based methods, recommended activities, activity volume, benefits and influential factors of the guidelines were discussed. Results:There were relevant backgrounds of health policies and theoretical fundamentals for the development of these guidelines. The recommended categories of physical activities involved the activities of fitness, skills and sports. The amount of activity all the guidelines recommended was at least 60 minutes of moderate to high intensity activity per day, and vigorous-intensity or musculoskeletal enhancement activities at least three times a week. Physical activities had benefit for children in the fields of development and maxima of functioning, promotion of activities and participation, formation of good habits of life, establishment of healthy lifestyles, and improvement of the relevant environmental factors. Conclusion:It is useful to analyze and compare the contents of guidelines of physical activities for children using framework, terminology and coding systems of ICF-CY. Both international and national guidelines of physical activity for children are developed in relevant health policies backgrounds and health-related theories. There are three types of physical activity for children aligning to ICF-CY: fitness, skills and sports. All guidelines recommended moderate to high level intensity of activity. Children can gain from physical activities for the development of exercise habits and active lifestyles. Accessible environments are recommended, including Products and Technology, Natural Environment and Human-Made Changes to Environment, Support and Relationships, Attitudes, and Services, Systems and Policies.
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Objective:To explore systematic implementation of World Health Organization Family International Classifications (WHO-FICs) in the field of rehabilitation: the theoretical and policy framework at macro level, governance and management mechanism at meso level, and implementation modules at micro levels, respectively. Methods:The policy and theoretical framework of rehabilitation development was discussed based on the international rehabilitation policy documents of WHO, mainly as World Report on Disability, Global Action Plan on Disability and Rehabilitation in Health Service System. Protocol and roadmap of systematic implementation of WHO-FICs, including International Classification of Diseases (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHIβ-2) was proposed. Results:With the use of WHO-FICs, the theoretical and policy framework of rehabilitation was constructed, and the contents and principles of modern rehabilitation services were clarified at macro-level. Rehabilitation is an important part of health service, there are six building blocks: i.e. leadership and governance, financing, human resources for health, service providing, medical technology and health information system. It proposed to use knowledge management system of WHO-FICs, including the classification, nomenclature, definitions, descriptions, terminology and coding systems, to standardize rehabilitation evaluation and statistics. The management and governance system of rehabilitation should be implemented using WHO-FICs. Rehabilitation services are based on the bio-psycho-social model and implemented the principles of people-centered and functioning-oriented. The systematic implementation of WHO-FICs in rehabilitation abide by the model of "Evaluation (ICHI)－Evaluation, Description, Classification and Coding of Functioning (ICF)－Disease Classification, Diagnosis and Coding (ICD)－Rehabilitation Intervention (ICHI)", and with the standardized process of "Evaluation (Functioning and unmet needs)－Diagnose (Disease and Functioning)－Planning of Rehabilitation－Intervention－Evaluation of Outcome". The mic-modules of implementation of WHO-FICs in rehabilitation had been constructed. There were 28 categories of diseases, 7 categories of functioning and 6 categories of rehabilitation interventions in rehabilitation proposed by International Society of Physical and Rehabilitation Medicine. According to ICD-11 and ICF, it proposed to use WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), Brief Model Disability Survey (MDS-B) and VB40 Generic Functioning Domains (VB40), and the ICF core-sets in evaluation of functioning and rehabilitation outcome. The implementation of WHO-FICs in management of medical records and reporting realized the standardized management of medical record, encoding of diseases, functioning and intervention, reporting of performance, and provided tools for billing, reimbursement and payment management of rehabilitation. It proposed to develop WHO-FICs based clinical data sets and big data to implement functioning-related Diagnosis Related Groups and case-mix statistics. Conclusion:With the systematic implementation of WHO-FICs in rehabilitation, the policy and theoretical framework at macro level had been developed. The mechanism of management and governance at meso level had been explored. The application modules and approaches at micro level had been established. A scientific and effective overall solution had been proposed to enhance the scientific, standardized, refined and informatization level, strengthen the level and governance capacity, and improve the quality, safety and the coverage of rehabilitation services.
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Objective:To investigate the health-related sedentary behavior (SB) characteristics of adolescents aged twelve to 17. Methods:From May to July, 2020, 300 adolescents were sampled and tested SB, break of sedentary time (BST), light physical activity (LPA) using wGT3X-BT accelerometer and Adolescent Sedentary Behavior Questionnaire. Results:The objective measurement showed that the daily sedentary time was high (80.28% on weekdays and 81.38% on weekends). The proportion of sedentary time was high in girls than in boys both on weekdays and weekends (F > 5.322, P < 0.05). There were significant differences in the proportion of SB (weekdays/weekends), the frequency of BST (weekdays/weekends), and the proportion of LPA (weekdays/weekends) among different grades (F > 11.355, P < 0.001). The subjective measurement showed that the sedentary time more than eight hours were 86.67% and 63.67% of children and adolescents on weekdays and weekends, respectively. The educational SB, social SB and video SB were the main types for children and adolescents. The educational SB time increased, and the social SB and video SB time decreased with grades. Traffic SB and cultural SB accounted for a small proportion of the total sedentary time. There were significant differences in social SB (weekdays), cultural SB (weekends), video SB (weekdays/weekends), educational SB (weekdays/weekends) and traffic SB (weekdays/weekends) among different grades (F > 2.934, P < 0.05). Conclusion:The sedentary time is high among children and adolescents, in which educational SB accounts the most, and varies with grade.