Sodiq Fakorede, Chloe McCloskey, Cory Wernimont, Anna L Kratz, Libak Abou
{"title":"Beyond physical function: the impact of nonmotor symptoms on activities and participation in wheelchair users with multiple sclerosis.","authors":"Sodiq Fakorede, Chloe McCloskey, Cory Wernimont, Anna L Kratz, Libak Abou","doi":"10.1097/MRR.0000000000000678","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000678","url":null,"abstract":"<p><p>While the impact of physical disabilities on daily activities is well documented, less is known about the influence of nonmotor symptoms on activities and participation. This study aims to fill this gap by examining how nonmotor symptoms affect activities and participation outcomes in wheelchair users with multiple sclerosis (MS). Data from 89 wheelchair users with MS collected through a nationwide survey were analyzed. Participants completed the Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function, PROMIS depression, PROMIS pain interference, Fatigue Severity Scale, and measures of self-efficacy and participation. Hierarchical multivariable linear regression was used to assess the impact of nonmotor symptoms on four self-efficacy and participation outcomes beyond physical function. As expected, physical function was a significant predictor of all outcomes: self-efficacy for managing daily activities (β = 0.59, P < 0.01), control over community participation (β = -1.06, P < 0.01), ability to participate (β = 0.46, P < 0.01), and satisfaction with participation in social roles and activities (β = 0.70, P < 0.01). Beyond physical function, nonmotor symptoms accounted for 6% of the variance in self-efficacy, 21% in control over community participation, 29% in ability to participate in social roles and activities, and 13% in satisfaction with participation in social activities. Among these, pain interference emerged as the most consistent nonmotor symptom, significantly associated with poorer outcomes across all domains (P < 0.05). This study demonstrates that nonmotor symptoms, particularly pain interference, are significantly associated with activities and participation outcomes in wheelchair users with MS.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Toderita, Charles Handford, Arul Ramasamy, Paul Hindle, Jonathan Kendrew, Anthony M J Bull, Louise McMenemy
{"title":"Self-reported health outcomes and medical complications at 6- and 8-year follow-up after direct skeletal fixation in individuals with bilateral transfemoral amputations.","authors":"Diana Toderita, Charles Handford, Arul Ramasamy, Paul Hindle, Jonathan Kendrew, Anthony M J Bull, Louise McMenemy","doi":"10.1097/MRR.0000000000000677","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000677","url":null,"abstract":"<p><p>Direct skeletal fixation (DSF) involves attaching the intramedullary portion of a prosthesis directly to the skeletal residuum, providing an alternative for amputees unable to mobilise with socket-based prostheses. This study investigates the effects of DSF on physical and mental health at 6- and 8-year follow-up for military bilateral transfemoral amputees in the UK. Eight male bilateral transfemoral military amputees who underwent implantation with the Osseointegration Group of Australia-Osseointegration Prosthetic Limb prosthesis consented to participate in the study. All patients are routinely reviewed annually in a dedicated clinic, and this paper reports the 6- and 8-year follow-ups. Patient-reported outcomes were assessed using the Short Form Health Survey (SF-36). Complications data were recorded at the 8-year follow-up. The SF-36 physical component score significantly increased from preoperative levels at 6 years (median: 29 vs. 47; P = 0.003) and 8 years (median: 29 vs. 45; P = 0.024). The SF-36 mental health component score improved significantly at 6 years from preop (median: 39 vs. 57; P = 0.011). Among 16 femoral residuums, there was one explantation because of infection at 8.5 years postimplantation, and two cases were managed with long-term suppressive antibiotics. A total of 17 additional procedures were performed on nine residuums: 11 for soft tissue revision, five for infection, and one for fracture repair. This research adds to the growing evidence base that DSF has the potential to enhance the health and well-being of amputee veterans and potentially the broader amputee population. Medical complications remain an important consideration.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seung Heun An, Eun Joo Kim, Sung Phil Yang, Su Ji Choi, Jun Min Lee
