NeuroRehabilitation最新文献

{"title":"Effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.","authors":"Jiyeon Lee, Jinseop Kim","doi":"10.3233/NRE-240132","DOIUrl":"https://doi.org/10.3233/NRE-240132","url":null,"abstract":"<p><strong>Background: </strong>Limited chest expansion and asymmetry in the respiratory muscles after a stroke lead to poor ventilation and reduced physical performance.</p><p><strong>Objectives: </strong>To determine the effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.</p><p><strong>Methods: </strong>Thirty stroke patients were randomly assigned to a chest expansion resistance group (CERG), a respiratory muscle stretching group (RMSG), and a control group (CG). CERG and RMSG received chest expansion resistance and respiratory muscle stretching, respectively, 3 times a week for 8 weeks. Respiratory function, respiratory muscle strength, and gait endurance were measured before and after the intervention period.</p><p><strong>Results: </strong>The experimental groups, CERG and RMSG, showed significant improvements in respiratory function variables (p < .05). For respiratory muscle strength variables, maximal inspiratory pressure (MIP) in the CERG and maximal expiratory pressure (MEP) in the RMSG showed significant changes compared to the CG (p < .05). Both CERG and RMSG also showed significant improvements in the 6MWT compared to the CG (p < .05).</p><p><strong>Conclusion: </strong>Chest expansion resistance exercise would be a more effective method, while both chest expansion resistance exercise and respiratory muscle stretching are helpful in improving respiratory function and gait endurance.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562950","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":"Spontaneous eye blinking as a diagnostic and prognostic marker in disorders of consciousness: Protocol of an international multicentre longitudinal study.","authors":"Alfonso Magliacano, Giovanni Scarano, Cinzia Fasano, Andrea Mannini, Piergiuseppe Liuzzi, Alice Finocchi, Anna Estraneo","doi":"10.3233/NRE-240127","DOIUrl":"https://doi.org/10.3233/NRE-240127","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic and prognostic decision-making in patients with Disorders of Consciousness (DoC) is challenging. It has been suggested that spontaneous eye blink rate is an index of patients' level of consciousness easy to detect in clinical practice. Further blinking features (i.e., amplitude, duration, variability in intervals between blinks) may change as a function of cognitive load, but have not been investigated in patients with DoC.</p><p><strong>Objective: </strong>This multicentre, longitudinal study aims at exploring the diagnostic and prognostic value of spontaneous eye blinking features in DoC.</p><p><strong>Methods: </strong>Eight European medical institutions will enrol consecutively admitted adult patients with DoC. Within two weeks from study entry demographic, anamnestic and clinical data will be collected. Moreover, patients will undergo two 20-minute EEG-EOG recordings at rest, to collect blinking features and EEG activity. A clinical follow-up will be performed after 6 months. A group of healthy individuals will be enrolled for reference.</p><p><strong>Results: </strong>Possible differences in blink features between patients and the reference group, differences across diagnostic sub-groups, and correlations between blinking features and clinical outcome will be investigated.</p><p><strong>Conclusion: </strong>The results of this study might help clinicians to reduce misdiagnosis rate in DoC and provide useful information for prognostication and care pathway plan.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471840","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":"Evaluation of YouTube videos as a source of information on facial paralysis exercises.","authors":"Onur Engin, Ayşe Sezgi Kızılırmak Karataş, Betül Taşpınar, Ferruh Taşpınar","doi":"10.3233/NRE-240027","DOIUrl":"https://doi.org/10.3233/NRE-240027","url":null,"abstract":"<p><strong>Background: </strong>YouTube has emerged as an important source for obtaining information regarding health issues.</p><p><strong>Objective: </strong>The study aimed to assess the reliability and quality of facial paralysis exercise videos that are accessible on the YouTube platform.</p><p><strong>Methods: </strong>The investigation was carried out on Youtube, utilizing the keyword \"facial paralysis exercises\". We listed the first 100 videos based on relevancy. The quality and reliability of the videos were assessed using DISCERN, the Journal of the American Medical Association (JAMA) Benchmark Criteria, the Global Quality Scale (GQS), and the Video Power Index (VPI).</p><p><strong>Results: </strong>Out of 100 studies, we excluded 52 and included the remaining 48. The scores we obtained for the videos were as follows: DISCERN Quality (2.92±0.91), DISCERN Total (39.16±6.75), JAMA (2.09±0.55), and GQS (3.00±0.89). Our study also revealed that videos uploaded by healthcare professionals had significantly higher DISCERN total, JAMA and VPI scores compared to those uploaded by non-healthcare professionals (p = 0.018, 0.001 and 0.023, respectively). Additionally, we observed a positive and statistically significant correlation between the DISCERN quality score, total score, JAMA, and video features.</p><p><strong>Conclusion: </strong>The facial paralysis exercise videos were determined to be of medium to low quality. Higher-quality videos need to be produced.