Journal of Rehabilitation Medicine最新文献

{"title":"Relationship between post-stroke trunk function and brain lesion locations: A support vector regression lesion-symptom mapping study.","authors":"Keita Nitto, Hiroaki Abe, Yuka Hashimoto, Yutaro Yabuki, Mayu Arai, Ryo Sato","doi":"10.2340/jrm.v57.42782","DOIUrl":"https://doi.org/10.2340/jrm.v57.42782","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between brain lesions and trunk function impairment in stroke patients.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects/patients: </strong>One hundred fifty-six first-time stroke patients admitted for rehabilitation between August 2021 and October 2023.</p><p><strong>Methods: </strong>Trunk function was assessed using the Trunk Control Test. Brain lesions were detected using magnetic resonance imaging scans. Support vector regression lesion-symptom mapping was used to identify brain lesions associated with trunk function on admission and discharge, adjusted for lesion volume, age, and lower limb motor impairment.</p><p><strong>Results: </strong>After adjusting for age, admission trunk function was linked to lesions in the right corticospinal tract, superior longitudinal fasciculus, superior thalamic radiation, and putamen. Further adjustment for lower limb motor impairment revealed associations not only with all aforementioned regions, but also with lesions in the right supplementary motor area and premotor cortex. For trunk function on discharge, no suprathreshold regions were found.</p><p><strong>Conclusion: </strong>Early post-stroke trunk control impairment was associated with lesions in the right hemisphere, which is involved in motor function, motor control, and sensory integration. These findings provide insights into trunk dysfunction mechanisms, and suggest that targeted rehabilitation could improve trunk control and independence in daily activities for stroke patients.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42782"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163758","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":"Corrigendum: Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study.","authors":"Yohei Otaka","doi":"10.2340/jrm.v57.43803","DOIUrl":"https://doi.org/10.2340/jrm.v57.43803","url":null,"abstract":"<p><p>is missing (Corrigendum) This Corrigendum relates to the following article: https://doi.org/10.2340/jrm.v56.40055.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm43803"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163755","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":"Feasibility and safety of automated multi-channel FES-assisted gait training in incomplete spinal cord injury.","authors":"Simone Berkelmans, Nadia Dominici, Maarten Afschrift, Sjoerd Bruijn, Thomas W J Janssen","doi":"10.2340/jrm.v57.42638","DOIUrl":"https://doi.org/10.2340/jrm.v57.42638","url":null,"abstract":"<p><strong>Objective: </strong>The feasibility, safety, and efficacy of automated multi-channel functional electrical stimulation-assisted gait training was assessed in individuals with chronic incomplete spinal cord injury, using an electrical stimulation suit with built-in surface electrodes and motion capture sensors (Teslasuit).</p><p><strong>Design: </strong>10-week functional electrical stimulation-assisted gait training, twice weekly for 30 min.</p><p><strong>Subjects/patients: </strong>Five individuals with chronic incomplete spinal cord injury (≥ 12 months post-injury, ASIA C/D, minimal Walking Index Spinal Cord Injury II ≥ 9).</p><p><strong>Methods: </strong>The quadriceps, gluteii, hamstrings, tibialis anterior, and gastrocnemius muscles were stimulated bilaterally during gait. Feasibility and safety were evaluated via questionnaires, session adherence, and adverse events. Gait function was assessed using a 10 m walk test, Walking Index Spinal Cord Injury II, and Hoffer classification at baseline, post-intervention, and follow-up. Surface electromyography and spatiotemporal parameters (walking speed, step length and width, cadence) were recorded during the 10 m walk test.</p><p><strong>Results: </strong>All participants completed the training (91% adherence) with no serious adverse events. Temporary skin redness, muscle soreness, and fatigue were reported by participants. Post-intervention, 4 participants increased their walking speed, step length, and cadence, with 2 maintaining and 2 further improving at follow-up. No consistent changes were found in muscle activity post training.</p><p><strong>Conclusion: </strong>Automated multi-channel functional electrical stimulation-assisted gait training was feasible, safe, and well received. Preliminary findings suggest that gait improved in most participants, though individual responses varied. The results highlight the potential of multi-channel functional electrical stimulation-assisted gait training as a valuable tool for enhancing gait recovery.