Journal of Neurologic Physical Therapy最新文献

{"title":"A New Protocol for Evaluating Maximum Respiratory Pressures in Individuals With Multiple Sclerosis: Concurrent Validity and Test-Retest Reliability.","authors":"Raúl Fabero-Garrido, Sandra Aguilar-Zafra, Tamara Del Corral, Ibai López-de-Uralde-Villanueva","doi":"10.1097/NPT.0000000000000586","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000586","url":null,"abstract":"<p><strong>Background and purpose: </strong>There is a need for new and inexpensive methods for the maximum inspiratory and expiratory pressures (MIP/MEP) test. The one-repetition maximum (1RM) test is an easy and cost-effective method to measure maximal strength. The purpose of this study was to validate a MIP/MEP test protocol based on the 1RM test, its test-retest reliability, and minimal detectable change (MDC) in individuals with multiple sclerosis.</p><p><strong>Methods: </strong>Fifty-two individuals (53.6 ± 10 years; 5.7 ± 1.8 points on Expanded Disability Status Scale) (46% relapsing-remitting; 23% primary progressive; 31% secondary progressive) attended two appointments 7 to 10 days apart. MIP/MEP tests were performed using a threshold valve device (1RM-based protocol) and a digital manometer (reference test). The 1RM-based protocol included an incremental phase (load increase [30 cmH2O] to achieve task failure) and a halving phase (load halfway between the lowest failed attempt and the last valid attempt was prescribed).</p><p><strong>Results: </strong>The concurrent validity of the 1RM-based protocol was good to excellent with respect to the reference test (MIP: day 1, n = 49, intraclass correlation coefficient [ICC (95% confidence intervals)] = 0.87 (0.78-0.93); day 2, n = 48, ICC = 0.91 (0.82-0.95); MEP: day 1, n = 49, ICC = 0.82 (0.60-0.91); day 2, n = 49, ICC = 0.88 (0.64-0.95)). The test-retest reliability was good for MIP [n = 46, ICC = 0.88 (0.79-0.93)] and excellent for MEP [n = 48, ICC = 0.90 (0.83-0.94)]. The MDC(90-95) for MIP ranged from 23.7 to 28.2 cmH2O, and for MEP ranged from 19 to 22.5 cmH2O.</p><p><strong>Discussion and conclusion: </strong>This study validated a new 1RM-based protocol for the MIP/MEP tests using a respiratory muscle training threshold valve device in individuals with multiple sclerosis, showing good to excellent concurrent validity compared with the reference test, as well as good to excellent test-retest reliability. The MDC reported can be interpreted and applied in the clinical setting.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Vestibular Symptoms on the Vestibular Ocular Motor Screening for Return-to-play After Sport-related Concussion: A Systematic Review and Meta-analysis.","authors":"Romina Rahmaniharedasht, Martina Andò, Diego Piatti, Silvia Zalambani, Andrea Turolla, Paolo Pillastrini, Marco Tramontano, Nicola Ferri","doi":"10.1097/NPT.0000000000000585","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000585","url":null,"abstract":"<p><strong>Background and purpose: </strong>The vestibulo-ocular reflex (VOR) contributes to gaze stabilization after head movement, but its independent prognostic value for return-to-play (RTP) after sport-related concussion (SRC) is unclear. This systematic review and meta-analysis examined associations between early vestibular-ocular motor screening (VOMS) assessment and RTP duration following SRC.</p><p><strong>Methods: </strong>Searches of PubMed, CINAHL, Scopus, PEDro, and Cochrane Library to March 2025 identified studies assessing within 14 days of SRC and reporting RTP outcomes. Two reviewers extracted data and assessed the risk of bias. Random-effects meta-analysis was performed for studies reporting prolonged recovery (≥28-30 days).</p><p><strong>Results: </strong>Twelve studies (N = 3297 athletes) met inclusion criteria. Meta-analysis of four studies (n = 968) found a positive VOMS screen was associated with increased odds of prolonged recovery (odds ratio 2.39; 95% confidence interval, 1.82-3.13; P < 0.00001; I2=0%). Among nine studies of isolated VOR gain, eight reported significant univariate associations with longer RTP, but only two retained significance after multivariable adjustment. VOMS reliably identifies athletes at risk for protracted recovery, but isolated VOR measures show inconsistent independent predictive value after adjustment.</p><p><strong>Discussion and conclusions: </strong>Objective VOR gain quantification (eg, vHIT, caloric) is needed to clarify whether physiological VOR dysfunction independently affects recovery. Clinicians should interpret VOR findings within a multimodal assessment.