Pediatric rehabilitation最新文献

{"title":"Object/wrist movements during manipulation in children with cerebral palsy.","authors":"M G Wright, L P Hunt, O H Stanley","doi":"10.1080/13638490500054982","DOIUrl":"https://doi.org/10.1080/13638490500054982","url":null,"abstract":"The kinematics of the wrist and a manipulated object were studied in a posting task in 30 control, eight hemiplegic and 10 diplegic children. Statistical analyses using ‘mixed’ models examined the effects of subject group, hand, object shape and repeated trials, together with all possible interaction terms. During transport to the posting hole, the number of significant peaks/troughs in the velocity/time profile of the wrist in the transport (‘z’) direction were increased in subjects with cerebral palsy, as were adjustment error and the distances moved by the object relative to the wrist, reflecting more unpredictable object movement. In the placing phase, relative object/wrist normalized ‘z’ distances and number of wrist ‘z’ velocity peaks increased with increasing object complexity, reflecting the need for more adjustment movements. The number of wrist ‘z’ velocity peaks/troughs and adjustment error were increased in cerebral palsy subjects, reflecting ineffective adjustment. Relative object/wrist distances and number of wrist ‘z’ velocity troughs were reduced in both phases with repeated trials. It is suggested that such variables may provide a quantitative measure of poor movement ‘quality’ in children with Cerebral Palsy and that these findings reflect reduced mechanical stability of the hand and arm during movement.","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 4","pages":"263-71"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490500054982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25610159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity in children and adolescents with acquired brain injury.","authors":"P Patradoon-Ho,&nbsp;A Scheinberg,&nbsp;L A Baur","doi":"10.1080/13638490500049578","DOIUrl":"https://doi.org/10.1080/13638490500049578","url":null,"abstract":"<p><strong>Objectives: </strong>To measure the prevalence of obesity and to assess associated clinical factors in children and adolescents with acquired brain injury (ABI).</p><p><strong>Study design: </strong>This cross-sectional study included 88 subjects aged between 2.4-17.7 years attending the Brain Injury Clinic at a tertiary paediatric hospital. Body mass index (BMI) and BMI z-scores were calculated. Obesity and overweight were defined using the International Obesity Taskforce cut-points. Associations were examined between BMI z-scores and the following: ABI severity, mobility level, duration from injury and presence of radiological injury.</p><p><strong>Results: </strong>The prevalence of obesity in this population (obese = 15%) was higher than those in Australian children and adolescents (1995 National Nutrition Survey) while the prevalence of overweight (19.3%) was comparable. There was a linear trend for the participants to have a higher BMI z-score with increasing level of mobility (F = 6.91, df 1.70, p = 0.011).</p><p><strong>Conclusion: </strong>There is no data about obesity in children and adolescents with ABI. The study with limited statistical power suggests that obesity is prevalent in this population and increases with increasing level of mobility. Further studies are required to address the issue of obesity and related complications in this population.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 4","pages":"303-8"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490500049578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25610689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ISMAR: an autotherapeutic device assisting patients from drooling to articulated speech.","authors":"H Haberfellner","doi":"10.1080/13638490400023954","DOIUrl":"https://doi.org/10.1080/13638490400023954","url":null,"abstract":"<p><p>This overview of three decades of clinical experience with oral therapies complemented by oral devices-vestibular screens (VS) and ISMARs (Innsbruck sensory motor activators and regulators)-tries to put these devices into an oral functional context including postural control of mobile structures both inside and outside the mouth-down to the feet. ISMARs have certain unique features which teach a person not only better postural control of the lower jaw and, hence, hyoid bone and tongue, but also to stimulate movements of lips and tongue to improve salivary control, functions of eating and drinking and the domain of communication, e.g. facial movements and articulation of speech. A review of the relevant postural background is provided and the mechanisms are explained and may serve as models for other oral therapies. The inter-relation and multi-functionality of muscular connections throughout the body explains the uniformity of facial, oral and pharyngeal dysfunctions in different conditions such as cerebral palsy, Moebius syndrome, chronic nasal congestion or developmental retardation and exposes patients with oral dysfunctions to the risks of vicious circles. However, at the same time the opportunity is given to trigger beneficious circles. Three principles of postural control in and for the neck region are postulated. Clinical observations and experiments with volunteers are described and some supporting information is given-hopefully enough to stimulate clinical work and give rise to further experimental work to illuminate this field which is extremely important for both human communication and inter-relation.