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42638"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152174","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":"Time course for acquiring toileting independence in patients with subacute stroke: a prospective cohort study.","authors":"Shin Kitamura, Yohei Otaka, Shintaro Uehara, Yudai Murayama, Kazuki Ushizawa, Yuya Narita, Naho Nakatsukasa, Daisuke Matsuura, Rieko Osu, Kunitsugu Kondo, Sachiko Sakata","doi":"10.2340/jrm.v57.42390","DOIUrl":"https://doi.org/10.2340/jrm.v57.42390","url":null,"abstract":"<p><strong>Objective: </strong>To determine the time course of longitudinal changes in the independence level of toileting-related subtasks in post-stroke patients.</p><p><strong>Design: </strong>Single-institution, prospective cohort study.</p><p><strong>Subjects/patients: </strong>A total of 101 consecutive patients with stroke admitted to subacute rehabilitation wards who urinated/defecated in bathrooms using wheelchairs upon admission.</p><p><strong>Methods: </strong>Occupational therapists assessed the independence level of patients in each of the 24 toileting subtasks on a 3-level rating scale using the Toileting Tasks Assessment Form every 2-4 weeks from admission to the endpoint (achieving independent toileting or discharge). Patients were classified based on admission and endpoint assessment form scores using a two-step cluster analysis.</p><p><strong>Results: </strong>Patients were classified into Cluster 1 (30 patients who exhibited a greater independence level in all subtasks upon admission [46.7-100% of patients performed each subtask independently] to the endpoint [73.3-100%]), Cluster 2 (41 patients who showed less independence upon admission [0-26.8%] but gained greater independence at the endpoint [34.1-73.2%]), and Cluster 3 (30 patients whose independence levels remained low in many subtasks from admission [0-26.7%] to the endpoint [3.3-26.7%]).</p><p><strong>Conclusion: </strong>Changes in toileting independence levels could be classified into 3 time courses. Effective intervention strategies may differ between each group.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42390"},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112678","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":"Efficacy of a single session of anticipatory postural adjustments training to support people with Parkinson's overcoming freezing of gait: a multi-methods approach.","authors":"Yuri Russo, Zijing Wang, Jiaxi Ye, Phaedra Leveridge, Alice Nieuwboer, Mark Wilson, Meriel Norris, Elmar Kal, Sarah E Lamb, William R Young","doi":"10.2340/jrm.v57.42491","DOIUrl":"10.2340/jrm.v57.42491","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of anticipatory postural adjustments training on the ability to successfully step from freezing of gait, and to evaluate the contribution of attentional processes to potential benefits using an additional attentional-control training intervention.</p><p><strong>Design: </strong>Crossover-design.</p><p><strong>Subjects/patients: </strong>Nineteen people with Parkinson's and freezing (females: 10; age:75.5 ± 7.5 years) tested while ON medication.</p><p><strong>Methods: </strong>Participants navigated a cluttered virtual domestic environment with freeze-provoking tasks. Assessments occurred in the laboratory at baseline, post-anticipatory postural adjustments training, and post-attentional-control training, with randomized training order. All training was video-based. Video annotation was used to identify freezing events. Participants' immediately recollected thoughts they had during the tasks were analysed with content analysis. Perceived safety and effectiveness of the strategies were reported in follow-up calls held 4 weeks post-assessment.</p><p><strong>Results: </strong>Successful step initiations increased from 57% at baseline to 77% post-anticipatory postural adjustments training (p = 0.034). Participants rated the interventions as safe and effective, reporting increased balance confidence (70% to 90%), and reduced fear (p = 0.01), after the anticipatory postural training. Attentional-control training alone was perceived as less effective compared with more goal-directed anticipatory postural adjustments training.</p><p><strong>Conclusion: </strong>Video-based anticipatory postural adjustments training significantly improved step initiation from freezing when used during challenging tasks and in complex environments. Anticipatory postural adjustments training shows promise as an effective \"rescue strategy\" that could be learned remotely/at home.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42491"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082093","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":"Self-perceived barriers to returning to work among employees with a low educational level on long-term sick leave: the \"NOW WHAT\" large-scale interview study.","authors":"Linn V Lervik, Elisabeth Frostestad, Kine Strømstad, Ida G Gulliksen, Monica Lillefjell, Jens C Skogen, Elin Ekbladh, Randi W Aas","doi":"10.2340/jrm.v57.40604","DOIUrl":"10.2340/jrm.v57.40604","url":null,"abstract":"<p><strong>Objective: </strong>Because employees with low educational levels have the highest rates of sick leave, this study aimed to identify the self-perceived return-to-work barriers of employees with low educational levels on long-term sick leave.</p><p><strong>Methods: </strong>Employees on long-term sick leave with primary/secondary educational attainment were included from the NOW WHAT large-scale interview study (n = 122). The World Health Organization's system of classifying functioning, disability, and health guided the deductive content analysis.