44卷4期

• Link 政策論壇 Policy Forum
• 大家醫計畫的願景、挑戰與契機The vision, challenges and opportunities of Family Physician Program 2.0
• 吳岱穎
  Tai-Yin Wu
• 無none
  無none
• 無none
  無none
• 325-327
• 10.6288/TJPH.202508_44(4).PF04

• Link 公衛論壇 Public Health Forum
• 生成式人工智慧在職業健康風險評估的展望Perspectives of generative artificial intelligence in occupational health risk assessment
• 陳靖傑、張立德、張大元
  Jing-Jie Chen, Li-Te Chang, Ta-Yuan Chang
• 無none
  無none
• 無none
  無none
• 328-337
• 10.6288/TJPH.202508_44(4).113091

• Link 公衛論壇 Public Health Forum
• 菸害防制政策的兩難：從FCTC公約第2.1條之前瞻性措施討論看菸草終局政策的挑戰與陷阱Tobacco control at a crossroads: unpacking the challenges and traps of tobacco endgame policies under forward-looking measures of FCTC Article 2.1
• 林映均、蔡奉真
  Ying-Jun Lin, Feng-Jen Tsai
• 無none
  無none
• 無none
  無none
• 338-343
• 10.6288/TJPH.202508_44(4).114014

• Link 公衛今與昔 Public Health Now and Then
• 群體醫療執業中心計畫之回顧與省思Review and reflection on the Project of the Group Medical Practice Centers
• 楊漢湶、戴桂英
  Han-Chuan Yang, Guey-Ing Day
• 無none
  無none
• 無none
  無none
• 344-349
• 10.6288/TJPH.202508_44(4).114038

• Link 綜論 Review Article
• 5G遠距醫療於偏鄉地區之應用現況與展望Role of 5G telemedicine in rural areas: current applications and prospects
• 王品文、林峻吉、陳胤愷、邱弘毅
  Pin-Wen Wang, Chun-Ji Lin, Yin-Kai Chen, Hung-Yi Chiou
• 5G、遠距醫療、偏鄉醫療、醫療可近性
  5G, telemedicine, rural healthcare, healthcare access
• 偏鄉地區因地理環境等因素，醫療資源相對不足。隨著資通訊技術的發展與完備，遠距醫療被視為解決偏鄉醫療不平等的有效途徑。同時醫療模式於COVID-19疫情期間發生轉變，為減少感染風險，相關法規適時放寬，促使醫療機構與民眾採用通訊診療，加速大眾對於數位醫療的接受度。然而，遠距醫療的順利推行有賴於快速且穩定的網路基礎設施。第五代行動通訊技術(5th Generation Mobile Networks，5G)具有高頻寬、廣連結與低延遲特性，能夠結合遠距醫療，實現即時同步診療影像分享，進行遠端診斷與諮詢，使醫療得以跨越地理障礙。本文針對偏鄉醫療需求、遠距醫療的政策發展、疫情影響與5G技術優勢等相關文獻進行盤點，歸納5G遠距醫療模式在偏鄉應用的實證案例，說明其在專科會診與慢性病管理等方面的實施成效，並探討未來發展方向與政策建議，期望後續建立符合實務需求的偏鄉5G遠距醫療模式，提升醫療資源使用效率並落實醫療可近性。
  Rural and remote areas often face a relative shortage of health-care resources due to geographical and environmental constraints. With advances in information and communication technologies, telemedicine has emerged as an effective means of addressing health-care inequities in rural communities. The COVID-19 pandemic resulted in a shift in health-care delivery approaches. To reduce the risk of viral transmission, regulations governing teleconsultations were temporarily relaxed, facilitating broader adoption by health-care providers and the public and thereby increasing societal acceptance of digital health technologies. However, effective implementation of telemedicine depends on the availability of fast and reliable network infrastructure. Fifth-generation mobile networks (5G), characterized by high bandwidth, broad connectivity, and low latency, enable real-time synchronous sharing of diagnostic images for remote consultation, thereby overcoming geographical barriers to health-care access. In this study, we reviewed the literature on the health-care needs of rural areas, policy evolution of telemedicine, implications of the COVID-19 pandemic, and technical advantages of 5G. In addition, we compiled evidence-based case studies on the application of 5G telemedicine in rural settings, evaluating its effectiveness in facilitating specialty consultations and chronic disease management. Furthermore, we explored future directions and policy recommendations, aiming to establish practical 5G telemedicine models for enhancing health-care resource efficiency and promote accessibility in rural areas.
• 350-363
• 10.6288/TJPH.202508_44(4).114033