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptual Overlap Between OPTIMAL Theory Constructs and Motor Presentations in Functional Neurological Disorder Rehabilitation.","authors":"Julie Maggio, Heather Salon, Julie Hershberg","doi":"10.1097/NPT.0000000000000583","DOIUrl":"10.1097/NPT.0000000000000583","url":null,"abstract":"<p><strong>Background and purpose: </strong>Functional neurological disorder (FND) is increasingly recognized as a disorder of brain network dysfunction with neuroimaging studies demonstrating altered communication among neural circuits involved in movement, attention, and self-agency. The Optimizing Performance Through Intrinsic Motivation and Attention for Learning (OPTIMAL) theory of motor learning is centered on the three constructs: external focus of attention, enhanced expectancies, and autonomy. This article explores the potential alignment between the pathophysiology underlying FND and the constructs proposed by the OPTIMAL theory and hypothesizes that OPTIMAL offers a promising, pathophysiology-informed framework for the physical therapy management of FND across varied practice settings.</p><p><strong>Summary of key points: </strong>• FND is characterized by disrupted brain network communication, particularly in circuits related to motor learning, attention, and self-agency.• Physical therapy is supported by evidence as a first-line treatment for motor symptoms in FND; however, existing consensus guidelines do not identify an explicit motor learning framework to guide PT intervention• The OPTIMAL theory of motor learning emphasizes external focus of attention, enhanced expectancies, and autonomy, constructs that align with the neural networks implicated in FND and have demonstrated efficacy to improve motor learning when applied to healthy and neurological populations.</p><p><strong>Recommendations for clinical practice: </strong>• Applying motor learning constructs from OPTIMAL offers a practical and evidence-aligned approach to treating motor learning deficits in FND across care settings and age groups.• Therapists may improve motor outcomes in FND by incorporating external cueing, success-oriented feedback, and patient choice.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Dizziness Handicap is Related to Functional Capacity in People with Vestibular Hypofunction.","authors":"Mariam Rojas-Ledezma, Andrew J Kittelson, Jaclyn Carson, John C Quindry, Michael C Schubert, Brian J Loyd","doi":"10.1097/NPT.0000000000000584","DOIUrl":"10.1097/NPT.0000000000000584","url":null,"abstract":"<p><strong>Background and purpose: </strong>Individuals with vestibular hypofunction (VH) report low levels of physical activity (PA), corresponding with restrictions when performing activities of daily living. However, a clear association between physical function and self-reported dizziness handicap and measures of vestibular function has not been established. Our purpose is to investigate whether functional aerobic capacity and PA are related to dizziness handicap and objective assessments of the vestibulo-ocular reflex in participants with VH.</p><p><strong>Methods: </strong>A total of 36 participants (14 males, 22 females; 70.11 ± 12.2 years) with evidence of VH of peripheral origin were included. Self-reported measures of dizziness handicap and impairment included the Dizziness Handicap Inventory and Visual Analogue Scale of dizziness. Objective measures included the Video Head Impulse Test and computerized Dynamic Visual Acuity. Outcomes of interest included the 2-minute walk test, average daily steps, light PA, and moderate-to-vigorous PA. Multiple linear regression models were built, controlling for age and sex, and adjusted using the Benjamini-Hochberg. Significance was set at alpha = 0.05.</p><p><strong>Results: </strong>Self-reported measures of dizziness handicap and impairment were significantly associated with the 2-minute walk test ( P ≤ 0.05). No significant associations between PA and the independent variables were found.</p><p><strong>Discussion and conclusions: </strong>Greater dizziness handicap was associated with lower functional aerobic capacity when adjusting for age and sex. Interestingly, this relation was not observed when examining objective measures of vestibular function. After adjusting for age and sex, age was associated with reduced moderate-to-vigorous PA time, whereas the vestibular-related measures were not.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Spinal Cord Stimulation for Spasticity in Primary Lateral Sclerosis: A Case Series.","authors":"Kayla Chomko, Lauren Tabor Gray, Alan V Boruch, Eduardo Locatelli","doi":"10.1097/NPT.0000000000000558","DOIUrl":"10.1097/NPT.0000000000000558","url":null,"abstract":"<p><strong>Background and purpose: </strong>Primary lateral sclerosis (PLS), a neurodegenerative disease characterized by lower extremity spasticity, significantly impacts mobility and quality of life. Treatment options predominantly involve pharmacological interventions offering limited relief. Transcutaneous spinal cord stimulation (tSCS) reduces spasticity in persons with spinal cord injury and multiple sclerosis but has yet to be investigated as a nonpharmacological intervention in persons with PLS. This study described postintervention changes in lower extremity spasticity and functional mobility in a small cohort of persons with PLS following a single tSCS session.