Physical Therapy最新文献

{"title":"Shared Decision-Making in Physical Therapist Care for People With Shoulder Problems: An Observer-Based Analysis of Audio-Recorded Consultations.","authors":"Sijmen Hacquebord, Henri Kiers, Philip van der Wees, Thomas J Hoogeboom","doi":"10.1093/ptj/pzaf047","DOIUrl":"10.1093/ptj/pzaf047","url":null,"abstract":"<p><strong>Objective: </strong>Despite the substantial diagnostic and therapeutic uncertainties in the decision-making process, it remains largely unclear to what extent shared decision-making (SDM) is applied in physical therapist care for people with shoulder problems. The purpose of our study was to determine to what extent SDM is part of the decision-making process in initial physical therapist consultations of people with shoulder problems and to identify factors associated with the level of SDM.</p><p><strong>Methods: </strong>In this cross-sectional study, the level of SDM was measured by assessing audio-recorded initial physical therapist consultations of people with shoulder problems using the 5-item Observing Patient Involvement in SDM tool (OPTION-5; 0-100, higher OPTION scores indicate higher level of SDM). Associations between the level of SDM and the characteristics of patients, physical therapists, and consultations were assessed using multilevel analysis.</p><p><strong>Results: </strong>A total of 100 initial physical therapist consultations of 41 participating physical therapists were included. The mean OPTION-5 score was 27 (range = 5-70). On none of the individual items of the OPTION-5, the highest score \"exemplar effort\" was observed. The multilevel analysis showed that 3 determinants were associated with higher level of SDM: younger age of the patient (b = -1.8; 95% CI = -3.1 to -0.4), longer duration of the consultation (b = 5.5; 95% CI = 2.7 to 8.3), and higher level of education of the physical therapist (b = 9.1; 95% CI = 2.7 to 15.4).</p><p><strong>Conclusions: </strong>The level of SDM in daily physical therapist practice for people with shoulder problems leaves room for improvement. Future research should focus on strategies to improve the application of SDM in physical therapist care for people with shoulder problems. The determinants such as duration of the consultation, and the level of education of the physical therapist might provide guidance in developing these strategies for improving the application of SDM.</p><p><strong>Impact: </strong>The findings of this study give insight into the limited application of SDM in physical therapy for people with shoulder problems. Duration of the consultations and level of education of the physical therapist impact the level of SDM.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response to Luo and He.","authors":"Leonardo Avila, Morgana Duarte da Silva, Marcos Lisboa Neves, Andre Rogerio Abreu, Cibelle Ramos Fiuza, Leandro Fukusawa, Arthur de Sá Ferreira, Ney Meziat-Filho","doi":"10.1093/ptj/pzaf056","DOIUrl":"10.1093/ptj/pzaf056","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006762","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":"Intrarater and Interrater Reliability and Concurrent Validity of the 3-Meter Backward Walk Test in Non-frail, Pre-frail, and Frail Older Adults in Residential Care Homes.","authors":"Ali Kapan, Milos Ristic, Andreas Konrad, Thomas Waldhoer","doi":"10.1093/ptj/pzaf066","DOIUrl":"10.1093/ptj/pzaf066","url":null,"abstract":"<p><strong>Importance: </strong>Assessing backward walking ability in older adults is crucial due to its strong association with balance, mobility, and fall risk. The 3-meter backward walk test (3MBWT) provides a quick and valid tool for this purpose.</p><p><strong>Objective: </strong>The objective of this study was to assess the reliability and validity of the 3MBWT and to determine its effectiveness in differentiating between different levels of frailty.</p><p><strong>Design: </strong>This study used a cross-section design.</p><p><strong>Setting: </strong>The study was carried out in residential care homes for older adults.</p><p><strong>Participants: </strong>Participants were able to walk with or without assistance and were excluded if they had a Mini-Mental State Examination score ≤ 17.</p><p><strong>Interventions: </strong>Participants underwent the 3MBWT and the 10-meter walk test (10MWT). In addition, the Short Physical Performance Battery (SPPB) was administered.