</p><p><strong>Results: </strong>1,942 meaning units describing return-to-work barriers across all classifications were identified. The most frequent components were body functions (n = 552, 28%, mean = 4.5), with mental functions (e.g., sleep, tiredness, emotional and cognitive functioning) the most frequent barriers; environmental factors (n = 414, 21%, mean = 3.4), with services, systems ,and policies (e.g., social security, healthcare system) the most prevalent barriers; activity limitations (n = 352, 18%, mean = 2.9); and personal factors (n = 323, 17%, mean = 2.6).</p><p><strong>Conclusion: </strong>Employees with low educational levels on long-term sick leave described a wide range of return-to-work barriers and combinations thereof. In addition to health-related functional barriers, identifying environmental, activity-limitation, and personal barriers is important to enhance understanding of this group's potential determinants of absence from work.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40604"},"PeriodicalIF":2.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082096","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":"Cognitive reserve and disparities in healthcare usage after traumatic brain injury and stroke: an observational cohort study.","authors":"Natascha Ekdahl, Marianne Lannsjö, Britt-Marie Stålnacke, Marika Möller","doi":"10.2340/jrm.v57.42400","DOIUrl":"10.2340/jrm.v57.42400","url":null,"abstract":"<p><strong>Background: </strong>Individuals with more education commonly have better outcome after brain injury, often attributed to cognitive reserve. However, evidence suggests that individuals with more education have better access to specialized care, potentially affecting outcomes.</p><p><strong>Objective: </strong>To investigate differences in healthcare usage based on cognitive reserve and examine the relationship between healthcare usage and outcomes after stroke and traumatic brain injury.</p><p><strong>Design: </strong>An observational cohort study with healthcare usage data from 3 years before to 4 years after injury, interviewing patients 5-15 years after injury.</p><p><strong>Patients: </strong>A total of 83 participants suffering a stroke or traumatic brain injury.</p><p><strong>Results: </strong>Healthcare usage over time varied based on educational level (repeated measures ANOVA, F(2, 227) = 4.17, p = 0.008). The differences in healthcare usage between educational levels was significant during the injury year (F(81) = -5.47, p = 0.022). Higher education implied more healthcare usage. Linear regression, controlling for possible confounders, confirmed the relationship between education and healthcare usage, (β = 4.3, p = 0.022). Healthcare usage was significantly related to long-term life satisfaction, but not to return to work.</p><p><strong>Conclusion: </strong>Individuals with more education received more healthcare in the year after traumatic brain injury or stroke. However, this was not related to long-term outcome regarding return to work, but we found a relationship between healthcare usage and life satisfaction.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42400"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058634","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":"Tele-rehabilitation using transcranial direct current stimulation combined with exercise in people with spinal cord injury: a randomized controlled trial.","authors":"Thanwarat Chantanachai, Irin Apiworajirawit, Pipat Klamruen, Benchaporn Aneksan, Paradee Auvichayapat, Alexandra Lackmy-Vallée, Wanalee Klomjai","doi":"10.2340/jrm.v57.42353","DOIUrl":"https://doi.org/10.2340/jrm.v57.42353","url":null,"abstract":"<p><strong>Objective: </strong>This study explored the effects of home-based transcranial direct current stimulation combined with exercise on motor and sensory function, spasticity, functional and transfer performance, and quality of life.</p><p><strong>Design: </strong>A prospective, double-blind, randomized, sham-controlled trial.</p><p><strong>Subjects and methods: </strong>Thirty individuals with SCI were allocated to receive either active transcranial direct current stimulation or sham transcranial direct current stimulation, followed by the same tele-rehabilitation programme, for 12 sessions over 4 weeks (3 sessions/week). Each session included 20 min of transcranial direct current stimulation followed by 1 h of tele-supervised exercise. Primary outcome was the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Secondary outcomes included (i) the upper limb muscle strength evaluated by hand-held dynamometer, (ii) spasticity evaluated by H reflex and modified-Modified Ashworth Scale, (iii) functional performance assessed by the spinal cord independence measure III, (iv) transfer performance assessed by the transfer assessment instrument, and (v) quality of life assessed by WHOQOL-BREF. Outcomes were assessed at baseline, post-intervention, and 1-month follow-up.