Journal of Hand Therapy最新文献

{"title":"A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome","authors":"Elena Muñoz-Gómez PT, PhD,&nbsp;Marta Aguilar-Rodríguez PT, PhD,&nbsp;Sara Mollà-Casanova PT, PhD,&nbsp;Nuria Sempere-Rubio PT, PhD,&nbsp;Marta Inglés PT, PhD,&nbsp;Pilar Serra-Añó PT, PhD","doi":"10.1016/j.jht.2024.02.007","DOIUrl":"10.1016/j.jht.2024.02.007","url":null,"abstract":"<div><h3>Background</h3><div>There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS).</div></div><div><h3>Purpose</h3><div>To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS.</div></div><div><h3>Study design</h3><div>Randomized clinical trial.</div></div><div><h3>Methods</h3><div>Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (<em>n</em> = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (<em>n</em> = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2).</div></div><div><h3>Results</h3><div>At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (<em>p</em> = 0.04, d = 0.8), maintained at T2 (<em>p</em> = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (<em>p</em> &gt; 0.05). MT exhibited enhanced handgrip strength at T1 (<em>p</em> = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (<em>p</em> = 0.04, d = 1.0; <em>p</em> = 0.03, d = 0.4). At T1, both groups decreased pain (<em>p</em> = 0.002, d = 1.1; <em>p</em> = 0.02, d = 0.7), and improved functionality (<em>p</em> &lt; 0.001, d = 0.8; <em>p</em> = 0.01, d = 0.5) (MT and TE respectively).</div></div><div><h3>Discussion</h3><div>MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles.</div></div><div><h3>Conclusions</h3><div>MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 534-543"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066276","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":"Pulsed negative pressure myofascial vacuum therapy and percutaneous electrolysis in the treatment of lateral epicondylalgia: A single-blind randomized controlled trial","authors":"Manuel Rodríguez-Huguet ,&nbsp;Daniel Rodríguez-Almagro ,&nbsp;Miguel Angel Rosety-Rodríguez ,&nbsp;Maria Jesus Vinolo-Gil ,&nbsp;Javier Molina-Jiménez ,&nbsp;Jorge Góngora-Rodríguez","doi":"10.1016/j.jht.2024.02.003","DOIUrl":"10.1016/j.jht.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><div><span>Lateral Epicondylalgia (LE) represents one of the most common </span>injuries of the upper limb. It is necessary to find effective treatments that reduce pain and increase functionality.</div></div><div><h3>Purpose</h3><div><span>To determine the effects of an integrated intervention of Pulsed Negative Pressure Myofascial Vacuum Therapy (VT), Percutaneous Electrolysis (PE) and </span>eccentric exercise<span> (EE) in the treatment of LE compared versus Manual Therapy soft tissue mobilization (MT) and Ultrasound therapy (US) and EE.</span></div></div><div><h3>Study design</h3><div>Single-blind randomized controlled trial.</div></div><div><h3>Methods</h3><div>Forty participants, with unilateral LE, were randomly divided into two groups: VT + PE + EE group (<em>n</em> = 20) and MT + US + EE group (<em>n</em><span><span> = 20). The VT + PE + EE group received one weekly session for four weeks and a regimen of EE daily at-home, and the MT + US + EE group received 10 sessions over a period of two weeks and a regimen of EE daily at-home. Numerical pain rating scale (NPRS), range of motion (ROM) </span>pressure pain threshold (PPT) and function (PRTEE questionnaire) were measured before treatment, at the end of treatment, and at one- and three-month follow-ups.</span></div></div><div><h3>Results</h3><div>The statistically significant improvements were found post-treatment, favoring the VT + PE group in pain intensity (<em>p</em> &lt; 0.001; ES = 0.408), PRTEE-S Pain (<em>p</em> = 0.001; ES = 0.377), PRTEE-S Specific function (<em>p</em> = 0.004; ES = 0.306) and PRTEE-S Total (<em>p</em><span> = 0.001; ES = 0.355). The VT + PE + EE treatment<span> showed greater effectiveness than the MT + US + EE treatment at immediate post-treatment, as well as at the one-month and three-months follow-up.</span></span></div></div><div><h3>Conclusions</h3><div>VT and PE added to an EE program could be an effective treatment for pain, ROM, PPT, and function in patients with LE.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 644-652"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061344","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":"Effectiveness of a home training program on improving pinch force perception in older adults","authors":"Rachel N. Logue Cook MS ,&nbsp;Kathy L. Kern MS,&nbsp;Susan H. Brown PhD","doi":"10.1016/j.jht.2024.02.002","DOIUrl":"10.1016/j.jht.