• Link 原著 Original Article
• 台北市社區對失智症預防準備度的群集分析Cluster analysis of community readiness for dementia prevention in Taipei City
• 陳端容、劉濱槐、郭俊東
  Duan-Rung Chen, Pin-Huai Liu, Chun-Tung Kuo
• 失智症預防、社區準備度、集體效能、群集分析、公共衛生介入
  dementia prevention, community readiness, collective efficacy, cluster analysis, public health interventions
• 目標：失智症預防需要依據不同社區的認知程度、準備度與共同行動能力，制定適切的介入策略。本研究應用社區準備度模型(Community Readiness Model，CRM)評估台灣社區在失智症預防的準備程度，並結合集體效能理論(collective efficacy theory)，探討社會凝聚力與共同行動能力是否與社區準備度類型有關。方法：本研究於2021年3月至6月進行橫斷面調查，調查對象為台北市456個社區(里)的社區領導者，共邀請3，129名領導者(里、鄰長及社區發展協會理事長)參與，最終獲得447份有效回應，涵蓋288個里(占全市總里數的63.16%)。調查內容包括社區知識、領導力、資源可用性、對政府計畫的認知，以及集體效能(如共同行動能力與社會凝聚力)。結果：本研究透過聚集分析出四種類型的社區準備度，並針對不同類型社區提出相應的公共衛生策略建議：對於低能力社區，應強化領導力培訓並優化資源分配;對已具備政策相關計畫認知的社區，建議擴展失智症教育與推動在地參與倡議;對於準備度較為平衡的社區，應維持其參與程度並促進資訊共享;至於高資源社區，則應進一步協助其提升對失智症的正確認知與持續參與。研究亦發現，不同群集的社區在集體效能(p < 0.001)得分不同，在曾推動失智症預防計畫(p < 0.001)上亦有顯著差異。多項式邏輯迴歸分析進一步指出社區失智症預防準備度較好的社區群集，在社區的社會凝聚力表現上也較佳(p < 0.01)。結論：針對不同社區類型進行量身訂製的介入措施，並增進社區社會凝聚力，將可能有助於將口號轉為行動，提升失智症預防工作的成效，並促進長期的公共衛生成果。
  Objectives: Effective dementia prevention requires tailored interventions that account for varying levels of community awareness, preparedness, and collective capacity for action. In this study, the community readiness model was employed to assess the readiness of Taiwanese communities for dementia prevention, and the theory of collective efficacy was utilized to investigate the association between collective efficacy and community readiness. Methods: A cross-sectional survey was conducted from March to June 2021 among leaders from 456 communities in Taipei City. A total of 3,129 leaders, including community heads and chairpersons of community development organizations, were invited to participate in the survey. In total, 447 valid responses were obtained from 288 communities, with this representing 63.16% of all communities in the city. The survey assessed community knowledge, leadership, resource availability, awareness of government programs, and collective efficacy (willingness to intervene/act and social cohesion). Results: A cluster analysis revealed four distinct types of community readiness. Corresponding public health strategy recommendations were proposed: communities with low capacities should strengthen leadership training and improve resource allocation, those familiar with government initiatives should expand dementia education and promote local engagement initiatives, those with balanced readiness should sustain participation and foster information sharing; and those with high resource levels should improve the accuracy of dementia knowledge and encourage continual involvement. The community readiness clusters varied significantly in terms of collective efficacy (p < .001) and prior implementation of dementia prevention programs (p < .001), indicating that disparities in community readiness correlate with varying levels of collective efficacy and proactive policy participation. A multinomial logistic regression analysis indicated that communities with greater readiness for dementia prevention demonstrated stronger social cohesion (p < .001). Conclusions: Implementing tailored interventions for different community types and fostering social cohesion may help translate slogans into action, thereby enhancing the effectiveness of dementia prevention efforts and ultimately improving long-term public health outcomes.
• 364-380
• 10.6288/TJPH.202508_44(4).114020