{"title":"Comparative reliability, concurrent and convergent validity, and predictive value of the 6-min walk test over 15 and 30 m in patients with subacute stroke.","authors":"Seung Heun An, Eun Joo Kim, Sung Phil Yang, Su Ji Choi, Jun Min Lee","doi":"10.1097/MRR.0000000000000674","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000674","url":null,"abstract":"<p><p>The 6-min walk test (6MWT) is used to assess gait capacity in patients with stroke; however, the standard 30-m version (6MWT-30 m) is often impractical in clinical settings because of space limitations. We investigated the validity and reliability of a 15-m version (6MWT-15 m) in 29 individuals with subacute stroke. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. Validity was evaluated through correlations with the 10-m walk test (10mWT), Berg Balance Scale (BBS), and Fugl-Meyer Assessment for the Lower Extremities (FMA-LE). The 6MWT-15 m demonstrated excellent reliability (ICC = 0.997) and acceptable measurement error (MDC = 19.5 m), with strong correlations with the 10mWT, BBS, FMA-LE, and 6MWT-30 m, supporting its validity. Regression analysis identified the 6MWT-15 m as the sole significant predictor of 6MWT-30 m (R2 = 0.98) walking distance. These findings support the 6MWT-15 m as a reliable, valid, and practical alternative for assessing walking capacity in patients suffering from subacute stroke, particularly in space-limited clinical settings.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the effectiveness of valgus knee braces in improving pain, stiffness, and physical function in medial compartment osteoarthritis.","authors":"Bashar Al Qaroot, Huda Alfatafta, Aws Khanfar","doi":"10.1097/MRR.0000000000000676","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000676","url":null,"abstract":"<p><p>Valgus knee orthosis is a common conservative treatment for medial compartment knee osteoarthritis (OA), though its efficacy in diverse socioeconomic and cultural contexts remains understudied. This investigation evaluated the short-term effects of a valgus knee orthosis on knee OA patients from a developing country, while monitoring adherence, to address this gap in the literature. The study included 35 participants with radiographically confirmed OA (Kellgren-Lawrence grades 2-3). The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index tool was used to assess participants. All participants utilized the Össur Unloader One orthosis, which was equipped with an integrated activPAL sensor to monitor adherence during a 2-week intervention period. WOMAC index demonstrated statistically significant improvement, with mean scores decreasing from 0.67 (0.15) to 0.42 (0.18) at 1 week (P < 0.001) and to 0.32 (0.16) at 2 weeks (P < 0.001) of wearing the orthosis. Notably, after 2 weeks, 86% of participants exceeded established minimal clinically important difference thresholds. ActivPAL data for adherence revealed a significant positive correlation between brace wearing time and clinical improvement (P = 0.008), with participants achieving ≥8 h daily wear time exhibiting the best outcomes (51% improvement in WOMAC index). The findings shed light on the possible usefulness of valgus knee orthosis in controlling symptoms of knee OA patients from resource-variable settings with unique cultural habits (i.e. kneeling and floor-sitting behaviors) while highlighting the critical role of adherence monitoring.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ijaz N Pillai, Nandyal C Chandini, Smitha Joseph, Badarinath Athani, Deepak J Prasad
{"title":"Decannulation patterns and predictors in acquired brain injury: a retrospective study.","authors":"Ijaz N Pillai, Nandyal C Chandini, Smitha Joseph, Badarinath Athani, Deepak J Prasad","doi":"10.1097/MRR.0000000000000675","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000675","url":null,"abstract":"<p><p>Tracheostomy is frequently performed in patients with acquired brain injury (ABI) requiring prolonged ventilatory support. However, prolonged tracheostomy use can impact communication, swallowing, and psychological well-being, making timely decannulation a crucial rehabilitation goal. This study examined the time to decannulation and associated factors in patients with ABI by conducting a retrospective review using medical records of patients with ABI admitted to the Department of Physical Medicine and Rehabilitation (2016-2024). Patients aged ≥18 years, with a tracheostomy tube at admission and who underwent decannulation, were included. The primary outcome was the time to attain decannulation (TAD), with secondary outcomes assessing clinical and functional predictors that may affect TAD. Seventy-seven patients met the inclusion criteria. A total of 77 subjects were included for the analysis, consisting of 19 patients with stroke, 52 patients with traumatic brain injury (TBI), and 6 patients of encephalopathy. The median TAD was 52 days in the overall sample. In simple linear regression, TAD was significantly longer in the stroke than in the TBI subsample (76 vs. 49.5 days, P = 0.019), in younger patients (P = 0.01), and in those admitted earlier to inpatient rehabilitation (P < 0.001). In multiple linear regression, younger age, higher Glasgow Coma Scale scores at admission, and earlier inpatient admission were associated with shorter TAD (P = 0.028, 0.044, <0.001; adjusted R2 = 0.597). The findings of this study may aid in tracheostomy decannulation-related goal setting, patient stratification, managing patient's expectations, and planning appropriate timelines related to tracheostomy decannulation in patients with ABI.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annika Miikkulainen, Mikhail Saltychev, Sara Widbom-Kolhanen, Juhani Juhola, Hanna-Stiina Taskinen