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 4","pages":"248-62"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400023954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25607385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin type A treatment in neurogenetic syndromes.","authors":"Frank S Pidcock","doi":"10.1080/13638490400022238","DOIUrl":"https://doi.org/10.1080/13638490400022238","url":null,"abstract":"<p><strong>Purpose: </strong>To review the use of therapeutic botulinum toxin type A (BoNT-A) treatments in uncommon neurogenetic syndromes.</p><p><strong>Method: </strong>A retrospective questionnaire and interview study of a selected case series to assess the efficacy and safety following initial BoNT-A treatment (50-400 units per subject) was conducted to determine the response of families to treatment. Twelve male and six female subjects with ages from 2-19 years were included. The reasons for treatments were based on both patient-related and caregiver-related objectives. Satisfaction with achievement of stated goals was assessed by follow-up interviews.</p><p><strong>Results: </strong>Beneficial effects were reported in 56%, some effects in 22% and no to minimal effects in 22%. The duration of effect ranged from 10 days to 12 months with an average of 3.16 months. Ten families would repeat the injections as needed, four would not and four were not sure. Unanticipated effects of BoNT-A treatments were reported by some families. Adverse effects did not occur with the doses that were used.</p><p><strong>Conclusions: </strong>The results suggest that obtaining family input may be useful when treating spasticity in unusual circumstances. The use of BTX-A in uncommon neurogenetic syndromes was supported by the majority of families interviewed.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 4","pages":"298-302"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400022238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25610165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent validity of the Neurobehavioural Assessment for Pre-term Infants (NAPI) at term age.","authors":"Chaya Hyman,&nbsp;Laurie M Snider,&nbsp;Annette Majnemer,&nbsp;Barbara Mazer","doi":"10.1080/13638490400022220","DOIUrl":"https://doi.org/10.1080/13638490400022220","url":null,"abstract":"<p><strong>Background: </strong>Accurate measurement of neonatal neurological integrity is critical for early identification of pre-term and full-term infants at-risk for developmental disability. The Neurobehavioural Assessment for Pre-term Infants (NAPI) was developed to measure the progression of neurobehavioural development in pre-term infants born between 32 weeks post-conceptional age (PCA) and term. This instrument has many unique advantages; however, criterion validity is unknown and results are subsequently difficult to interpret.</p><p><strong>Objectives: </strong>This study examined the concurrent validity of the NAPI against a criterion instrument, the Einstein Neonatal Neurobehavioural Assessment Scale (ENNAS), which measures similar constructs and has demonstrated excellent reliability and validity.</p><p><strong>Methods: </strong>A sample of 41 pre-term and full-term infants (40 +/- 2 weeks) was assessed with the NAPI and ENNAS on the same day.</p><p><strong>Results: </strong>The findings demonstrated that correlations between similar NAPI clusters and ENNAS clusters ranged from 0.35-0.65 and correlations between many similar individual NAPI and ENNAS items ranged from 0.40-0.60. Two NAPI clusters also discriminated between normal, abnormal and suspect performance on the ENNAS.</p><p><strong>Conclusion: </strong>The NAPI has many unique advantages as a tool. It examines neonates serially, has established weekly normative data and requires minimal infant handling. This study provides new validation of the NAPI instrument.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"225-34"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400022220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25237967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brace treatment during pubertal growth spurt in girls with idiopathic scoliosis (IS): a prospective trial comparing two different concepts.","authors":"Hans-Rudolf Weiss,&nbsp;Grita Maria Weiss","doi":"10.1080/13638490400022212","DOIUrl":"https://doi.org/10.1080/13638490400022212","url":null,"abstract":"<p><strong>Study design: </strong>Prospective comparison of the survival rates of two different bracing concepts with respect to curve progression and duration of treatment during pubertal growth spurt in two cohorts of patients followed up prospectively.</p><p><strong>Objectives: </strong>To determine whether the results obtained by the use of a soft brace (SpineCor) is comparable to the results of the Chêneau derived TLSO during pubertal growth spurt.</p><p><strong>Background data: </strong>In recent peer reviewed literature, the SpineCor is described as an effective method of treatment for patients with scoliosis. However, until now, no controlled study has been presented comparing the results obtained with this soft brace to a sample treated with other bracing concepts proven effective.