</p><p><strong>Main outcome(s) and measure(s): </strong>Frailty was assessed using the SHARE-FI instrument, with participants classified as non-frail, pre-frail, or frail. Reliability of the 3MBWT was assessed using intraclass correlation coefficient (ICC [3,1]), and concurrent validity was assessed using the 10MWT and SPPB. Fall history over the past year was obtained from medical records and participant interviews.</p><p><strong>Results: </strong>Participants (n = 217) were categorized as non-frail (27%), pre-frail (31%), or frail (42%). The average 3MBWT times were 5.0, 5.9, and 11.8 seconds for participants who were non-frail, pre-frail, and frail, respectively. The 3MBWT showed good to excellent intrarater reliability (ICC = 0.89-0.93) and excellent interrater reliability (ICC = 0.90-0.99). It showed strong correlations with the 10MWT (r = 0.91) and SPPB walking speed (r = 0.94), and a negative correlation with the SPPB total score (r = -0.86). Moderate correlations were found with the Falls Efficacy Scale International (r = 0.71) and Multidimensional Fatigue Inventory (r = 0.61), and a high correlation with falls in the last 12 months (r = 0.74).</p><p><strong>Conclusions: </strong>The 3MBWT is a reliable tool for assessing physical performance and differentiating levels of frailty in older adults, with a strong association with fall history.</p><p><strong>Relevance: </strong>The 3MBWT offers clinicians a quick, simple, and valid tool for assessing older adults in residential care.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivation Matters: Elucidating Factors Driving Exercise in People With Parkinson Disease.","authors":"Caro I Cools, Sonja A Kotz, Bastiaan R Bloem, Annelien A Duits, Nienke M de Vries","doi":"10.1093/ptj/pzaf048","DOIUrl":"10.1093/ptj/pzaf048","url":null,"abstract":"<p><strong>Objective: </strong>Despite the known benefits of exercise for people with Parkinson disease (PwP), activity levels are not sustained over time due to various motivators and barriers impacting exercise adherence. Previously, studies on exercise adherence in PwP explored such barriers without describing or providing specific questions related to the determinants of motivation. Exercise adherence in PwP can be improved by addressing 3 key perspectives on motivation: personal factors (age, sex, premorbid motivation level, time when PwP started exercising, exercise before diagnosis, self-compassion), disease-related factors (perceived disease severity, depression score), and environmental factors (distance to exercise therapy, weather conditions, encouragement received from partners).</p><p><strong>Methods: </strong>Six hundred seventy-two PwP from the Netherlands participated in an online survey that comprised questionnaires on demographics, depression, self-compassion, perceived disease severity, and additional questions on sports, motivation, and barriers related to sports. A multiple regression analysis was applied with current motivation as an outcome measure, and age, sex, perceived disease severity, premorbid motivation, depression, self-compassion, age starting exercising, and exercise before diagnosis as determinants.</p><p><strong>Results: </strong>The results revealed that current motivation levels to exercise are associated with higher levels of premorbid motivation (b = 0.14), greater self-compassion (b = 0.32), lower age (b = -0.03), lower perceived disease severity (b = -0.10), and lesser degrees of depression (b = -0.10). Barriers stopping PwP from exercising were fatigue, weather conditions, and having less energy for other activities after exercising.</p><p><strong>Conclusion: </strong>Understanding these motivational factors and barriers helps shape and promote better exercise adherence and thereby ascertain greater symptomatic benefits for PwP.</p><p><strong>Impact: </strong>This study outcome gives health care professionals insight into determinants of motivation and exercise adherence, which will help enabling tailored approaches for improved engagement.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines: Present, Past, and Future.","authors":"Philip J van der Wees","doi":"10.1093/ptj/pzaf072","DOIUrl":"https://doi.org/10.1093/ptj/pzaf072","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529276","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":"Transforming Care: Implications of Glucagon Like Peptide-1 Receptor Agonists on Physical Therapist Practice.","authors":"Julie Mulcahy, Anna DeLaRosby, Todd Norwood","doi":"10.1093/ptj/pzaf061","DOIUrl":"10.1093/ptj/pzaf061","url":null,"abstract":"<p><p>The goal of this perspective is to bring awareness to the prevalence of glucagon-like peptide 1 receptor agonist (GLP-1 agonist) use, medication side effects, intervention considerations, and the role of the physical