[Purpose] To summarize the existing official guidelines issued by the World Confederation for Physical Therapy and Associations of Physical Therapy in various countries and to clarify the recommended methods of respiratory rehabilitation and physiotherapy for patients in different stages of the coronavirus disease of 2019 (COVID-19). [Methods] An introductory literature search was conducted using the keywords “COVID-19”, “respiratory rehabilitation”, “physical therapy”, and others in the database of the Association of Physical Therapy. [Results] Using 12 coronavirus disease-2019 rehabilitation-related articles, we summarized data on physical therapy (PT) evaluation; treatment; indications; contraindications; and termination indicators for patients in acute, stable, and post-discharge stages. [Conclusion] PT for COVID-19 patients with coronavirus disease 2019 should be formulated according to the stage of the disease and condition of the patients.

Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004–9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936–0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m² (95% confidence interval: 0.984–0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.

Purpose: This study aimed to identify the current status and barriers to exercise rehabilitation among Chinese patients with acute musculoskeletal injury. Patients and Methods: This single-center, sequential explanatory mixed-methods evaluation included a quantitative survey and qualitative semi-structured interviews. The quantitative survey was distributed online to patients who had acute musculoskeletal injury within five years. For the qualitative component, patients and their families, as well as physiotherapists, orthopedic surgeons, coaches, and personal trainers were recruited. Interview guides were inductively developed and revised based on data analysis. Thematic analysis was conducted using the Capability, Opportunity, and Motivation Behavior model. Results: Among 284 participants, only 65.1% visited the hospital, 22.9% sought rehabilitation services, and 6.0% completed training after injury. The most common reasons for not going to the hospital (92.9%) or rehabilitation department (70.1%) was underestimation of the injury severity. However, one year after injury, 65.7% still experienced abnormalities at the injury sites, and 46.9% had changed their sport habits. In total, 23 participants were interviewed. Barriers of exercise rehabilitation included patient’s lack of knowledge about the requirement of exercise rehabilitation guidance and instruction from orthopedic surgeons, difficulty with mobility and enough time, insufficient number of qualified physiotherapists or clinics, underestimation of injury severity, low expectation of rehabilitation, and cost reasons. Conclusion: This study provides novel evidence on systemic and behavioral barriers to exercise rehabilitation in China, supporting efforts in education for both orthopedic providers and patients, expanding the workforce of qualified specialists, and integrated referral and remote-supervision models. Plain Language Summary: Guidelines recommend exercise rehabilitation guidance in the early stage following acute musculoskeletal injury. However, physiotherapists are insufficient to meet the healthcare needs of the population in China. This was the first mixed methods study focusing on exercise rehabilitation among patients with Chinese acute musculoskeletal injury. The quantitative and qualitative data from participants in different roles demonstrated consistency at multiple points.

Response to Letter in regards to Knowledge, Practice and Barriers to Exercise Rehabilitation Among Chinese Patients with Acute Musculoskeletal Injury: A Mixed-Methods Study [Letter]