</p><p><strong>Methods: </strong>Twelve patients with Cobb angles between 16-32 degrees during pubertal growth spurt are presented as a case series treated with the SpineCor. The survival rate of this sample is described and compared to a matched group of patients treated with the Chêneau brace of the same age group. All girls treated in both studies were pre-menarchial with the first clinical signs of maturation (Tanner 1-3).</p><p><strong>Results: </strong>During the pubertal growth spurt, most of the patients (11/12) with SpineCor progressed clinicly and radiologicly as well (at least 5 degrees ). Progression could be stopped changing SpineCor to the Chêneau brace in most of the samples described (7/10). The avarage Cobb angle at the start of treatment with the SpineCor was 21.3 degrees , after an avarage observation time of 21.5 months, 31 degrees. The control sample, primarily treated with the Chêneau brace (n=15), showed at average no progression. Cobb angle at the start of treatment was 33.7 degrees and after the observation time of 37 months, 33.9 degrees . Radiological improvements can be reported for some of the cases (3/15) as well as progressions (3/15). At 24 months of treatment time, 73% of the patients with a Chêneau brace and 33% of the patients with the SpineCor where still under treatment with their original bracing concept, at 42 month follow-up time 80% of the patients with Chêneau braces and 8% of the patients with the SpineCor survived with respect to curvature progression. The differences of the proportions statisticly where highly significant.</p><p><strong>Conclusions: </strong>The SpineCor does not change natural history of idiopathic scoliosis during the pubertal growth spurt. The use of the Chêneau brace seems to do so. Oncoming studies with the aim to test the efficiency of braces should be based on samples at immediate risk for progression (only girls with first signs of maturation but pre-menarchial).</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"199-206"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400022212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24946068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term psychological distress in parents of child survivors of severe meningococcal disease.","authors":"Tirtsa R Ehrlich,&nbsp;Ines A Von Rosenstiel,&nbsp;Martha A Grootenhuis,&nbsp;Astrid I Gerrits,&nbsp;Albert P Bos","doi":"10.1080/13638490400022246","DOIUrl":"https://doi.org/10.1080/13638490400022246","url":null,"abstract":"<p><strong>Objective: </strong>To study psychological distress in parents of child survivors of Severe Meningococcal Disease (SMD) after discharge of their child from the Paediatric Intensive Care Unit (PICU).</p><p><strong>Methods: </strong>This study approached parents of child survivors of SMD treated on the PICU between 1993-2001. Five cross-sectional groups were created for mothers and fathers separately. The five groups differed from each other by the period after discharge they entered the project (ranging from 3 months to 7 years after discharge). For research purposes, mothers and fathers (n = 192) individually completed the Goldberg General Health Questionnaire-30 (GHQ), measuring their level of psychological distress.</p><p><strong>Statistics: </strong>Mean group scores were examined and a one-way-analysis of variance (ANOVA) performed to study differences between groups for mothers and fathers separately. In addition, percentages of parents with GHQ scores above cut-off were calculated and it was determined whether it differed from norm data.</p><p><strong>Results: </strong>Data reveal that both mothers and fathers experience high mean levels of psychological distress after discharge, showing no significant differences in group means over time. High percentages of parents experience psychological distress after discharge, if compared with the normal population.</p><p><strong>Conclusions: </strong>Parents of child survivors of SMD experience profound and prolonged psychological distress after discharge. Future interventions should focus on follow-up care for this population to help them re-adjust after this stressful event.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"220-4"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400022246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25237964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic values of plants.","authors":"Paula Diane Relf","doi":"10.1080/13638490400011140","DOIUrl":"https://doi.org/10.1080/13638490400011140","url":null,"abstract":"The article ‘Horticultural therapy: the ‘healing garden’ and gardening in rehabilitation. Measures at Danderydd Hospital Rehabilitation Clinic, Sweden’ by Soderstrom et al. in issue 7:4 of Pediatric Rehabilitation brings together a great deal of existing information and clearly illustrates the need for more research and professional publication in this field. A review of the literature is an integral part of the understanding of any therapeutic modality and over the years a number of literature reviews have been published or made available electronically [1–4]. However, these literature reviews have been broadbased and comprehensive collections of articles from many sources that are not easily available