therapist in supporting their patients in their health journey when taking these medications. Management of obesity and diabetes is undergoing significant change with the increasing prevalence of GLP-1 agonist medications. This class of medications, which 1-in-8 adults in the United States report having taken, is becoming a critical component of obesity management, affecting the physiology and psychology of weight loss in novel ways. Due to the prevalence of musculoskeletal conditions in patients with diabetes and obesity, physical therapists can play a crucial role in the comprehensive care of patients on GLP-1 agonist therapy. This perspective explores the practice implications for managing patients living with obesity and/or diabetes who are taking GLP-1 agonists by describing the impact of GLP-1 agonists; the challenges of GLP-1 agonist use; and the considerations for recommending physical activity to patients using these medications. Physical therapists are well equipped to assist this population of patients by implementing strategies that enhance mobility, alleviate pain, prevent injury, mitigate lean muscle mass loss, and promote metabolic health, while adapting to the evolution of health and function patients experience while on GLP-1 agonist medications. As use of these drugs is expected to expand to other health conditions, there is a pressing need for physical therapists to adapt their practices to support the long-term health goals of their patients and ensure optimal patient outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Whole-Body Vibration Therapy on Physical Function in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Chi-Hung Huang, Chi-Ying Chen, Ho-Wei Lin, Yu-Fen Chiu, Li-Fong Lin, Ka-Wai Tam, Tung-Wu Lu, Shih-Wen Chiang, Yi-Chun Kuan","doi":"10.1093/ptj/pzaf052","DOIUrl":"10.1093/ptj/pzaf052","url":null,"abstract":"<p><strong>Objective: </strong>Although whole-body vibration (WBV) is often employed alongside traditional physical therapies to treat cerebral palsy, its effects on motor function remain unclear. Therefore, this study investigated the effects of WBV either alone or in combination with other therapies in children with cerebral palsy, compared with control groups that underwent traditional physical therapy or remained untreated.</p><p><strong>Methods: </strong>We analyzed randomized controlled trials published up to September 2024 that assessed motor function in WBV and control groups, including those receiving conventional physical therapy or no intervention. Articles were retrieved from PubMed, EMBASE, Scopus, and the Cochrane Library. The random-effects model was used to analyze the outcomes of these trials.</p><p><strong>Results: </strong>Our search yielded 23 studies involving 729 participants. Compared with the control group, the WBV group exhibited significantly greater improvements in walking speed (pooled mean difference: 14.26 cm/s [95% CI = 6.45 to 22.08 cm/s]), Timed \"Up & Go\" test (TUG) results (pooled mean difference = -2.52 seconds [95% CI = -3.66 to -1.37 seconds]), Gross Motor Function Measure scores (total score: pooled mean difference = 0.69 [95% CI = 0.30 to 1.08]; dimension D: pooled mean difference = 3.41 [95% CI = 0.53 to 6.29]; dimension E: pooled mean difference = 3.28 [95% CI = 1.36 to 5.20]), and overall stability index values (standardized mean difference = -1.20 [95% CI = -2.28 to -0.11]). The Modified Ashworth Scale results varied between the muscle groups, and no intolerable adverse effects of WBV were reported.</p><p><strong>Conclusion: </strong>WBV improves postural control and motor performance in children with cerebral palsy by enhancing walking speed, TUG performance, and gross motor function without causing intolerable adverse effects. However, the certainty of the current evidence on the topic is very low or low. Additional well-structured trials are required to determine the optimal intensity of WBV treatment.</p><p><strong>Impact: </strong>Given its therapeutic benefits and safety, WBV may be considered as an adjunctive therapy for managing cerebral palsy, particularly for children with spastic cerebral palsy.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037878","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":"Meeting Physical Activity Guidelines for Persons With Multiple Sclerosis Reduces Fatigue Severity and Impact: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Libak Abou, Tanner Murphy, Ethan Truong, Joseph Peters","doi":"10.1093/ptj/pzaf046","DOIUrl":"10.1093/ptj/pzaf046","url":null,"abstract":"<p><strong>Objective: </strong>Regular physical activity is a recommended behavioral goal for persons with multiple sclerosis. This review aimed to determine the effect of interventions that met physical activity guidelines for persons with multiple sclerosis on fatigue measures and to compare the magnitudes of the effect sizes for meeting these guidelines with the minimal clinically important differences for fatigue measures.