Dongsen Liu

Background: Post–COVID-19 condition (PCC) is characterized by persistent symptoms and functional limitations that impair quality of life, and rehabilitation is an important component of its management. Because access to conventional face-to-face rehabilitation may be limited, telerehabilitation has emerged as an accessible alternative. However, the effectiveness of telerehabilitation across clinical outcomes remains uncertain, and the influence of different delivery modes is not well understood. Objective: This study aimed to evaluate the effects of telerehabilitation on health-related quality of life (HRQoL), physical capacity, and symptom burden in adults with PCC, and to determine whether delivery mode (synchronous, asynchronous, or hybrid) modified these effects. Methods: Seven databases (PubMed, Cochrane Library, Web of Science, Scopus, Embase, EBSCO, and PEDro) were searched for randomized controlled trials published from January 2020 through December 2025. Eligible trials enrolled adults with PCC and compared telerehabilitation with usual care or another control condition. The primary outcome was HRQoL; secondary outcomes included functional capacity assessed by the 6-minute walk test and sit-to-stand test, dyspnea, fatigue, and symptoms of anxiety and depression. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Mean differences or standardized mean differences (SMDs) with 95% CIs were pooled using random-effects models with the Hartung-Knapp-Sidik-Jonkman adjustment. Heterogeneity was quantified using I² and τ², with 95% prediction intervals reported where estimable. Certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Results: A total of 22 randomized controlled trials involving 2294 participants were included. Telerehabilitation was associated with significant improvements in HRQoL (SMD 1.26, 95% CI 0.07-2.45; P=.04), dyspnea (SMD 1.95, 95% CI 0.60-3.31; P=.005), and functional aerobic capacity (6-minute walk test : mean difference 77.79 meters, 95% CI 30.44-125.14; P=.001). Fatigue was also significantly reduced (SMD 0.89, 95% CI 0.16-1.62; P=.02), but no significant effects were observed for lower-limb strength (sit-to-stand test: SMD 0.55, 95% CI –0.15 to 1.25; P=.12) or symptoms of anxiety and depression (SMD 0.12, 95% CI –0.13 to 0.38; P=.36). No significant differences between delivery modes were observed for HRQoL (P=.93), functional aerobic capacity (P=.29), or dyspnea (P=.16). A significant subgroup difference was observed for lower-limb strength (P=.02). Conclusions: Telerehabilitation may improve quality of life, aerobic capacity, and symptom burden in PCC and offer an accessible option for post-COVID rehabilitation, although the certainty of evidence was generally limited. Asynchronous delivery appears feasible for general reconditioning, whereas its benefit for lower-limb strength and the value of synchronous supervision remain uncertain. Trial Registration: PROSPERO CRD42023490863; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023490863

BACKGROUND Post–COVID-19 condition (PCC) is characterized by persistent symptoms and functional limitations that impair quality of life, and rehabilitation is an important component of its management. Because access to conventional face-to-face rehabilitation may be limited, telerehabilitation has emerged as an accessible alternative. However, the effectiveness of telerehabilitation across clinical outcomes remains uncertain, and the influence of different delivery modes is not well understood. OBJECTIVE This study aimed to evaluate the effects of telerehabilitation on health-related quality of life (HRQoL), physical capacity, and symptom burden in adults with PCC, and to determine whether delivery mode (synchronous, asynchronous, or hybrid) modified these effects. METHODS Seven databases (PubMed, Cochrane Library, Web of Science, Scopus, Embase, EBSCO, and PEDro) were searched for randomized controlled trials published from January 2020 through December 2025. Eligible trials enrolled adults with PCC and compared telerehabilitation with usual care or another control condition. The primary outcome was HRQoL; secondary outcomes included functional capacity assessed by the 6-minute walk test and sit-to-stand test, dyspnea, fatigue, and symptoms of anxiety and depression. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Mean differences or standardized mean differences (SMDs) with 95% CIs were pooled using random-effects models with the Hartung-Knapp-Sidik-Jonkman adjustment. Heterogeneity was quantified using I² and τ², with 95% prediction intervals reported where estimable. Certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. RESULTS A total of 22 randomized controlled trials involving 2294 participants were included. Telerehabilitation was associated with significant improvements in HRQoL (SMD 1.26, 95% CI 0.07-2.45; P=.04), dyspnea (SMD 1.95, 95% CI 0.60-3.31; P=.005), and functional aerobic capacity (6-minute walk test : mean difference 77.79 meters, 95% CI 30.44-125.14; P=.001). Fatigue was also significantly reduced (SMD 0.89, 95% CI 0.16-1.62; P=.02), but no significant effects were observed for lower-limb strength (sit-to-stand test: SMD 0.55, 95% CI –0.15 to 1.25; P=.12) or symptoms of anxiety and depression (SMD 0.12, 95% CI –0.13 to 0.38; P=.36). No significant differences between delivery modes were observed for HRQoL (P=.93), functional aerobic capacity (P=.29), or dyspnea (P=.16). A significant subgroup difference was observed for lower-limb strength (P=.02). CONCLUSIONS Telerehabilitation may improve quality of life, aerobic capacity, and symptom burden in PCC and offer an accessible option for post-COVID rehabilitation, although the certainty of evidence was generally limited. Asynchronous delivery appears feasible for general reconditioning, whereas its benefit for lower-limb strength and the value of synchronous supervision remain uncertain. CLINICALTRIAL PROSPERO CRD42023490863; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023490863