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Hand function is reduced with aging which can lead to impairments in the performance of daily activities and eventually loss of independence. The ability to perceive the forces being applied to an object is an important component of hand control that also declines with age. However, the extent to which force perception can be improved through training remains largely unknown.</div></div><div><h3>Purpose</h3><div>This study evaluated the effectiveness of a home-training program focused on improving force perception in older adults.</div></div><div><h3>Study Design</h3><div>Quasi-experimental - Uncontrolled trial.</div></div><div><h3>Methods</h3><div><span>Eleven independent, healthy adults (mean age: 77.2 ± 6.8 years) participated in a home-based sensorimotor hand training program 6 days/week for 6 weeks. Force perception, the primary outcome variable, was measured as the ability to reproduce a pinch force equal to 25% maximum voluntary contraction in the </span>absence<span> of visual feedback using either the ipsilateral remembered or contralateral<span> concurrent (CC) hand. We also measured hand strength, dexterity, tactile acuity, and cognition before and after training.</span></span></div></div><div><h3>Results</h3><div>After the program was completed, participants showed a 35% reduction in absolute (<em>p</em><span> &lt; 0.01, confidence interval (CI): [7.3, 33.2], effect sizes (ES): 0.87) and constant (</span><em>p</em> = 0.05, CI: [0.0, 34.9], ES: 0.79) force matching errors in the CC condition. Improvements in dominant hand dexterity (Purdue pegboard test) (<em>p</em> &lt; 0.05, CI: [0.2, 2.4], ES: 0.60) and tactile sensitivity (JVP thresholds) (<em>p</em> &lt; 0.05, CI: [−1.7, −0.1], ES: 0.94), as well as cognition (Trail Making Test B) (<em>p</em> &lt; 0.05, CI: [−24,1. −1.6], ES: 0.30) were also observed post-training.</div></div><div><h3>Conclusions</h3><div>The results suggest that home-hand training can be an effective way to improve force perception among older adults.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 635-643"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472789","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":"Patients living with upper extremity arthritis may experience limitations in physical, mental, and social health: A technical report","authors":"Nancy Naughton OTD, OTR/L, CHT ,&nbsp;Brocha Z. Stern PhD, OTR, CHT ,&nbsp;Priya Bakshi OTD, OTR, CHT ,&nbsp;Sophie E. Goloff MS, OTR/L, CHT ,&nbsp;Sarah B. Doerrer PhD, OTR/L, CHT","doi":"10.1016/j.jht.2023.12.006","DOIUrl":"10.1016/j.jht.2023.12.006","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 687-690"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567573","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":"Perspectives on remote learning of orthotic fabrication by certified hand therapists","authors":"Katherine A. Schofield ,&nbsp;Deborah A. Schwartz ,&nbsp;Charlotte Bolch","doi":"10.1016/j.jht.2023.11.002","DOIUrl":"10.1016/j.jht.2023.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic caused disruption to continuing educational opportunities for hand therapists. In response, some courses were offered via online platforms, including virtual orthotic<span> fabrication courses. It is important to determine the effectiveness and benefits of these courses for educating certified hand therapists and examine if remote learning of orthotic fabrication skills has continued merit and relevance.</span></div></div><div><h3>Purpose</h3><div>To investigate the value and effectiveness of orthotic fabrication courses taught in a virtual format.</div></div><div><h3>Study Design</h3><div>Cross-sectional, mixed methods survey study.</div></div><div><h3>Methods</h3><div>A 31-item survey consisting of Likert-type, direct response, and open-ended questions about experiences and opinions of virtual orthotics courses was electronically delivered to certified hand therapists. Data analysis included descriptive and correlational statistics to highlight frequencies, ranges, and relationships between the participant demographics and opinions/experiences. Thematic analysis guided the coding of the qualitative data.</div></div><div><h3>Results</h3><div>A total of 459 responded, with a response rate of 9.7%. Most respondents had not participated in online courses on orthotic fabrication. Those that did reported high satisfaction but noted that clinical experience and knowledge from previous courses influenced this experience. Most participants felt that novice clinicians and students would not gain enough skills and confidence from online courses. However, participants with all levels of experience found the courses to be of value.