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292870","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":"Research, education and practice of tele-neurorehabilitation in low and middle-income countries: A Scoping Review.","authors":"Dorcas B C Gandhi, Sureshkumar Kamalakannan, Jennifer V Dsouza, Vinicius Montanaro, Nistara S Chawla, Amreen Mahmood, Etienne Ngeh, Sania Zarreen, Pranay J Vijayanand, John M Solomon","doi":"10.3233/NRE-240053","DOIUrl":"https://doi.org/10.3233/NRE-240053","url":null,"abstract":"<p><strong>Background: </strong>Tele-neurorehabilitation (TNR) allows for remote delivery of rehabilitation services for those with neurological disabilities. Despite growing global interest and uptake, its adoption remains challenging in Low-and-Middle-Income-Countries (LMICs).</p><p><strong>Objective: </strong>To explore available literature on the nature of training and education, research and practice of TNR in LMICs.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines and predefined selection criteria, four databases were screened. Quality assessment was performed using the Joanna Briggs Institute tools. Relevant data was extracted to using a data extraction form in Microsoft Excel and were narratively synthesised under Education/training, Research and Clinical Practice of TNR.</p><p><strong>Results: </strong>We identified no formal structured training courses/programs for TNR users/providers. Sessions were mainly delivered as part of a research project. The included studies highlighted the need to engage stakeholders in TNR research and improve digital-literacy among healthcare providers/users. Development and use of clinical decision-making-tools, models of TNR suitable for varied populations and prior area-mapping were a few suggestions for clinical/research practice.</p><p><strong>Conclusion: </strong>There is an immense need to develop academic/structured programs for TNR to build capacity among providers/users in LMICs. Practice must adhere to principles of safety, effectiveness, and based on high quality clinical-guidelines suitable to the context to ensure optimal uptake and practice of TNR in LMICs.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292874","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 role of nutrition in mild traumatic brain injury rehabilitation for service members and veterans.","authors":"Katrina Monti,Maj William Conkright,Shawn R Eagle,David W Lawrence,Ltc Michael Dretsch","doi":"10.3233/nre-230241","DOIUrl":"https://doi.org/10.3233/nre-230241","url":null,"abstract":"BACKGROUNDVeterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle.OBJECTIVEThis narrative review aims to summarize the existing evidence surrounding the role of special diets and select nutrients in mild TBI outcomes, gut microbiota changes, and special considerations for Service members and Veterans recovering from mild TBI.METHODSWe conducted a literature review in PubMed and Google Scholar limited to nutritional interventions and nine topics with primary focus on mild TBI, although we included some articles related to moderate-to-severe TBI where relevant: 1) ketogenic diet, 2) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, 3) omega-3 fatty acids, 4) creatine, 5) vitamin D, 6) weight management, 7) gut microbiota, 8) caffeine, and 9) alcohol. We summarized key findings and safety factors where appropriate for each intervention. We also identified nutritional supplement safety and operational rations considerations and areas in need of further research.RESULTSPreclinical studies and early human trials suggest that the specific nutrients and diets discussed in the current article may offer neuroprotection or benefit during mild TBI rehabilitation. Omega-3 fatty acids, creatine, and vitamin D are generally safe when taken within recommended guidelines.CONCLUSIONMore evidence is needed to support nutritional recommendations for enhancing neuroprotection and mitigating mild TBI symptoms in humans. The DOD's Warfighter Nutrition Guide recommends a whole food diet rich in antioxidants, phytonutrients, omega-3 fatty acids, micronutrients, probiotics, and fiber to optimize long-term health and performance.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"22 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247717","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":"Prerequisites and barriers to telerehabilitation in patients with neurological conditions: A narrative review.","authors":"Yeşim Kurtaiş Aytür","doi":"10.3233/nre-240092","DOIUrl":"https://doi.org/10.3233/nre-240092","url":null,"abstract":"BACKGROUNDA field of study that uses telerehabilitation (TR) is neurorehabilitation; however, standards for medical and technological applications, medicolegal and ethical regulations, and other aspects of neuro-TR are still being developed.OBJECTIVETo address the prerequisites and barriers for implementing TR in neurorehabilitation in the light of present findings.METHODSA narrative review was conducted based on specific questions about the prerequisites for neuro-TR and barriers to its implication. According to a foreground search strategy in the context of neurorehabilitation using TR in neurological patient population, PubMed, EMBASE and Cochrane databases were searched and reviewed.RESULTSBarriers and prerequisites for neuro-TR were mostly grouped under the categories of administrative/organizational, human (beneficiaries/providers), technical, and ethical. Apart from the technical framework, knowledge and the presence of an administrative leader responsible for overseeing TR are crucial prerequisites. The internet and technological constraints rank highest among the barriers.CONCLUSIONSince neuro-TR is relatively new with minimal guidelines and regulations, highly technologic, and lack of established practices, it is imperative to determine and fully comprehend the criteria for its uses. After the prerequisites are established, it is imperative to recognize and address implementation constraints, which may differ depending on the community's infrastructure and neurologic condition.