Purpose: To translate and culturally adapt the Evidence-Based Practice and Evidence-Informed Practice Questionnaire into the Chinese version and evaluate its psychometric properties. Methods: The process of translation and cross-cultural adaptation adhered to the established guidelines, followed by psychometric evaluation that assessed floor/ceiling effects, face validity, content validity, construct validity, internal consistency, and test–retest reliability. The evaluation engaged 5 experts and 279 students (170 undergraduates and 109 postgraduates) from Beijing Sport University. Questionnaire items were categorized according to Evidence-Based Practice (EBP) and Evidence-Informed Practice (EIP) concepts, with varying response options for degree and frequency. Forty students completed the Chinese version of the questionnaire for the second time after a two-week period. Results: No floor or ceiling effects were observed. Following the revision of item 32 and deletion of item 14, the Item-Level Content Validity Index (I-CVI) for all other items ranged from 0.80 to 1.00, with an average scale-level CVI (S-CVI/Ave) of 0.91. The final Chinese version of the questionnaire consists of 52 items, showing adequate internal consistency, with Cronbach’s alpha values of 0.78, 0.86, 0.86, and 0.89 for the EBP (degree and frequency) and EIP (degree and frequency) items, respectively. Comparison between test–retest scores produced significant differences in all items, with Spearman correlation coefficient (r) ranging from 0.33 to 0.80 (p< 0.05), except for item 16 (r=0.29, p=0.065). Exploratory Factor Analysis (EFA) results indicated Kaiser–Meyer–Olkin (KMO) values for EBP degree, EBP frequency, and EIP degree items ranging from 0.78 to 0.87. Bartlett’s test of sphericity yielded significant results, explaining 63.62%, 69.35%, and 70.91% of the total variance, respectively, after removing items 23 and 42– 44 (cross-loading items). Conclusion: The Chinese version of the Evidence-Based Practice and Evidence-Informed Practice Questionnaire demonstrated good psychometric properties for assessing the effectiveness of EBP and EIP educational programs tailored for physiotherapy and exercise rehabilitation students.

Background & Aims: Nowadays, the world is facing a common problem that the population aging process is accelerating. How to delay metabolic disorders in middle-aged and elderly people, has become a hot scientific and social issue worthy of attention. The liver plays an important role in lipid metabolism, and abnormal lipid metabolism may lead to liver diseases. Exercise is an easily controlled and implemented intervention, which has attracted extensive attention in improving the health of liver lipid metabolism in the elderly. This article reviewed the body aging process, changes of lipid metabolism in the aging liver, and the mechanism and effects of different interventions on lipid metabolism in the aging liver, especially focusing on exercise intervention. Methods: A literature search was performed using PubMed-NCBI, EBSCO Host and Web of Science, and also a report from WHO. In total, 143 studies were included from 1986 to 15 February 2020. Conclusion: Nutritional and pharmacological interventions can improve liver disorders, and nutritional interventions are less risky relatively. Exercise intervention can prevent and improve age-related liver disease, especially the best high-intensity interval training intensity and duration is expected to be one of the research directions in the future.