Douglas Creighton, David Fausone, Brian Swanson, William Young, Spencer Nolff, Amanda Ruble, Noraan Hassan, Emily Soley
{"title":"Myofascial and discogenic origins of lumbar pain: A critical review.","authors":"Douglas Creighton, David Fausone, Brian Swanson, William Young, Spencer Nolff, Amanda Ruble, Noraan Hassan, Emily Soley","doi":"10.1080/10669817.2023.2237739","DOIUrl":"10.1080/10669817.2023.2237739","url":null,"abstract":"<p><p>The purpose of this three-part narrative review is to examine the anatomy of, and the research which supports, either the lumbar myofascia or intervertebral disc (IVD) as principal sources of our patient's low back pain. A comprehensive understanding of anatomical lumbar pain generators in combination with the current treatment-based classification system will further improve and enhance clinical decision-making skills. Section I reviews the anatomy of the spinal myofascia, myofascial sources of lumbar pain, and imaging of myofascial tissues. Part II reviews the anatomy of the IVD, examines the IVD as a potential lumbar pain generator, and includes detailed discussion on Nerve Growth Factor, Inflammatory Cytokines, Vertebral End Plates and Modic change, Annular tears, and Discogenic instability. Part III looks at the history of myofascial pain, lab-based research and myofascial pain, and various levels of discogenic pain provocation research including animal, laboratory and human subjects. Our review concludes with author recommendations on developing a comprehensive understanding of altered stress concentrations affecting the posterior annulus fibrosis, neo-innervation of the IVD, inflammatory cytokines, discogenic instability, and how this knowledge can complement use of the Treatment-Based Classification System.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"435-448"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9986516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Journal of Manual and Manipulative Therapy now has a Clarivate impact factor and is ranked Q2 in Physical Therapy, Sports Therapy, and Rehabilitation Journals.","authors":"Jean-Michel Brismée","doi":"10.1080/10669817.2023.2275388","DOIUrl":"10.1080/10669817.2023.2275388","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":"31 6","pages":"391-392"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaitlin Kirker, Melanie O'Connell, Lisa Bradley, Rosa Elena Torres-Panchame, Michael Masaracchio
{"title":"Manual therapy and exercise for adhesive capsulitis: a systematic review with meta-analysis.","authors":"Kaitlin Kirker, Melanie O'Connell, Lisa Bradley, Rosa Elena Torres-Panchame, Michael Masaracchio","doi":"10.1080/10669817.2023.2180702","DOIUrl":"10.1080/10669817.2023.2180702","url":null,"abstract":"<p><strong>Background: </strong>Adhesive capsulitis (AC) affects approximately 1% of the general population. Current research lacks clear guidance on the dosage of manual therapy and exercise interventions.</p><p><strong>Objective: </strong>The purpose of this systematic review was to assess the effectiveness of manual therapy and exercise in the management of AC, with a secondary aim of describing the available literature present on the dosage of interventions.</p><p><strong>Methods: </strong>Eligible studies were randomized clinical/quasi-experimental trials with complete data analysis and no limits on date of publication, published in English, recruited participants >18 years of age with primary adhesive capsulitis, that had at least two groups with one group receiving manual therapy (MT) alone, exercise alone, or MT and exercise, that included at least one outcome measure of pain, disability, or external rotation range of motion, and that had dosage of visits clearly defined. An electronic search was conducted using PubMed, Embase, Cochrane, Pedro, and clinicaltrials.gov. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 Tool. The Grading of Recommendations Assessment, Development, and Evaluation was used to provide an overall assessment of the quality of evidence. Meta-analyses were conducted when possible, and dosage was discussed in narrative form.</p><p><strong>Results: </strong>Sixteen studies were included. All meta-analyses revealed non-significant effects of pain, disability, and external rotation range of motion at short- and long-term follow-up, with an overall level of evidence ranging from very low to low.</p><p><strong>Conclusion: </strong>Non-significant findings with low-to-very-low-quality of evidence were found across meta-analyses, preventing seamless transition of research evidence to clinical practice. Lack of consistency in study designs, manual therapy techniques, dosing parameters, and duration of care impedes the ability to make strong recommendations regarding optimal dosage of physical therapy for individuals with AC.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"311-327"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10819163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sinikka Kilpikoski, Eetu N Suominen, Jussi P Repo, Arja H Häkkinen, Kati Kyrölä, Hannu Kautiainen, Jari Ylinen