</p><p><strong>Case description: </strong>Six participants with PLS received 30-minutes of tSCS with pre-post assessments and 24-hour postintervention follow-up. Spasticity outcomes included the Modified Ashworth Scale, deep tendon reflexes, and the Numerical Rating Scale. Functional mobility outcomes included the Tinetti Performance Oriented Mobility Assessment, 10-Meter Walk Test, and 6-Minute Walk Test.</p><p><strong>Intervention: </strong>Participants, positioned supine, received a 30-minute tSCS session. Electrodes were placed at T11-T12 and para-umbilically. tSCS was delivered at 50 Hz, 400 μs, and individualized amplitude.</p><p><strong>Outcomes: </strong>No adverse events occurred. Modified Ashworth Scale and Tinetti Performance Oriented Mobility Assessment scores improved in all participants; Numerical Rating Scale scores improved in 5 of 6 participants. Changes in deep tendon reflexes, 6-Minute Walk Test, and 10-Meter Walk Test were variable.</p><p><strong>Discussion: </strong>A single 30-minute tSCS session was well tolerated in 6 participants with PLS. tSCS may be an effective intervention for spasticity reduction and functional mobility improvement in this population; however, larger controlled trials are needed to evaluate the effectiveness of tSCS and determine the clinical significance and generalizability of these findings.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"e1-e8"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sensory Adaptation Program for Individuals With Mal de Débarquement Syndrome: A Case Series.","authors":"Chelsea R Van Zytveld, Elliot Gann, Sarah Gallagher, Karen Zacharewicz, Patricia Winkler","doi":"10.1097/NPT.0000000000000568","DOIUrl":"10.1097/NPT.0000000000000568","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mal de débarquement syndrome (MdDS) is a rare disorder characterized by persistent oscillatory sensations following exposure to prolonged passive motion. Inadequate readaptation of the sensory balance systems may contribute to MdDS symptoms. Sensory adaptation exercises modify sensory input to improve balance and reduce symptoms; however, research on this intervention in MdDS is limited. The purpose of this case series was to describe a sensory adaptation program for individuals with MdDS and report changes in perceived severity of oscillatory motion, balance, and patient-reported function. Feasibility was also examined retrospectively.</p><p><strong>Case description: </strong>Ten participants (mean age = 64.4 years [standard deviation: 11.7]; 8 women) with MdDS completed the study. Outcomes assessed at baseline and post-intervention included: perceived severity of oscillatory motion (Visual Analog Scale and Numeric Rating Scale [NRS]); balance (Modified Clinical Test for Sensory Interaction on Balance and Functional Gait Assessment); patient-reported function (Patient Specific Functional Scale 2.0 [PSFS 2.0]); and feasibility (retention, adherence, safety, and acceptability). The PSFS 2.0 and NRS were repeated at 3-month post-intervention.</p><p><strong>Intervention: </strong>Participants completed 9 intervention sessions over 3 weeks. Interventions included education, sensory adaptation, and functional mobility.</p><p><strong>Outcomes: </strong>All participants completed the study, no adverse events were reported, and clinically meaningful improvements on the Visual Analog Scale, NRS, Functional Gait Assessment, and PSFS 2.0 were observed. Seven of 10 participants sustained improvement on the PSFS 2.0, and 6 of 10 sustained improvement on NRS at 3 months.</p><p><strong>Discussion: </strong>The sensory adaptation program was feasible, and improvements in perceived oscillatory motion, dynamic gait, and patient-reported function were observed. Future efficacy studies are warranted.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"252-259"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Power Exercise for Stroke Recovery: The POWER Feasibility Trial.","authors":"Kenneth S Noguchi, Juliano A Abreu, Zoe M Sanvido, Paula Bochnak, Angelica McQuarrie, Brad Elliott, Stuart M Phillips, Marla K Beauchamp, Lehana Thabane, Kirsten E Bell, Ada Tang","doi":"10.1097/NPT.0000000000000561","DOIUrl":"10.1097/NPT.0000000000000561","url":null,"abstract":"<p><strong>Background and purpose: </strong>Strength training is recommended after stroke to retain strength and function. Muscle power is important for mobility, presenting an opportunity for power training programs. The objectives of this study were to (1) determine the feasibility and (2) effects of the power exercise for stroke recovery (POWER) intervention in people with mild to moderate chronic stroke.