Objectives To investigate superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to exercise capacity, lower limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL) and dyspnoea. Design Parallel-group randomised controlled trial with 1:1 block randomisation. Setting Three major hospitals from Jiangsu and Hubei provinces, China. Participants 120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO. Intervention Unsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry. Outcomes Primary outcome was 6 min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up). Results Adjusted between-group difference in change in 6MWD was 65.45 m (95% CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12 s (95% CI 12.34 to 27.9; p<0.001) post-treatment and 22.23 s (95% CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up. Conclusions This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL. Trial registration number ChiCTR2000031834.

Nursing students from vocational college programs contribute to over 60% of the nursing student population in China. However, there remains a lack of systematic, quantitative studies examining the prevalence of mental health problems in this population. The purpose of this study was to explore the prevalence of depression, anxiety and stress symptoms and associated factors in vocational college nursing students in Sichuan, China. A total of 554 nursing students from vocational colleges participated in this cross-sectional study. Outcomes were measured with the Depression, Anxiety and Stress Scale 21 (DASS 21). Logistic regressions analysis was performed to examine correlates of mental health problems. The prevalence rates of depression, anxiety and stress symptoms among vocational college nursing students in China were 28.7% (95% CI 24.9%–32.5%), 41.7% (95% CI 37.6%–45.9%) and 20.2% (95% CI 16.8%–23.6%). Mental health problems were elevated as compared to a reference population of Chinese college students of all majors. However, only two percent indicated to seek treatment. The most consistent correlates of mental health problems were reduced engagement in physical and other leisure activities, poor sleep quality, experience of negative life events and poor self-perceived mental health.

BackgroundNatural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.ObjectivesTo examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability.DesignQualitative literature review and secondary data analysis.ResultsAbsolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in na...

Background: Disability can be broken down into difficulties in different components of functioning such as impairments and limitations in activities and participation (A&P). Previous studies have produced the seemingly surprising result that persons with severe impairments tend to report high quality of life (QoL) including perceived health regardless of their condition; the so-called “disability paradox”. We aim to study the role of contextual factors (i.e. the personal and environmental situation) in explaining the disability paradox. Methods: The Swiss Health Survey provides information on the perceived health of 18,760 participants from the general population. We construct a conditional independence graph applying random forests and stability selection in order to represent the structure of impairment, A&P limitation, contextual factors, and perceived health. Results: We find that impairment and A&P limitations are not directly related but only via a cluster of contextual factors. Similarly, impairment and perceived health are not directly related. On the other hand, perceived health is directly connected with A&P limitations. We hypothesize that contextual factors have a moderating and/or mediating effect on the relationship of impairment, A&P limitations, and perceived health. Conclusion: The disability paradox seems to dissolve when contextual factors are put into consideration. Contextual factors may be responsible for some persons with impairments developing A&P limitations and others not. In turn, persons with impairments may only then perceive bad health when they experience A&P limitation. Political interventions at the level of the environment may reduce the number of persons who perceive bad health.

Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year.