{"title":"Internal consistency, factor structure, and floor/ceiling effect of Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire among people with carpal tunnel syndrome.","authors":"Annika Miikkulainen, Mikhail Saltychev, Sara Widbom-Kolhanen, Juhani Juhola, Hanna-Stiina Taskinen","doi":"10.1097/MRR.0000000000000673","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000673","url":null,"abstract":"<p><p>Quick Disability of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) is commonly used in carpal tunnel syndrome, while the knowledge on its psychometrics in this disorder is limited. The objective of this study was to explore the internal consistency, factor structure, and floor/ceiling effect of QuickDASH among patients with carpal tunnel syndrome. This was a retrospective cross-sectional register-based study among 1597 patients with electromyography-confirmed carpal tunnel syndrome. The internal consistency was assessed using Cronbach's α. Exploratory factor analysis was used to evaluate factor structure. Of 1597 respondents, 896 (56%) were women. The average age was 55.0 (16.3) years. The mean QuickDASH score was 38 (23.2) points. QuickDASH demonstrated an excellent internal consistency with α of 0.92 (95% confidence interval: 0.92-0.93). Exploratory factor analysis demonstrated unidimensionality. Item loadings were moderate to substantial for all 11 items, varying from 0.55 to 0.83. A significant floor effect was observed for nine of 11 items varying from 20 to 51%. A ceiling effect was observed for one item (#6 'recreational activities'). Despite its significant floor effect, QuickDASH can be recommended as a valid and reliable scale to assess the severity of disability caused by carpal tunnel syndrome.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid Lin, Catherine M Dean, Joanne V Glinsky, Lindy Clemson, Elisabeth Preston, Petra L Graham, Katharine Scrivener
{"title":"Association of device-based and self-reported measures of physical activity in community-dwelling older people after stroke: an exploratory study.","authors":"Ingrid Lin, Catherine M Dean, Joanne V Glinsky, Lindy Clemson, Elisabeth Preston, Petra L Graham, Katharine Scrivener","doi":"10.1097/MRR.0000000000000668","DOIUrl":"10.1097/MRR.0000000000000668","url":null,"abstract":"<p><p>The association between device-based (activPAL) and self-reported [Incidental Exercise and Planned Exercise Questionnaire (IPEQ)] measures of physical activity has not been investigated. This study aimed to determine the association between activPAL and IPEQ measures of physical activity in a sample of community-dwelling older people after stroke. Data from an exploratory analysis embedded within a randomized trial was used. Spearman correlation was used to assess the relationship between activPAL (upright time and step count) and IPEQ (self-reported total exercise time) measures at three timepoints [months 0 ( n = 46), 6 ( n = 39) and 12 ( n = 36)] Strong Spearman correlation between upright time and self-reported total exercise time ( r = 0.51-0.72) and step count and self-reported total exercise time was found at all timepoints ( r = 0.54-0.62). Though further research could confirm these results in a larger sample, there is potential for the IPEQ to be used as a simple estimate of physical activity in a clinical setting.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":"48 2","pages":"126-129"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preinjury functional status is associated with functional status after hip fracture in older adults without preinjury perceived social support.","authors":"Yan Zhang, Isaac Kolam, Dmitry Tumin","doi":"10.1097/MRR.0000000000000662","DOIUrl":"10.1097/MRR.0000000000000662","url":null,"abstract":"<p><p>We investigated if preinjury perceived social support moderated the association between pre- and postinjury functional status after hip fracture in older adults. Using data from the longitudinal Health and Retirement Study (biennial interviews from 1998 to 2018), we analyzed perceived social support measured preinjury and functional status [activities of daily living (ADL) or instrumental activities of daily living (IADL) limitations] measured at pre- and postinjury interviews. Among 709 respondents, 61% anticipated social support from friends or family if they required future assistance with personal care, 16% had difficulty with ADL preinjury, and 9% had difficulty with IADL preinjury. Among 1697 postinjury follow-up interviews (mean