</p><p><strong>Methods: </strong>The search was conducted in PubMed, Embase, Web of Science, SPORTDiscus, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO from inception to October 2024. Only randomized clinical trials that explicitly met physical activity guidelines and evaluated fatigue were included. Two independent reviewers screened articles for inclusion and evaluated the risk of bias of included trials using the Cochrane risk-of-bias tool for randomized trials. Findings were summarized, and a meta-analysis was conducted. Fatigue measures included the Fatigue Severity Scale, Fatigue Impact Scale, and modified Fatigue Impact Scale. The Grading of Recommendations, Assessment, Development and Evaluation was used to evaluate the quality of the evidence. The review protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42023387305).</p><p><strong>Results: </strong>Twenty-two randomized clinical trials with 920 participants were included in the review; 17 studies were included in the meta-analysis. Findings indicated that interventions meeting physical activity guidelines for at least 4 weeks significantly reduced fatigue severity (standardized mean difference = -1.46; 95% CI = -2.11 to -0.81) and fatigue impact measured with the modified Fatigue Impact Scale (mean difference = -11.88; 95% CI = -20.57 to -3.19) and Fatigue Impact Scale (mean difference = -21.08; 95% CI = -31.01 to -11.15). All findings were clinically relevant, with effect sizes exceeding the established minimal clinically important differences for the fatigue measures. Some methodological concerns were noted, and the evidence level ranged from very low to moderate.</p><p><strong>Conclusions: </strong>Evidence suggests that engaging in physical activity for at least 150 minutes per week or 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week results in clinically significant reductions in fatigue severity and impact necessary to improve the quality of life of persons with multiple sclerosis.</p><p><strong>Impact: </strong>Fatigue is a highly prevalent symptom associated with poor outcomes, including falls, activity restrictions, pain, cognitive problems, functional limitations, and mortality risk among persons with multiple sclerosis. Our study suggests that adhering to physical activity guidelines developed for persons with multiple sclerosis clinically reduces the severity a","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Dose of Aerobic Exercise Programs to Reduce Pain Intensity and Improve Health Status in Patients With Fibromyalgia: A Dose-Response Meta-Analysis.","authors":"Rodrigo Núñez-Cortés, Luis Suso-Martí, Javier Almonacid-Lleida, Joaquín Salazar-Méndez, Rubén López-Bueno, Carlos Cruz-Montecinos, Lars L Andersen, Robinson Ramírez-Vélez, Joaquín Calatayud","doi":"10.1093/ptj/pzaf057","DOIUrl":"10.1093/ptj/pzaf057","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia.</p><p><strong>Data sources: </strong>Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024.</p><p><strong>Study selection: </strong>Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included.</p><p><strong>Data extraction: </strong>Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model.</p><p><strong>Data synthesis: </strong>Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = -0.67; 95% CI = -0.70 to -0.65) and a total duration of 600 min (SMD = -0.65; 95% CI = -0.69 to -0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = -1.14; 95% CI = -1.19 to -1.09) and 1200 min total duration (SMD = -1.08; 95%CI = -1.13 to -1.02). Additionally, a minimum dose of 65 min per week (SMD = -0.62; 95% CI = -0.6 to -0.69) and a total duration of 950 min (SMD = -0.61; 95% CI = -0.60 to -0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = -1.77; 95% CI = -1.89 to -1.65) and 3000 min of total duration (SMD = -1.43; 95% CI = -1.54 to -1.31).</p><p><strong>Conclusion: </strong>These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009829","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":"Author Response to Kleebayoon and Wiwanitkit.","authors":"Yoav Gimmon, Yael Arbel, Liora Shmueli","doi":"10.1093/ptj/pzaf054","DOIUrl":"10.1093/ptj/pzaf054","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}