{"title":"Comparison of magnetic resonance imaging findings among sciatica patients classified as centralizers or non-centralizers.","authors":"Sinikka Kilpikoski, Eetu N Suominen, Jussi P Repo, Arja H Häkkinen, Kati Kyrölä, Hannu Kautiainen, Jari Ylinen","doi":"10.1080/10669817.2023.2174555","DOIUrl":"10.1080/10669817.2023.2174555","url":null,"abstract":"<p><strong>Objective: </strong>To compare if the degenerative findings from MRI differ between the sciatica patients classified as centralizers (CEN) and non-centralizers (Non-CEN) according to the McKenzie Method of mechanical diagnosis and therapy.</p><p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>Patients (<i>N</i> = 100) referred to a spine clinic of a single tertiary hospital for specialist consultation for sciatica. The McKenzie-based assessment was performed by the mechanical diagnosis and therapy-trained physiotherapists. Clinical data and prevalence of lumbar MRI findings were compared between the groups.</p><p><strong>Results: </strong>There was no significant difference in leg pain intensity between the groups. The Non-CEN had significantly more intense back pain, mean 56 (SD 30) and were more disabled 44 (SD 15) compared to the CEN mean 41 (SD 25) and mean 31 (11), measured with a visual analogue scale (0-100), and the Oswestry Disability Index (0-100), respectively. The CEN had more severe degenerative findings on MRI than the Non-CEN: vertebral end-plate changes were 63% and 43%; mean Pfirrmann's disc degeneration lumbar summary score was 12.8, and 10.6; and severity score of total damage was 12.0 and 10.1, respectively. There were differences neither in disc contour changes nor nerve root stenosis on MRI.</p><p><strong>Conclusions: </strong>Sciatica patients classified as non-centralizers had significantly more severe back pain, and were significantly more disabled than centralizers, who instead had more severe degenerative findings on MRI. Thus, classification to non-centralizers by the McKenzie method seems not predict higher incidence of degenerative findings on MRI compared to centralizers.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"358-367"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9229206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Regional vs global physical therapy interventions to treat chronic pain in survivors of trauma: a randomized controlled trial.","authors":"Justine McCuen Dee, Benjamin Littenberg","doi":"10.1080/10669817.2022.2159615","DOIUrl":"10.1080/10669817.2022.2159615","url":null,"abstract":"<p><strong>Background: </strong>A history of traumatic life events is associated with chronic pain in later life. Physical therapists utilize a variety of methods to treat pain, however, they have struggled to find effective interventions to improve patient outcomes.</p><p><strong>Objective: </strong>To compare impairment-based, regional (REGION-PT) physical therapy (PT) to a global (GLOBAL-PT) model consisting of pain neuroscience education, graded motor imagery, and exercise for adults with chronic pain and history of trauma.</p><p><strong>Design: </strong>Randomized Controlled Trial.</p><p><strong>Methods: </strong>Adults ≥ 18 years of age with chronic pain and a history of ≥1 trauma identified through the Life Events Checklist received the allocated intervention once a week for six weeks. Treatment effects were assessed using linear mixed models.</p><p><strong>Results: </strong>Ninety-eight participants completed the trial. There were no difference in outcomes between groups. There were significant interactions between race and intervention. Both interventions were associated with improvements in pain interference for white participants, but non-white participants experienced improvement only with GLOBAL-PT. Regardless of allocation, participants improved in physical function, six of the PROMIS-29 domains, and in pain interference measures.</p><p><strong>Conclusion: </strong>Both interventions are reasonable strategies for individuals with chronic pain and a history of trauma.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"328-339"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10780053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony Baumann, Robert J Trager, Deven Curtis, Mingda Chen, Keith Baldwin
{"title":"Screening for Vertebrobasilar pathology and upper cervical instability by physical therapists treating neck pain: a retrospective chart review.","authors":"Anthony Baumann, Robert J Trager, Deven Curtis, Mingda Chen, Keith Baldwin","doi":"10.1080/10669817.2023.2192998","DOIUrl":"10.1080/10669817.2023.2192998","url":null,"abstract":"<p><strong>Introduction: </strong>Vertebrobasilar vascular pathology and upper cervical ligament instability may contraindicate the use of cervical manual therapy. We examined physical therapists' documentation of screening for these conditions and hypothesized screening would be more common with specific risk factors and when using manual therapy.