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"38 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247718","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":"Video-Based Directly Observed Therapy (ViDOT) as a strategic tool to improve medication adherence in epilepsy: A narrative review.","authors":"Paul Olowoyo, Olabode Oguntiloye, Luqman Ogunjimi, Olaleye Adeniji, Segun Atolani, Olumuyiwa Ariyo, Mayowa Owolabi","doi":"10.3233/NRE-240080","DOIUrl":"https://doi.org/10.3233/NRE-240080","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.</p><p><strong>Objective: </strong>We performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.</p><p><strong>Methods: </strong>The selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.</p><p><strong>Results: </strong>The review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.</p><p><strong>Conclusion: </strong>Giving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036558","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":"Telerehabilitation - historical perspectives and conceptual framework in reference to neurological disorders: A narrative review.","authors":"Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi","doi":"10.3233/NRE-240079","DOIUrl":"https://doi.org/10.3233/NRE-240079","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems.</p><p><strong>Objective: </strong>To review the historical perspective and conceptual framework of telerehabilitation in neurological disorders.</p><p><strong>Methods: </strong>A narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024).</p><p><strong>Results: </strong>Telerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users.</p><p><strong>Conclusion: </strong>The future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601186","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 effects of visual information deprivation and feedback balance training on balance in patients with stroke","authors":"Taewoong Jeong, Yijung Chung","doi":"10.3233/nre-230358","DOIUrl":"https://doi.org/10.3233/nre-230358","url":null,"abstract":"BACKGROUND:\u0000Patients with stroke depend on visual information due to balance deficits. Therefore, it is believed that appropriate visual deprivation training could have an impact on improving balance abilities. OBJECTIVE:\u0000The purpose of this study was to compare the effects of balance training performed in visual deprivation and feedback conditions on balance in stroke survivors. METHODS:\u0000The 39 participants were randomly assigned to either the Visual Deprivation Group (VDG; n = 13), the Visual Feedback Group (VFG; n = 13), or the Control Group (CG; n = 13). The training sessions were conducted five times a week for three weeks. Participants completed the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Four Square Step Test (FSST), and Limit of Stability (LOS) assessments. RESULTS:\u0000The VDG showed significant improvements in BBS, FSST, TUG, and LOS. In VFG, significant improvements were observed in BBS and TUG. There were statistically significant differences among the groups in all variables related to balance. CONCLUSION:\u0000The results of this study suggest that balance training under visual deprivation is effective in improving static and dynamic balance and gait in patients with stroke. In other words, patients with stroke need to reduce their over-reliance on visual information.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"207 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140593290","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":"Musculoskeletal morbidity in adults with spinal cord injuries: A nationwide cohort study","authors":"Youngoh Bae, Hohyun Jung, Nakyung Shin, Masoud Rahmati, Raphael Udeh, Abdolreza Kazemi, Yusheng Li, Marco Solmi, Muhammad Syafrudin, Norma Latif Fitriyani, Guillaume Fond, Laurent Boyer, Seung Won Lee","doi":"10.3233/nre-230263","DOIUrl":"https://doi.org/10.3233/nre-230263","url":null,"abstract":"BACKGROUND:An increase in the demand for quality of life following spinal cord injuries (SCIs) is associated with an increase in musculoskeletal (MSK) pain, highlighting the need for preventive measure research. OBJECTIVE:This study aimed to evaluate the incidence and hazards of MSK morbidities among Korean adults with SCIs, as well as the influence of SCI location on MSK morbidities. METHODS:Patient populations were selected from Korean National Health Insurance Service data (n = 276). The control group included individuals without SCIs (n = 10,000). We compared the incidences and determined the unadjusted and adjusted hazard ratios (HRs) of common MSK morbidities (osteoarthritis, connective tissue disorders, sarcopenia, myalgia, neuralgia, rheumatoid arthritis, myositis, and musculoskeletal infections) based on the location of injury (cervical, thoracic, or lumbar). RESULTS:Adults with SCIs had a higher incidence of MSK morbidity (48.45% vs. 36.6%) and a lower survival probability than those without SCIs. The incidence of MSK morbidity and survival probabilities were not significantly different for cervical cord injuries, whereas both measures were significantly different for thoracic and lumbar injuries. CONCLUSION:SCI increases the risk of MSK morbidity. Lumbar SCI is associated with a higher incidence and risk of MSK morbidity than are cervical or thoracic SCIs.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"21 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140799133","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}