to the general public, thus giving the impression of a wider body of knowledge than is actually available to researchers in healthcare. The importance and advantage of the current article is that the authors focused primarily on medical databases (AMED, CINHAL, MEDLINE) and limited their search to the three terms that should be in common usage in any articles related to the therapeutic value and uses of horticulture and gardening: ‘gardening’, ‘healing garden’ and ‘horticultural therapy’. This choice of approach by the authors brought into clear focus the extremely limited information readily available to members of the medical professions and the need for high quality, rigorous research that can be published in peer-reviewed healthcare and medical journals. Perhaps the greatest hindrance to wider application of healing gardens and horticultural therapy in health care is the lack of documentation of the efficacy of these techniques utilizing medically acceptable research methods. As pointed out by Frumkin [5], for a long time medical practice ‘relied on some combination of inductive reasoning and seductive beliefs’. In a similar fashion, practitioners in horticultural therapy and users of healing gardens tend to write and lecture on their benefits without research-based documentation on the efficacy, in the mistaken belief that the benefits and efficacy are so obvious that further documentation is not required. However, as Frumkin elaborates regarding medicine, ‘in recent years, more and more treatments have been subjected to rigorous deductive study. The goal here is evidence-based medicine’ because ‘those who pay for health care—employers and insurance companies in the US, national health care systems in most other countries, and patients themselves in some places—don’t want to pay without evidence of value’. The same applies to the practice of horticultural therapy and implementation of healing gardens; it will not be paid for by anyone without strong evidence supporting its efficacy. Properly designed, randomized controlled trials can establish the value of an intervention. Exceptions to this research design have been used effectively in cases where randomized treatments occurred serendipitously, despite the fact that the variable being analys","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"235-7"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400011140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25237965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GMFM 1 year after continuous intrathecal baclofen infusion.","authors":"Linda E Krach,&nbsp;Robert L Kriel,&nbsp;Richard C Gilmartin,&nbsp;Dale M Swift,&nbsp;Bruce B Storrs,&nbsp;Rick Abbott,&nbsp;John D Ward,&nbsp;Karen K Bloom,&nbsp;William H Brooks,&nbsp;Joseph R Madsen,&nbsp;John F McLaughlin,&nbsp;Joseph M Nadell","doi":"10.1080/13638490400021479","DOIUrl":"https://doi.org/10.1080/13638490400021479","url":null,"abstract":"<p><p>The purpose of this study was to assess whether there is an improvement in motor function in persons with cerebral palsy (CP) who have had a reduction of muscle tone by continuous intrathecal baclofen infusion. This was a prospective, open label, non-blinded case series without a control group, conducted at multiple centres. There were 31 subjects, aged 4-29 years. All had a pre-treatment mean lower extremity Ashworth scores of >or= 3 and a significant reduction in tone after a bolus injection of intrathecal baclofen (ITB) and received an implanted pump for continuous delivery of ITB. Motor function was assessed by the Gross Motor Function Measure (GMFM) prior to and 1 year following pump implantation. Significant improvement (p < 0.05) in mean GMFM scores was seen in subjects < 8 years (mean change 4.1) and in those from 8-18 years (mean change 3.7) and in subjects with CP Classes 2 and 5 (mean changes 6.2 and 2.9). There was a statistically significant decrease (p < 0.05) in Ashworth scores in CP classes 2-5. Subjects or their caregivers that completed a survey about perceived changes stated that motor control, positioning and endurance improved.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"207-13"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400021479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24946069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries.","authors":"Jo Anne Gorski,&nbsp;Keith J Slifer,&nbsp;Vanessa Townsend,&nbsp;Jennifer Kelly-Suttka,&nbsp;Adrianna Amari","doi":"10.1080/13638490400021438","DOIUrl":"https://doi.org/10.1080/13638490400021438","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury.</p><p><strong>Method: </strong>A case series design was used to examine three adolescents (aged 14-16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy.</p><p><strong>Results: </strong>Compliance with rehabilitation demands improved from a baseline of 20-65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started.</p><p><strong>Conclusions: </strong>The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict 'readiness' to participate in rehabilitation.</p>","PeriodicalId":79705,"journal":{"name":"Pediatric rehabilitation","volume":"8 3","pages":"187-98"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13638490400021438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24946067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}