</p><p><strong>Methods: </strong>This was a single-group trial in people with mild to moderate chronic stroke (modified Rankin Scale < 4). The POWER intervention was delivered in a community-based gym over 3 phases: familiarization (week 1), strength (weeks 2-5), and power (weeks 6-10), where repetitions were performed as quickly as possible. Feasibility was the primary outcome, measured using preestablished indicators. Effects were measured with the timed up and go test, short physical performance battery, 30-second chair stand test, fast-paced walking speed, isokinetic strength, power, and the stroke impact scale.</p><p><strong>Results: </strong>Fifteen people (61.5 years, 4.9 years poststroke, n = 7 female) were recruited within 6 months. Attendance was high (96%), with minimal attrition (n = 1) and no serious adverse events or exaggerated blood pressure responses to exercise. Most (71%) exercise sets were adhered to. There were improvements in timed up and go performance (-1.6 seconds [95% confidence interval, CI: -0.6, -2.6]), short physical performance battery (+0.9, 95% CI: 0.1, 1.8), fast-paced walking (+0.1 m/s, 95% CI: 0.01, 0.2), and the 30-second chair stand test (+3.0, 95% CI: 1.7, 4.2). There were also moderate to large improvements in muscle strength, power, and health-related quality of life.</p><p><strong>Discussion and conclusions: </strong>POWER was feasible and shows potential effects on muscle strength, power, physical function, and health-related quality of life in community-dwelling people with mild to moderate chronic stroke.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"212-222"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Association of Neurofunctional Physiotherapy (ABRAFIN) Best Abstract Awards.","authors":"","doi":"10.1097/NPT.0000000000000557","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000557","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":"50 4","pages":"274-275"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable Devices and the 24-Hour Patient.","authors":"Lori Quinn","doi":"10.1097/NPT.0000000000000581","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000581","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":"50 4","pages":"201"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Predictors of Discordance Between Balance Perception and Ability in Parkinson Disease.","authors":"Sarah J Conklin, Franziska Albrecht, Andrew Hooyman, Daniel Peterson, Erika Franzén, Jason K Longhurst","doi":"10.1097/NPT.0000000000000556","DOIUrl":"10.1097/NPT.0000000000000556","url":null,"abstract":"<p><strong>Background and purpose: </strong>Balance discordance, or malalignment between balance ability and confidence, has been linked to retrospective falls in Parkinson disease. This study aimed to identify modifiable factors related to balance discordance to determine potential targets for fall prevention interventions.</p><p><strong>Methods: </strong>This cross-sectional secondary analysis included 188 individuals with Parkinson disease. Balance discordance was derived from balance ability (Timed Up and Go) and balance confidence (Activities Balance Confidence Scale). Demographic factors (age, sex), disease severity (disease duration, Hoehn and Yahr Scale), balance ability (Mini-BESTest), daily physical activity via actigraphy, perceived health (EuroQol-5D Visual Analog Scale [EQ5D-VAS]), cognitive ability (Trail Making Test B, Montreal Cognitive Assessment), anxiety and depression (Hospital Anxiety and Depression Scale) were examined in relation to balance discordance. Pearson correlations explored bivariate relationships, and ridge regression with cross-validation identified unique contributors.</p><p><strong>Results: </strong>Discordance was significantly related to EQ5D-VAS ( r = 0.46), depression ( r = -0.47), and anxiety ( r = -0.37). The final model (EQ5D-VAS, sex, disease duration) accounted for 29.08% of variance, with EQ5D-VAS (β = 0.513, P < 0.001) as a significant predictor.</p><p><strong>Discussion and conclusions: </strong>Perceived health was strongly related to discordance, suggesting shared perceptual factors may drive discordance and fall risk. Anxiety and depression were also related to discordance. Addressing these factors may facilitate improved alignment between balance ability and confidence, reduce fall risk, and improve physical engagement and quality of life.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"232-242"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}