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Gravesteijn AS, Ouwerkerk M, Eijssen ICJM, Beckerman H, De Groot V. Perceived and physiological strains of societal participation in people with multiple sclerosis: a real-time assessment study. J Rehabil Med 2024; 56:jrm40838. [PMID: 38910543 PMCID: PMC11218757 DOI: 10.2340/jrm.v56.40838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 05/30/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVE To examine the relationship between perceived and physiological strains of real-time societal participation in people with multiple sclerosis. DESIGN Observational study. SUBJECTS/PATIENTS 70 people with multiple sclerosis. METHODS Perceived and physiological strain of societal participation (10 participation-at-location and 9 transport domains) were measured in real time using the Whereabouts smartphone app and Fitbit over 7 consecutive days. Longitudinal relationships between perceived (1 not strenuous to 10 most strenuous) and physiological strains (heart rate reserve) were examined using mixed-model analyses. Type of event (participation-at-location or transport) was added as covariate, with further adjustments for fatigue and walking ability. RESULTS Median perceived strain, summarized for all societal participation domains, varied between 3 and 6 (range: 1-10), whereas physiological strain varied between 18.5% and 33.2% heart rate reserve. Perceived strain (outcome) and physiological strain were not associated (β -0.001, 95%CI -0.008; 0.005, with a 7-day longitudinal correlation coefficient of -0.001). Transport domains were perceived as less strenuous (β -0.80, 95%CI -0.92; -0.68). Higher fatigue levels resulted in higher perceived strain (all societal participation domains) (β 0.05, 95%CI 0.02; 0.08). CONCLUSION Societal participation resulted in low-to-moderate perceived and physiological strain. Perceived and physiological strain of societal participation were unrelated and should be considered different constructs in multiple sclerosis.
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Affiliation(s)
- Arianne S Gravesteijn
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience research Institute, Neuroinfection & Neuroinflammation, Amsterdam, The Netherlands.
| | - Maaike Ouwerkerk
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience research Institute, Neuroinfection & Neuroinflammation, Amsterdam, The Netherlands
| | - Isaline C J M Eijssen
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience research Institute, Neuroinfection & Neuroinflammation, Amsterdam, The Netherlands; Amsterdam Public Health research Institute, Social Participation and Health, Amsterdam, The Netherlands
| | - Heleen Beckerman
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience research Institute, Neuroinfection & Neuroinflammation, Amsterdam, The Netherlands; Amsterdam Public Health research Institute, Social Participation and Health, Amsterdam, The Netherlands
| | - Vincent De Groot
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience research Institute, Neuroinfection & Neuroinflammation, Amsterdam, The Netherlands
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Blokland IJ, Schiphorst LFA, Stroek JR, Groot FP, van Bennekom CAM, van Dieen JH, de Koning JJ, Houdijk H. Relative Aerobic Load of Daily Activities After Stroke. Phys Ther 2023; 103:pzad005. [PMID: 37172129 PMCID: PMC10071588 DOI: 10.1093/ptj/pzad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/31/2022] [Accepted: 01/16/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Individuals after stroke are less active, experience more fatigue, and perform activities at a slower pace than peers with no impairments. These problems might be caused by an increased aerobic energy expenditure during daily tasks and a decreased aerobic capacity after stroke. The aim of this study was to quantify relative aerobic load (ie, the ratio between aerobic energy expenditure and aerobic capacity) during daily-life activities after stroke. METHODS Seventy-nine individuals after stroke (14 in Functional Ambulation Category [FAC] 3, 25 in FAC 4, and 40 in FAC 5) and 22 peers matched for age, sex, and body mass index performed a maximal exercise test and 5 daily-life activities at a preferred pace for 5 minutes. Aerobic energy expenditure (mL O2/kg/min) and economy (mL O2/kg/unit of distance) were derived from oxygen uptake ($\dot{\mathrm{V}}{\mathrm{O}}_2$). Relative aerobic load was defined as aerobic energy expenditure divided by peak aerobic capacity (%$\dot{\mathrm{V}}{\mathrm{O}}_2$peak) and by $\dot{\mathrm{V}}{\mathrm{o}}_2$ at the ventilatory threshold (%$\dot{\mathrm{V}}{\mathrm{o}}_2$-VT) and compared in individuals after stroke and individuals with no impairments. RESULTS Individuals after stroke performed activities at a significantly higher relative aerobic load (39%-82% $\dot{\mathrm{V}}{\mathrm{o}}_2$peak) than peers with no impairments (38%-66% $\dot{\mathrm{V}}{\mathrm{o}}_2$peak), despite moving at a significantly slower pace. Aerobic capacity in individuals after stroke was significantly lower than that in peers with no impairments. Movement was less economical in individuals after stroke than in peers with no impairments. CONCLUSION Individuals after stroke experience a high relative aerobic load during cyclic daily-life activities, despite adopting a slower movement pace than peers with no impairments. Perhaps individuals after stroke limit their movement pace to operate at sustainable relative aerobic load levels at the expense of pace and economy. IMPACT Improving aerobic capacity through structured aerobic training in a rehabilitation program should be further investigated as a potential intervention to improve mobility and functioning after stroke.
