Education and development of rehabilitation therapy in China under the background of aging.

The World Health Organization (WHO) estimates that about one-third of people worldwide currently have a need for rehabilitation. This demand is expected to increase in the coming years due to changes in population health and characteristics. For example, with the intensification of global aging, the rehabilitation needs of patients with chronic diseases and disabilities, postoperative dysfunction, and cognitive impairment continue to grow, and emergencies such as conflicts, disasters, and epidemics may lead to a surge in rehabilitation needs. Early and sustained rehabilitation could reduce complications, improve function, and reduce disability in affected populations, but rehabilitation services are often underestimated due to underfunding and poor short-term outcomes. WHO sees rehabilitation as an essential part of achieving universal health coverage and the Sustainable Development Goals. With the development of China's economy and society and the trend of an aging population, the demand for rehabilitation therapists is growing rapidly. Since the development of rehabilitation education in China at the beginning of this century, great progress has been made in both the training mode and the number of people trained, especially in the construction of higher education of rehabilitation in related colleges and universities. Through descriptive qualitative analysis, this study collected information from national policy documents and official websites of colleges and universities on policies concerning degree systems, cultivating goals and ideas, courses, education internationalization, continuing education in practice, standardized training after graduation, the number of colleges and universities with rehabilitation therapy related majors in China, and summarizes the current situation of the development of rehabilitation personnel education in Chinese colleges and universities. Judging from the results, during the development of rehabilitation education, China has continuously improved in terms of policy support, educational goals and concepts, the number and quality of institutions, degree systems, and internationalization, while gradually adapting to China's development status. This also provides direction and feasible suggestions for China to improve the rehabilitation education development system and formulate a national rehabilitation education plan in the future to deal with the challenge of aging.

Study on the Rehabilitation Therapist Estimation Under Institutional Perspective by Applying the Workload Indicators of Staffing Needs in the Aging Context.

Background: The need for rehabilitation therapy has increased dramatically with the aging of the population, the prevalence of non-communicable diseases, and the increase in the number of disabilities. Rehabilitation therapists are crucial to provide high quality rehabilitation therapy; however, there is a significant shortage of these professionals in China. One of the effective strategies to address this challenge is using the norm of the workforce for rehabilitation therapy, which is an index for assessing the personnel required in a facility. This research aimed to create a rehabilitation therapist-required norm under institutional perspective in Shandong Province, China, based on the Workload Indicators of Staffing Needs (WISN) method, which was created by the World Health Organization (WHO) in 1998 to analyse staff utilization at various levels of the health care system. Methods: We conducted descriptive and quantitative research from October to November 2020 in the rehabilitation department of a tertiary hospital in Weifang City, China. Focus groups, online interviews, and document reviews were conducted to gather data and calculations of the WISN method performed. Results: Admission assessment, pre-treatment evaluation, rehabilitation therapy, post-treatment evaluation, and health education for patients were identified as the main priority group activities. Interviews and analysis of documents summarized five factors related to rehabilitation therapists' health service activities. In this study, the annual working time of each therapist was 1,776 h per year. The WISN method calculations showed that the norm of rehabilitation therapists in this tertiary hospital was 23 therapists. As the department had 13 therapists, there was a shortage of 10 therapists based on the WISN calculation, with a ratio of 0.57, which represented the actual compared to the ideal number of therapists. Conclusion: Workload pressure was high for therapists in this tertiary hospital. This model revealed a demand for ten more therapists in the rehabilitation department. The WISN method can help hospital administrators in therapist workforce monitoring, including in regard to therapists. Therefore, the WISN method should be embraced as part of hospital human resource planning and recruitment strategies to meet increasing rehabilitation needs.

Increased Stiffness of the Superficial Cervical Extensor Muscles in Patients With Cervicogenic Headache: A Study Using Shear Wave Elastography.

Background: Cervicogenic headache (CEH) is a secondary headache caused by lesions of the cervical spine and surrounding soft tissues. Cervical muscle dysfunction may be related to the onset of CEH. However, whether cervical muscle stiffness changes in patients with CEH has not been well studied. The purpose of this study was to explore changes in superficial cervical extensor muscle stiffness in patients with CEH using shear wave elastography (SWE). Methods: In this study, 19 patients with CEH and 20 healthy controls were recruited. Superficial cervical extensor muscle stiffness was obtained from SWE, and the SuperLinear SL10-2 MHz linear array probe in the musculoskeletal muscle mode was chosen as the transducer. Regions of interest in the trapezius (TRAP), splenius capitis (SPL), semispinalis capitis (SCap), and semispinalis cervicis (SCer) were manually segmented. Correlations between superficial cervical extensor muscle stiffness and visual analog scale (VAS) scores, age, and body mass index (BMI) were analyzed using Pearson's correlation. Receiver operating characteristic (ROC) curve was used to investigate the diagnostic ability of superficial cervical extensor stiffness for CEH. Results: Superficial cervical extensor muscle stiffness on the headache side of patients with CEH was higher than that on the non-headache side and in healthy controls (p < 0.05). Increased stiffness was also observed in SCer on the non-headache side of patients with CEH compared to healthy controls (p < 0.01). In patients with CEH, SCer stiffness was positively correlated with VAS scores (r = 0.481, p = 0.037), but no correlation was found between other muscles and VAS scores (p > 0.05). The areas under the curve of TRAP, SPL, SCap, and SCer in diagnosing CEH were 0.766, 0.759, 0.964, and 1.000, respectively. Conclusions: Increased stiffness was observed in the superficial cervical extensor muscles on the headache side of patients with CEH. SCer stiffness was correlated with headache intensity in patients with CEH and may provide clues for the diagnosis of CEH.