</p><p><strong>Results: </strong>Two-way mixed ANOVA revealed an interaction effects between group and time (F(1,18)=4.49, p=0.043) and main effects of time (F(1,18)=7.82, p=0.009). Bonferroni post-hoc analysis showed a significant improvement only within the active group at 1-month follow-up (p=0.002) for the upper extremity motor scores (UEMS). No significant differences were observed for any of the secondary outcomes.</p><p><strong>Conclusion: </strong>The effect of 12 sessions of home-based transcranial direct current stimulation combined with exercise was limited to improved upper limb motor recovery, with after-effect at 1-month post-intervention as compared with exercise alone. No improvements were found in sensory function, spasticity, functional and transfer performance, and quality of life. However, this intervention appeared to be feasible, safe, and well-adhered to and provides insight into the use of transcranial direct current stimulation as a tool for tele-rehabilitation in a spinal cord injury outpatient population.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42353"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058602","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":"The Czech Fugl-Meyer assessment for post-stroke sensorimotor function: translation and cross-cultural adaptation and validation.","authors":"Barbora Kolářová, Petra Gaul-Aláčová, Nicole Musilová, Anna Majerová, Margit Alt Murphy","doi":"10.2340/jrm.v57.43010","DOIUrl":"10.2340/jrm.v57.43010","url":null,"abstract":"<p><strong>Objective: </strong>To ensure wider use of the internationally recommended Fugl-Meyer Assessment (FMA) of sensorimotor function for people with stroke, official translations of the scale are needed. This study aimed to perform a translation and cross-cultural adaptation/validation of the FMA into the Czech language.</p><p><strong>Design: </strong>Translation and cross-cultural adaptation/validation.</p><p><strong>Subjects/patients: </strong>Five clinical experts and 1 external expert participated as reviewers; 11 individuals with stroke in the early subacute phase were included in the pilot testing.</p><p><strong>Methods: </strong>A standardized process using forward-backward translations, expert panel reviews, and pilot testing between and within the raters (inter- and intra-rater reliability) were employed to ensure conceptual, semantic, and operational validity of the new Czech FMA. Agreement between raters was assessed in 11 individuals with stroke on 2 consecutive days at University Hospital Olomouc by using Svensson's rank-based statistics.</p><p><strong>Results: </strong>Percentage of agreement between and within raters ranged between 70-100% and 55-100%, respectively. Systematic disagreements, found in 7 out of 96 FMA items, were discussed and revised in the final version.</p><p><strong>Conclusion: </strong>The Czech FMA offers a more unified and standardized assessment of sensorimotor impairment in clinical and research settings. This will improve stroke rehabilitation care and allow for wider international collaboration.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm43010"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048508","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":"Global research trends in aquatic exercise therapy for musculoskeletal disorders: a bibliometric analysis.","authors":"Wei Guo, Xiaowei Feng, Weiping Du","doi":"10.2340/jrm.v57.42473","DOIUrl":"https://doi.org/10.2340/jrm.v57.42473","url":null,"abstract":"<p><strong>Objective: </strong>Aquatic exercise therapy has gained recognition as a valuable non-pharmacological intervention for managing musculoskeletal disorders. Despite the growing body of evidence supporting its efficacy, research on aquatic exercise therapy remains fragmented, with limited understanding of key trends, influential studies, and evolving themes within the field. This study aims to conduct a comprehensive bibliometric analysis to identify publication trends, key authors, and the evolution of research themes in aquatic exercise therapy for musculoskeletal disorders.</p><p><strong>Methods: </strong>A total of 117 articles were selected based on predefined search terms and inclusion criteria, resulting in 3,985 citations, with an average of 35.9 citations per article and an H-index of 37.</p><p><strong>Results: </strong>Publications surged between 2013 and 2024, accounting for 88.3% of total output. Peaks occurred in 2019 (n = 14) and 2022 (n = 368 citations). Key contributors include Mariana Arias Avila and Basia Belza, with journals such as BMC Musculoskeletal Disorders and Arthritis & Rheumatism-Arthritis Care & Research playing pivotal roles. Research trends shifted from disease-specific studies to broader quality-of-life outcomes, with keywords such as \"rheumatoid arthritis\", \"balneotherapy\", and \"quality of life\" emerging as focal points.</p><p><strong>Conclusion: </strong>The findings underscore the growing importance of aquatic exercise therapy in clinical rehabilitation and suggest that future research should focus on long-term outcomes, underrepresented populations, and the integration of aquatic exercise therapy with emerging rehabilitation technologies.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42473"},"PeriodicalIF":2.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006402","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}