follow-up time: 2.8 years), ADL limitations and IADL limitations were reported in 752 and 683 interviews, respectively. During follow-up, any preinjury IADL limitations were associated with more postinjury IADL limitations among people without social support [adjusted incidence rate ratio (aIRR): 2.505, 95% confidence interval (CI): 1.765-3.555] but not among people with preinjury perceived social support (aIRR: 1.355, 95% CI: 0.950-1.940, interaction P = 0.016). Any preinjury ADL limitations were associated with more postinjury ADL limitations among people with (aIRR: 1.471, 95% CI: 1.124-1.925) or without (aIRR: 2.084, 95% CI: 1.563-2.778) preinjury perceived social support. Preinjury perceived social support moderates the association between pre- and postinjury functional status in older adults experiencing a hip fracture. Older adults experiencing pre-existing IADL limitations without social support are at high risk for continued or increased activity limitations.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":"100-105"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social support, depression, and quality of life among parents of children with cerebral palsy in Benin, West Africa: a cross-sectional case-control study.","authors":"Ange Loutou, Renaulde Soudé, Espérance Gandonou, Toussaint Kpadonou, Emmanuel Segnon Sogbossi","doi":"10.1097/MRR.0000000000000666","DOIUrl":"10.1097/MRR.0000000000000666","url":null,"abstract":"<p><p>Caring for a child with cerebral palsy (CP) is challenging and can significantly impact caregivers' quality of life. This study aimed to examine the psychological state, perceived social support, and quality of life of parents of children with CP in Benin, West Africa. This cross-sectional, case-control design included 50 parents of children with CP (mean age 39.4 ± 8.3 years, 46 mothers) paired with 58 parents of typically developing children (mean age 38.1 ± 7.4 years, 52 mothers) as controls. Both groups completed the Social Provisions Scale (SPS-10), Patient Health Questionnaire-9 (PHQ-9), and Medical Outcome Study Short Form (SF-12) to assess social support, depression, and quality of life. Additionally, parents of children with CP completed the Impact on Family Scale to evaluate caregiving burden. The results showed that parents of children with CP reported lower social support and higher depression levels than controls ( P < 0.05). However, their quality of life (both physical and mental scores) was similar to the control group ( P > 0.05). Only depression was significantly linked to lower quality of life ( P < 0.05) in parents of children with CP. In conclusion, parents of children with CP have a comparable physical and mental health-related quality of life to parents of typically developing children, despite experiencing lower perceived social support and higher levels of depression in Benin country. These findings underscore the need for enhanced social and psychological support systems to improve the well-being of families caring for children with CP in such environments.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":"113-119"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The validity and reliability of the 10-meter walk test with obstacles in community-dwelling older adults.","authors":"Birol Önal, Ayşe Abit Kocaman","doi":"10.1097/MRR.0000000000000665","DOIUrl":"10.1097/MRR.0000000000000665","url":null,"abstract":"<p><p>The aim of this study was to determine the validity and reliability of the 10-meter walk test modified by adding 5 and 17 cm obstacles (10MWT-O) in community-dwelling older adults and to examine its ability to differentiate between older and younger adults. The study included 65 older adults and 55 younger adults. 10MWT-O (obstacle height: 0, 5, 17 cm) was performed on two different days (day 1 and day 2). All participants were assessed by the same assessor on days 1 and 2. Berg Balance Scale (BBS), Time Up and Go (TUG) test, Mini Mental State Test, and Functional Reach Test (FRT) assessments were performed on day 1. 10MWT-O speed for all obstacle heights showed moderate to good correlations with FRT distance ( r = 0.474-0.539, P < 0.001), TUG Test time ( r = -0.722 to -0.671, P < 0.001), and BBS score ( r = 0.619-0.660, P < 0.001). Test-retest reliability (intraclass correlation coefficient = 0.924-0.960) was found to be within the excellent range for 10MWT-O speed across all obstacle heights. For obstacle heights of 0, 5, and 17 cm, the minimum detectable change for 10MWT-O speed was 0.16, 0.19, and 0.20 m/s, and the optimal cutoff values for differentiating older from young adults were 1.12, 0.98, and 0.85 m/s, respectively. The 10MWT-O is a reliable and valid clinical measure for assessing walking ability and adaptability in older adults. ClinicalTrials.gov identifier: NCT06307769.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":"120-125"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}