• Link 原著 Original Article
• 推動明智抉擇於品質改善活動—來自台灣的經驗The implementation of a Choosing Wisely® campaign on quality improvement – an experience from Taiwan
• 蔡哲福、陳柏霖、李隆軍、陳淑真、劉時安
  Che-Fu Tsai, Po-Lin Chen, Lung-Chun Lee, Shu-Chen Chen, Shih-An Liu
• 低價值醫療、臨床稽核、缺血性腦中風、抗癲癇藥物、安寧療護
  low-value care, clinical audit, ischemic stroke, anticonvulsant, hospice care
• 目標：減少低價值醫療是全球趨勢。本研究目的在從一個台灣醫學中心的角度來分享推動明智抉擇(Choose Wisely®，CW)於品質改進活動的經驗。方法：本研究選擇「在缺血性腦中風病人不常規使用預防性抗癲癇藥物」及「末期病人不要延後安寧緩和療護之介入時間」二項主題來推動明智抉擇，我們收集在中部某醫學中心推動明智抉擇前、中、後之數據。我們藉由臨床稽核檢核表之修正版本，運用於明智抉擇的推動過程。此外，我們也設立品質指標，定期召開會議進行回饋和檢討改善計劃。品質指標於「在缺血性腦中風病人不常規使用預防性抗癲癇藥物」部分包括：「缺血性腦中風病人住院中使用預防性抗癲癇藥物比率」及「缺血性腦中風病人出院開立預防性抗癲癇藥物比率」，而於「末期病人不要延後安寧緩和療護之介入時間」部分則包括：「癌症病人安寧緩和療護涵蓋率」及「癌症病人死亡前一週接受安寧緩和療護比率」。結果：從2020年1月至2022年12月，我們收集2，844名病人因缺血性腦中風入院。住院期間抗癲癇藥物使用比例從12.7%下降至9.4%(p = 0.001)，出院後抗癲癇藥物使用比例從4.4%下降2.6%(p = 0.001)。在癌症病人中，有3，034名病人在研究期間死亡。上述病人接受安寧療護的比例從51.2%上升至68.0%(p < 0.01)，而臨終1週前接受安寧療護的病人比例也從33.4%上升至41.0%(p < 0.01)。結論：藉由臨床稽核來推動明智抉擇活動能提高醫師對明智抉擇建議的遵循程度。
  Objectives: Elimination of low-value healthcare is a global trend. We aimed to investigate the implementation of the Choosing Wisely® (CW) campaign on the improvements in quality from the perspective of a medical center of Taiwan. Methods: We chose “Don’t routinely use seizure prophylaxis in patients following ischemic stroke” and “Don’t delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment” as our topics for CW. We collected data before, during and after the launch of a CW campaign in the studied hospital. We modified the checklists used for the clinical audit to accommodate the process of adopting CW recommendations. In addition, quality indicators (QI) were set up and regular meetings were held for feedback and discussion of improvement plans. QIs for “Don’t routinely use seizure prophylaxis in patients following ischemic stroke” were “the proportion of prophylactic anticonvulsants in stroke hospitalized patients” and “the proportion of anticonvulsants after discharge in stroke hospitalized patients”. In addition, the QIs for “Don’t delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment” were “the coverage of hospice care in deceased patients due to cancer” and “the proportion of cancer patients receiving hospice care one week before they died”. Results: From Jan. 2020 till Dec. 2022, a total of 2,844 patients were admitted due to ischemic stroke. The proportion of prescriptions for anticonvulsants during hospitalization decreased from 12.7% to 9.4% (p = 0.001), while the proportion of anticonvulsant prescription after discharge decreased from 4.4% to 2.6% (p = 0.001). Among cancer patients, 3,034 patients died during the study period. The proportion of the abovementioned patients receiving hospice care increased from 51.2% to 68.0% (p < 0.01) while the proportion of patients receiving hospice care one week before dying also improved from 33.4% to 41.0% (p < 0.01). Conclusions: The CW campaign is useful for improving physicians’ adherence to CW recommendation via clinical audit.
• 381-392
• 10.6288/TJPH.202508_44(4).114029