</p><p><strong>Methods: </strong>This chart review included adults with neck pain presenting for outpatient physical therapy from 2015-2021. Exclusions were age<18 and history of cervical spine surgery. Demographics, vertebrobasilar and upper cervical ligament instability screening questions and examination tests, risk factors (i.e. hypertension, whiplash), and use of manual therapy were extracted.</p><p><strong>Results: </strong>260 patients were included (mean age ± standard deviation 59.6 ± 16.2 years, 70.8% female). Physical therapists infrequently administered vertebrobasilar and upper cervical ligament instability tests (each<14%). Screening questions were generally more common (e.g. headache, visual disturbances; each>13%). There was no significant difference in any frequency of screening method given the presence of hypertension, whiplash, or use of manual therapy (<i>p</i> > .05 for each).</p><p><strong>Conclusion: </strong>In the present study, physical therapists infrequently documented performance of vertebrobasilar or upper cervical ligament instability screening for adults with neck pain, even in the presence of risk factors or preceding manual therapy. Further research should corroborate these findings and explore reasons for use/avoidance of screening.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"376-382"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9201584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kerstin Luedtke, Luisa Luebke, Ignacio Elizagaray-Garcia, Oskar Schindler, Tibor M Szikszay
{"title":"Effectiveness of online teaching during the COVID-19 pandemic on practical manual therapy skills of undergraduate physiotherapy students.","authors":"Kerstin Luedtke, Luisa Luebke, Ignacio Elizagaray-Garcia, Oskar Schindler, Tibor M Szikszay","doi":"10.1080/10669817.2023.2179285","DOIUrl":"10.1080/10669817.2023.2179285","url":null,"abstract":"<p><strong>Objectives: </strong>This study includes two separate parts: the objective for part A was to evaluate the practical manual therapy skills of undergraduate physiotherapy students who had learned manual therapy techniques either online or in classroom depending on the phases of the pandemic. The objective for part B was to evaluate in a randomized prospective design the effectiveness of video-based versus traditional teaching of a manual therapy technique.</p><p><strong>Design: </strong>Cross-sectional cohort study (part A) and randomized controlled trial (part B).</p><p><strong>Setting: </strong>University of Luebeck, undergraduate physiotherapy students in years 1-3.</p><p><strong>Method: </strong>In part A, physiotherapy students who had learned manual therapy either online (during the pandemic) or in classroom (prior to and after the lock down periods of the pandemic) were videotaped while performing two manual techniques on the knee joint and on the lumbar spine. Recordings were analyzed independently by two blinded raters according to a 10-item list of criteria. Inter-rater reliability was assessed using Cohen's kappa for each item. Performance across cohorts was analyzed using analysis of variance. In part B, students were randomized to learn a new technique on the cervical spine either from a lecturer or from the same lecturer on a video recording (independent variable). Practical performance of the technique was analyzed by two raters blinded to group allocation according to a 10-item list of criteria (dependent variable). Results were analyzed statistically by using ANCOVA with year of study as a covariate.</p><p><strong>Results: </strong>Sixty-three and 56 students participated in part A and part B of the study, respectively. The inter-rater reliability for video analyses for both parts of the study was moderate (k = 0.402 to 0.441). In part A, there was no statistically significant difference across years of study for the practical performance of the technique on the back F(2,59) = 2.271; <i>p</i> = 0.112 or the knee joint F(2,59) = 3.028; <i>p</i> = 0.056. In part B, performance was significantly better when learned from a lecturer and practiced on a peer than when learned from a video and practiced on a rescue dummy (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Practical skill performance can be acquired from videos but immediate skill reproduction is significantly better when the technique is presented by a lecturer in classroom and practiced on peer students.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"349-357"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design.","authors":"Hiroshi Takasaki, Chisato Yamasaki","doi":"10.1080/10669817.2023.2201918","DOIUrl":"10.1080/10669817.2023.2201918","url":null,"abstract":"<p><strong>Background: </strong>Selective deep neck flexor muscle activation through craniocervical flexion exercises has been considered to be different from cervical retraction exercises.</p><p><strong>Objective: </strong>To compare the immediate analgesic effect of craniocervical flexion versus cervical retraction exercises in individuals with nonacute, directional preference (DP) for cervical retraction or extension.