</div></div><div><h3>Conclusions</h3><div>Results suggest that while online learning of this skill set is valuable and effective, it is most beneficial for experienced clinicians. Disadvantages included the lack of instructor feedback necessary for hands-on skill development and the lack of peer interaction. Advantages included convenience of time, cost, accessibility, and the ability to revisit the topic as needed. Online learning of orthotic fabrication skills is a sustainable option for clinicians seeking to advance their skills. Nevertheless, it is not a substitute for initial training for novice hand therapists due to the lack of feedback and skill development.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 572-582"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736785","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":"Management of everyday life after a hand operation—A qualitative study of patients with a weak sense of coherence","authors":"Alice Ørts Hansen ,&nbsp;Kamilla Kielsgaard ,&nbsp;Stina Meyer Larsen","doi":"10.1016/j.jht.2023.12.016","DOIUrl":"10.1016/j.jht.2023.12.016","url":null,"abstract":"<div><h3>Background</h3><div>A hand-related disorder (HRD) has a more significant impact on participation in everyday life for patients with a weak sense of coherence (SOC) compared to those with a strong SOC. Therefore, understanding how patients with a weak SOC manage the conditions of everyday life after a hand operation is of clinical interest.</div></div><div><h3>Purpose</h3><div>This study aimed to explore how patients with a weak SOC experience and manage the conditions of everyday life after an operation for an HRD.</div></div><div><h3>Study Design</h3><div>A qualitative design with a hermeneutic approach.</div></div><div><h3>Methods</h3><div>An in-depth interview was conducted with each of eight adults—five women and three men—with an HRD and a weak SOC (SOC-13 score &lt;52). Participants with varying HRDs were interviewed once between six and 13 weeks after the hand operation. Data were analyzed based on a hermeneutic approach.</div></div><div><h3>Results</h3><div>The analyses resulted in five themes: even more conditions to handle, challenges in everyday life, managing everyday life, different expectations, and the influence of information on everyday life. The lives of most participants were significantly impacted: they experienced a range of difficulties managing their activities and roles after their operation. The participants felt uncertain about managing everyday life and the future and expressed unfulfilled expectations for different reasons. All wanted individualized information about what to expect.</div></div><div><h3>Conclusions</h3><div>Participants had several conditions in life that challenged their everyday lives, and the HRD made their everyday lives even more challenging. The extent to which they felt affected appeared to relate to their perception of their presurgery activities. They had several strategies to manage everyday life but used these to varying extent. Their expectations about the outcome had both positive and negative effects on their ability to manage everyday life, and individually adapted information was requested about what to expect and how to cope with everyday life after the surgery.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 625-634"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139555853","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":"Research should advance the quintuple aims of better patient experience and outcomes, improved provider work role experience, cost efficiency and equity","authors":"Joy C MacDermid","doi":"10.1016/j.jht.2024.11.005","DOIUrl":"10.1016/j.jht.2024.11.005","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 493-494"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792707","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":"Immediate effects of Kinesio taping in carpal tunnel syndrome: A randomized controlled double-blind ultrasonographic study","authors":"Orhan Güvener MD ,&nbsp;Figen Dağ PhD, PT ,&nbsp;Günşah Şahin MD ,&nbsp;Levent Özçakar MD","doi":"10.1016/j.jht.2023.12.017","DOIUrl":"10.1016/j.jht.2023.12.017","url":null,"abstract":"<div><h3>Background</h3><div>The effects of Kinesio taping (KT) in carpal tunnel syndrome are controversial.</div></div><div><h3>Purpose</h3><div>This study aimed to examine whether KT has any effect on the skin, subcutaneous tissue<span>, and median nerve measurements and to compare the effects of two different KT applications.