• Link 原著 Original Article
• 從阿美族視角探討園藝健康促進方案對原住民高齡者健康促進效果的影響Role of horticultural programs in promoting health among indigenous older adults: a perspective from the Amis tribe
• 吳宗瓊、王義善、邱于珊
  Tsung-Chiung, Wu Yi-Shan Wang, Yu-Shan Chiu
• 阿美族、高齡者、園藝健康促進、文化敏感度
  Amis tribe, elders, horticultural health promotion, cultural sensitivity
• 目標：本研究由阿美族的視角來探索園藝健康促進方案如何促進阿美族高齡者的健康福祉，並評估具文化意涵的園藝健康促進方案對原住民高齡者健康促進的效益。方法：採準實驗法，共執行三週，研究對象為阿美族長者，以隨機分配法將其分配到實驗組和對照組，並以問卷方式進行量測。結果：對照組在生理健康、心理健康與幸福感等三個構面並未達顯著水準，惟在整體健康促進效果具顯著水準;而實驗組在社會互動、認知強化、心理健康、生理健康、自我提升、幸福感等構面均達顯著差異，且整體效果明顯;另兩組比較後發現，實驗組在園藝健康促進方案各構面效益及整體效果上，均優於對照組且多具顯著水準。結論：本研究證實綠色生命園藝健康促進方案對阿美族高齡者皆具正向效益，且導入文化元素後，可在更廣泛且核心的健康面向上提升效益，顯示文化適切性在阿美族高齡者健康促進成效中具有加乘作用，故未來在設計原住民族健康促進方案時，建議可將文化元素納入並做為整體健康促進規劃的重要條件。
  Objectives: This study adopted an Amis cultural perspective to determine how horticultural programs promote health and well-being among older adults belonging to the Amis tribe. Methods: The present quasi-experimental study was conducted over a 3-week period. Amis older adults were randomly assigned to experimental and control groups. Health outcomes of a horticultural program were assessed using structured questionnaires. Results: In the control group, no significant improvements were observed in physiological health, psychological health, or well-being; however, overall health improved significantly. By contrast, in the experimental group, significant improvements were observed in all dimensions—social interaction, cognitive enhancement, psychological health, physiological health, self-improvement, and well-being—as well as in overall health. A comparative analysis revealed higher overall health and dimension scores in the experimental group than in the control group, with significant differences in social interaction, cognitive enhancement, psychological health, physiological health, self-improvement, and overall health scores. Conclusions: The findings revealed that the horticultural health promotion program benefitted Amis older adults. Incorporating cultural elements enhanced program effectiveness across comprehensive and core health dimensions, indicating that cultural appropriateness exerts a synergistic effect on health promotion outcomes. Thus, future health promotion programs for indigenous older adults should integrate cultural elements as core components.
• 393-404
• 10.6288/TJPH.202508_44(4).114032

• Link 原著 Original Article
• 沒有血緣的一家人：探討鄉村型失智互助家庭成員之間的關係維繫Family without kinship: relational maintenance among primary caregivers of mutual support family members with dementia in rural settings
• 林冠承、盧鴻毅
  Guan-Cheng Lin, Hung-Yi Lu
• 失智者、互助家庭、主要照顧者、關係維繫
  dementia, mutual help family, primary caregiver, relational maintenance
• 目標：本研究以鄉村型失智互助家庭的主要照顧者作為研究對象，探討沒有血緣的互助家庭成員如何維繫彼此關係。方法：研究團隊針對7位互助家庭成員進行一對一深度訪談及虛擬社群線上觀察。結果：深度訪談結果發現，互助家庭成員的關係維繫可歸納出「傾聽苦悶」、「共同付出」、「相互照顧」、「避免衝突」及「在虛擬世界中延續關係」等面向，成員之間的關係是「流動的」，彼此關係融洽時，會將對方視為家人，當互動面臨衝突時，會退回非利害關係，進而避免非必要的互動。討論：互助家庭成員需要原生家庭之外的外部支持力量，為了不讓這股社會支持力量消失，成員之間遇見衝突時，寧可隱忍退步，以保持彼此關係的平衡狀態，而LINE群組是延續面對面互動及彼此之間發生衝突時化解不悅的互動平台。
  Objectives: This study examined how primary caregivers of mutual support family members with dementia in rural settings maintain their relationships. Methods: One-on-one in-depth interviews were conducted with seven mutual support family members to explore their interactions. Results: Several dimensions through which mutual support family members maintain their relationships were identified, including “listening to distress,” “shared contributions,” “caring for each other,” “conflict avoidance,” and “maintaining relationships in the virtual world.” The relationships among mutual support family members were characterized as “fluid.” When interactions were harmonious, they regarded each other as family. By contrast, when conflicts arose, they shifted to a distant relationship style and avoided unnecessary interaction. Conclusions: Mutual support family members require external support beyond that provided by their original families. To maintain this social support system when conflicts arise, these members tend to give in on certain matters to maintain a balanced relationship. LINE groups serve as a means to mitigate unpleasant interactions during conflicts among mutual support family members.
• 405-417
• 10.6288/TJPH.202508_44(4).114025