</p><p><strong>Methods: </strong>A two-arm, assessor-blinded, pretest-posttest randomized experiment was conducted. Participants were randomly assigned to either craniocervical flexion or cervical retraction exercises and those who were confirmed at the post-intervention examination to have a DP for cervical retraction or extension were analyzed. The primary outcome measure was pressure pain thresholds at the C2 and C5-C6 levels.</p><p><strong>Results: </strong>A total of 10 (mean age = 20.6 years) and nine participants (mean age = 19.4 years) undertook craniocervical flexion and retraction exercises, respectively. One-way analysis of variance demonstrated no statistically significant (<i>p</i> > 0.05) interaction effect regardless of the neck level. In the pre-post change percentages, retraction exercises provided greater analgesic effects compared to craniocervical flexion exercises at the C2 (Hedges' g = 0.679) and C5-C6 levels (g = 0.637).</p><p><strong>Conclusion: </strong>This study showed a comparable or greater immediate neck analgesic effect from cervical retraction exercises compared to craniocervical flexion exercises in individuals with a DP for cervical retraction or extension.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"368-375"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9343342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher K Wong, Gregory A Youdan, Stanford T Chihuri
{"title":"Beyond exercise. Can application of manual therapy before exercise benefit a low functioning person with limb loss? A case study.","authors":"Christopher K Wong, Gregory A Youdan, Stanford T Chihuri","doi":"10.1080/10669817.2023.2192650","DOIUrl":"10.1080/10669817.2023.2192650","url":null,"abstract":"<p><strong>Background: </strong>Most people with lower-limb loss (PLL) have musculoskeletal conditions and range-of-motion and muscle performance impairments. Such impairments limit potential for functional movement but can be reduced with manual therapy. Manual therapy, however, is rarely used for PLL. This case demonstrated how integrating manual therapy, exercise, and functional training led to lasting benefits for one low functioning PLL.</p><p><strong>Case description: </strong>A 54-year-old woman more than 1 year after transtibial amputation due to peripheral artery disease presented with multiple comorbidities and yellow flags. Her function remained limited to the Medicare K-1 household walking level with slow gait speed <0.25 m/s. Treatment included four weekly sessions each beginning with manual therapy, followed by exercise and functional training.</p><p><strong>Outcomes: </strong>After 1 month, performance-based strength, balance, walking speed, and physical activity increased. She advanced to the K-2 limited community walking level and maintained her functional level without further treatment after 3 months.</p><p><strong>Discussion: </strong>Improvements maintained without treatment expanded upon research that lacked follow-up and excluded K-1 level walkers. Marked improvement after only four sessions was noteworthy since exercise protocols require ≥4 sessions.</p><p><strong>Conclusion: </strong>Manual therapy followed by exercise and functional training may optimize movement potential and contribute to improving strength, balance, gait, and physical activity among PLL.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"383-389"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9147991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saurab Sharma, Arianne P Verhagen, Mark Elkins, Jean-Michel Brismée, George D Fulk, Jakub Taradaj, Lois Steen, Alan Jette, Ann Moore, Aimee Stewart, Barbara J Hoogenboom, Anne Söderlund, Michele Harms, Rafael Zambelli Pinto
{"title":"Research from low-income and middle-income countries will benefit global health and the physiotherapy profession, but it requires support.","authors":"Saurab Sharma, Arianne P Verhagen, Mark Elkins, Jean-Michel Brismée, George D Fulk, Jakub Taradaj, Lois Steen, Alan Jette, Ann Moore, Aimee Stewart, Barbara J Hoogenboom, Anne Söderlund, Michele Harms, Rafael Zambelli Pinto","doi":"10.1080/10669817.2023.2253071","DOIUrl":"10.1080/10669817.2023.2253071","url":null,"abstract":"School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; International Society of Physiotherapy Journal Editors Australia; Journal of Physiotherapy Australia; Journal of Manual and Manipulative Therapy USA; Journal of Neurologic Physical Therapy USA; Physiotherapy Review Poland; Fysioterapi (Swedish Physiotherapy Journal) Sweden; PTJ: Physical Therapy & Rehabilitation Journal USA; Musculoskeletal Science & Practice UK; South African Journal of Physiotherapy South Africa; International Journal of Sports Physical Therapy USA; European Journal of Physiotherapy UK; Physiotherapy UK; International Society of Physiotherapy Journal Editors and Brazilian Journal of Physical Therapy Brazil","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"305-310"},"PeriodicalIF":2.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/38/YJMT_31_2253071.PMC10566383.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}