</span></div></div><div><h3>Study Design</h3><div>This is a prospective, double-blinded, randomized trial. This study was prospectively registered on the clinicaltrials.gov (NCT05475197). A total of 34 wrists (21 patients) who were clinically and electrophysiologically diagnosed with mild/moderate carpal tunnel syndrome were randomly divided into two KT intervention groups (group 1: neural technique and area correction technique and group 2: area correction technique).</div></div><div><h3>Methods</h3><div><span>At baseline and immediately after the removal of KT (48 hours), pain was assessed with visual analog scale, hand grip strength with a hand-held </span>dynamometer<span>, and pinch strength using a pinch meter. Likewise, using ultrasound, skin and subcutaneous tissue thicknesses, median nerve cross-sectional area and flattening ratio, as well as median nerve depth were measured at the carpal tunnel inlet and outlet levels.</span></div></div><div><h3>Results</h3><div>While there was significant improvement in the pain scores (compared to the baseline) immediately after the KT in both groups (group 1: <em>p</em> = 0.03, η_p² = 0.44; group 2: <em>p</em> &lt; 0.001, η_p² = 0.71), there was no difference in between (<em>p</em> = 0.07, η_p² = 0.10). Grip strength significantly increased only in group 2 (<em>p</em> = 0.01, η_p² = 0.35). None of the sonographic measurements displayed significant difference either within or between groups at baseline and after KT (all <em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>While pain scores improved after KT, they were not coupled with any morphologic changes assessed by ultrasound.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 520-528"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742747","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":"Impaired intrinsic hand strength in women with osteoarthritis","authors":"Verónica Gracia-Ibáñez PhD ,&nbsp;Alba Roda-Sales PhD ,&nbsp;Pablo J. Rodríguez-Cervantes PhD ,&nbsp;José F. Fuentes-Ballesteros DipHE ,&nbsp;Pablo Granell PhD ,&nbsp;Margarita Vergara PhD ,&nbsp;Joaquín L. Sancho-Bru PhD","doi":"10.1016/j.jht.2024.02.005","DOIUrl":"10.1016/j.jht.2024.02.005","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 691-694"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332533","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":"Focal dystonia in musicians, a literature review","authors":"Silvia Comoletti MA Medicine (Physiotherapy) ,&nbsp;Chiara Mercogliano MA Psychology (Organizational Wellbeing)","doi":"10.1016/j.jht.2024.02.011","DOIUrl":"10.1016/j.jht.2024.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Musician’s focal dystonia<span> (mFD) is a rare, neurological, task-specific disorder that mainly affects the upper extremity (especially the hands) and generally appears as a painless muscular incoordination that can mark the end of a musician's professional career. The present literature review intends to highlight the current understanding of musician's focal dystonia, its underlying neural mechanisms and the role of prevention and treatment in physiotherapy, psychotherapy and other fields as occupational therapy.</span></div></div><div><h3>Purpose</h3><div>The aim of the present literature review was to gain an overview of mFD in the medical, psychological and physical therapy literature and investigate what strategies for diagnosis and rehabilitation are available today.</div></div><div><h3>Study design</h3><div>The present article is a literature review, based on the search for full-text publications with the goal of comparing the main strategies for mFD rehabilitation and prevention presented in the literature.</div></div><div><h3>Methods</h3><div>This literature review compared many relevant papers and studies available in literature today for mFD epidemiology, neural mechanisms, treatment and prevention, to discuss what we know today and highlight the aspects that can still be enhanced in the future.</div></div><div><h3>Results</h3><div>According to our results, current literature gives a good understanding of mFD epidemiology, but further studies are needed to fully comprehend the neurological aspects and develop more rehabilitation strategies, especially in the psychological field. Our research also highlighted the need for a multidisciplinary approach that considers both physical and psychological aspects.</div></div><div><h3>Conclusions</h3><div>Physical rehabilitation strategies are helpful but, considering the amount of psychological aspects involved in mFD, a holistic approach should be considered and developed in the future. Finally, prevention must have a primary role in mFD treatment, raising awareness around it and, possibly, avoiding its development.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 616-624"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472791","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}