• Link 原著 Original Article
• 預測台灣社區長者衰弱轉換惡化之身體、心理及社會層面因子：縱貫性研究Predictors of worsening frailty transitions in Taiwanese community-dwelling older adults: a longitudinal study
• 唐翊華、林彥光、莊宇慧、陳逸卉
  Yi-Hua Tang, Yen-Kuang Lin, Yeu-Hui Chuang, I-Hui Chen
• 衰弱、衰弱轉換惡化、社區長者、縱貫性研究
  frailty, frailty transitions worsening, community-dwelling older adults, longitudinal study
• 目標：衰弱是高齡社會面臨的重要健康議題，其對個人、家庭及社會影響深遠。近年「衰弱轉換」備受關注，研究顯示衰弱轉換惡化顯著提高失能與死亡風險，凸顯早期診斷與介入的重要性。衰弱受身體、心理與社會多面向影響，然而這些因素如何影響衰弱轉換惡化仍有待釐清。因此，本研究旨在探討社區長者衰弱轉換惡化之多面向預測因子。方法：採用衛生福利部2007及2011年「台灣地區中老年身心社會生活狀況長期追蹤調查」資料，納入1，670位60歲(含)以上之長者。以衰弱轉換惡化為依變項，將身體、心理及社會層面因素作為自變項。分析方法包括描述性統計及羅吉斯迴歸分析。結果：研究發現30.2%的社區長者經歷衰弱轉換惡化。關節炎或風濕症、抽菸行為、年齡及教育程度則為顯著預測因子。結論：衰弱轉換惡化在社區長者中具相當高的發生率。健康照護人員應採取整合性衰弱管理策略，特別關注罹患關節炎或風濕性疾病、有吸菸史、高齡及不識字的長者，以提升早期預防與介入的成效。
  Objectives: Frailty is a major health concern in aging societies and has substantial effects on individuals, families, and communities. Researchers have recently shifted their attention to frailty transitions, with evidence indicating that worsening frailty transitions markedly increase the risks of disability and mortality; therefore, early intervention is crucial. Although physical, psychological, and social factors influence frailty, their roles in worsening frailty transitions remain unclear. Accordingly, this study explored key predictors of worsening frailty transitions in community-dwelling older adults. Methods: This longitudinal study included 1,670 community-dwelling adults aged ≥60 years. Relevant data were collected from the Taiwan Longitudinal Study on Aging (2007–2011). The data were analyzed using descriptive statistics and multiple logistic regression models. In the statistical models, the dependent variable was worsening frailty transitions, whereas the independent variables were physical, psychological, and social factors. Results: Approximately 30.2% of the included older adults exhibited worsening frailty transitions. Significant predictors of this trend included arthritis or rheumatism, smoking habits, advanced age, and low educational attainment. Conclusions: Worsening frailty transitions are common in community-dwelling older adults. For early prevention of worsening frailty transitions, health-care professionals should implement comprehensive management strategies, particularly targeting older adults with arthritis or rheumatism, a history of smoking, advanced age, or low educational attainment.
• 418-431
• 10.6288/TJPH.202508_44(4).114019

• Link 評論 Commentary
• 評論：預測台灣社區長者衰弱轉換惡化之身體、心理及社會層面因子：縱貫性研究Commentary: predictors of worsening frailty transitions in Taiwanese community-dwelling older adults: a longitudinal study
• 吳至行
  Chih-Hsing Wu
• 無none
  無none
• 無none
  無none
• 432-433
• 10.6288/TJPH.202508_44(4).11401901

• Link 原著 Original Article
• 腦中風急性後期照護功能狀態之趨勢分析及影響因子：前瞻性世代研究Factors influencing functional status in patients with stroke receiving postacute care: a prospective cohort study
• 董聖俐、許弘毅
  Sheng-Li Tung, Hon-Yi Shi
• 急性後期照護、生活品質、影響因子
  post-acute care, quality of life, impact factor
• 目標：自2014年開始，衛生福利部開始試辦腦中風急性後期照護計劃，強調透過復健之介入，以改善腦中風病患之生活品質。本研究的目的為分析腦中風病患接受急性後期照護計畫後復建的成效。方法：本研究為前瞻性世代研究(prospective cohort study)，於2021年1月1日至2023年3月31日間，針對整體功能狀態(MRS)2-4級之病患以問卷方式進行資料蒐集，納入台灣南部兩家醫學中心、兩家區域醫院及一家地區醫院之680位缺血性與151位出血性中風病患進行研究。追蹤時間點分別為入院時、入院後6週和入院後12週，三個時間點。研究工具採用廣義估計方程式(GEE)進行生活品質的趨勢分析。結果：復健後六周相較於入院時，PAC組相對Non-PAC組在BI(effect size， ES 0.19 vs. 0.20)、FOIS(ES 0.01 vs. 0.14)、IADL(ES 0.09 vs. 0.17)、BBS(ES 0.04 vs. 0.20)改善幅度皆顯著較差;然而，復健後12周相較於入院時，PAC組相對Non-PAC組在IADL(ES 0.47 vs. 0.18)、BBS(ES 0.67 vs. 0.17)、MMSE(ES 0.28 vs. 0.03)改善幅度皆顯著較佳。控制時間因素，年紀較輕男性教育程度較佳，身體質量指數(BMI)較高，急性住院天數較短、無30天再入院、無導尿管、無鼻胃管、無高血壓、無腦中風病史，復健前功能狀態較佳者，其復健後功能狀況皆有顯著改善(p<0.05)。結論：在腦中風病患的急性後期，3個月內是黃金治療期間，腦中風病患在急性後期最適合的復健治療時程為6至9週，這段時間進行高強度的復健治療能顯著改善病患的預後。
  Objectives: Since 2014, Taiwan’s Ministry of Health and Welfare has implemented a postacute care (PAC) program for patients with stroke, emphasizing rehabilitation interventions for improving quality of life. This study analyzed rehabilitation outcomes in patients with stroke receiving a PAC intervention. Methods: For this prospective cohort study, data (January 1, 2021, to March 31, 2023) were collected from patients with stroke having a global functional status grade of 2–4. The study cohort comprised 680 patients with ischemic stroke and 151 patients with hemorrhagic stroke from two medical centers, two regional hospitals, and one district hospital in southern Taiwan. Patients receiving the PAC intervention constituted the PAC group, whereas those not receiving it constituted the control group. Follow-up assessments were performed at admission and 6 and 12 weeks after it. Generalized estimating equation models were used to analyze trends in quality of life. Results: After 6 weeks of rehabilitation, the PAC group exhibited less improvements (from baseline results) in the following parameters than did the Non-PAC group: the Barthel Index (effect size [ES]: 0.19 vs. 0.20), Functional Oral Intake Scale score (ES: 0.01 vs. 0.14), Instrumental Activities of Daily Living score (ES: 0.09 vs. 0.17), and Berg Balance Scale score (ES: 0.04 vs. 0.20). However, after 12-week rehabilitation, the PAC group exhibited significantly greater improvements in the following parameters than did the Non-PAC group: Instrumental Activities of Daily Living score (ES: 0.47 vs. 0.18), Berg Balance Scale score (ES: 0.67 vs. 0.17), and Mini-Mental State Examination score (ES: 0.28 vs. 0.03). Statistical models adjusted for time effects revealed that younger age, male sex, higher education level, high body mass index, shorter acute hospitalization duration, no 30-day readmission, no urinary catheter or nasogastric tube use, no previous hypertension or stroke, and better prerehabilitation functional status were significantly associated with greater postrehabilitation functional improvement (p < .05). Conclusions: For patients with acute stroke, the first 3 months after the event constitute the golden treatment period. A 6–9-week rehabilitation program during this phase can ensure optimal outcomes. High-intensity rehabilitation therapy during this period can markedly improve prognosis.
• 434-443
• 10.6288/TJPH.202508_44(4).114026