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Affiliation(s)
- Ilse J Blokland
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Heliomare Research and Development, Heliomare, Wijkaan Zee, The Netherlands
| | - Linda F A Schiphorst
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Heliomare Research and Development, Heliomare, Wijkaan Zee, The Netherlands
| | - Jessie R Stroek
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Heliomare Research and Development, Heliomare, Wijkaan Zee, The Netherlands
| | | | - Coen A M van Bennekom
- Coronel Institute of Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap H van Dieen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jos J de Koning
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Han Houdijk
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
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Liu T, Chan AWK, Chair SY. Group- plus home-based Tai Chi program improves functional health among patients with coronary heart disease: a randomized controlled trial. Eur J Cardiovasc Nurs 2022; 21:597-611. [PMID: 35022661 DOI: 10.1093/eurjcn/zvab126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/05/2021] [Accepted: 12/12/2021] [Indexed: 11/13/2022]
Abstract
AIMS Tai Chi is a promising exercise option in cardiac rehabilitation to manage coronary heart disease (CHD). Increasing attention was paid on home-based cardiac rehabilitation to improve participation rate, but no study has yet emphasized the effect of home-based Tai Chi. A single-blinded randomized controlled trial is used to examine the effects of a group- plus home-based Tai Chi program on functional health. METHODS AND RESULTS Ninety-eight community-dwelling patients with CHD were randomly assigned to the Tai Chi and control groups. Participants in the Tai Chi group attended 6-week group- plus 6-week home-based Tai Chi program. Outcome measures included physical functions, cardiovascular risk factors, and exercise self-efficacy. Data were collected at baseline, 6-week, 12-week, and 24-week. Intervention effects were analysed using the generalized estimating equation model. Compared with changes in the control group, the intervention group achieved significant improvements in aerobic endurance, lower-body strength, agility and dynamic balance, diastolic blood pressure, and exercise self-efficacy over the 24-week study period (all Ps < 0.05). Intervention adherence was high (79.6% of participants attending >75% of all Tai Chi sessions). CONCLUSIONS This Tai Chi program significantly improved the functional health of patients with CHD, indicating that Tai Chi could be taught in group sessions and then continued independently as a home exercise routine for health promotion.
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Affiliation(s)
- Ting Liu
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China
| | - Aileen Wai Kiu Chan
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China
| | - Sek Ying Chair
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China
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Fukui S, Kawakami M, Otaka Y, Ishikawa A, Yashima F, Hayashida K, Muraoka K, Liu M. Activities of daily living among elderly persons with severe aortic stenosis. Disabil Rehabil 2019; 43:338-344. [PMID: 31204521 DOI: 10.1080/09638288.2019.1624838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine the level of limitations in activities of daily living (ADL) and instrumental ADL, and identify related factors to instrumental ADL among elderly persons with severe aortic stenosis (AS). MATERIALS AND METHODS We prospectively enrolled 112 consecutive elderly persons (mean age, 84.6 ± 4.4 y) with severe AS. We assessed ADL and instrumental ADL using the Barthel index (BI) and the Frenchay activities index (FAI), respectively. Cardiac, physical, cognitive and kidney functions, nutritional status, medical histories, and comorbidities were assessed. A multiple logistic analysis was developed to explore related factors to the FAI. RESULTS The medians (ranges) of BI and FAI were 100 (15-100) and 21 (0-38), respectively. The multiple logistic analysis revealed that a history of heart failure (sβ = -0.189), a history of cerebrovascular disease (sβ = -0.233), the short physical performance battery score ≤ 8 (sβ = -0.272), the mini-mental state examination score ≤ 23 (sβ = -0.168) were significantly related to the FAI (p < 0.05). CONCLUSIONS Physical frailty, a history of heart failure, cerebrovascular disease, and cognitive decline were independently related to declined instrumental ADL. IMPLICATIONS FOR REHABILIATION Activities of daily living was well-preserved among elderly persons with severe aortic stenosis. Instrumental activities of daily living varied among patients with aortic stenosis and was sometimes impaired. Physical frailty, a history of heart failure, and a history of cerebrovascular disease were independently associated with instrumental activities of daily living in elderly persons with severe aortic stenosis.
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Affiliation(s)
- Shogo Fukui
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Aiko Ishikawa
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Muraoka
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Meigen Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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Liu T, Chan AW, Liu YH, Taylor-Piliae RE. Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2017; 17:368-383. [PMID: 29256626 DOI: 10.1177/1474515117749592] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Tai Chi is an attractive exercise to improve cardiovascular health. This review aimed to synthesize articles written both in Chinese and in English to evaluate the effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being and cardiovascular diseases risk reduction for coronary heart diseases patients. METHODS PRISMA guidelines were used to search major health databases to identify randomized controlled trials or non-randomized controlled clinical trials that evaluated Tai Chi intervention compared with active or non-active control groups in coronary heart disease patients. When suitable, data were pooled using a random-effects meta-analysis model. RESULTS Thirteen studies met the inclusion criteria. Tai Chi groups showed a large and significant improvement in aerobic endurance compared with both active and non-active control interventions (standard mean difference (SMD) 1.12; 95% confidence interval (CI): 0.58-1.66; p <0.001). Tai Chi groups also showed a significantly lower level of anxiety (SMD=9.28; CI: 17.46-1.10; p=0.03) and depression (SMD=9.42; CI: 13.59-5.26; p <0.001), and significantly better quality of life (SMD=0.73; 95% CI: 0.39-1.08; p <0.001) compared with non-active control groups. CONCLUSION Significant effects of Tai Chi have been found in improving aerobic endurance and psychosocial well-being among coronary heart disease patients. Tai Chi could be a cost-effective and safe exercise option in cardiac rehabilitation. However, the effect of Tai Chi on cardiovascular disease risk reduction has not been amply investigated among coronary heart disease patients. Caution is also warranted in view of a small number of studies for this meta-analysis and potential heterogeneity in differences in the varied designs of Tai Chi intervention.
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Affiliation(s)
- Ting Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Aileen Wk Chan
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Hong Liu
- 1 Faculty of Medicine, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Gjellesvik TI, Brurok B, Tjønna AE, Tørhaug T, Askim T. Oxygen uptake during functional activities after stroke-Reliability and validity of a portable ergospirometry system. PLoS One 2017; 12:e0186894. [PMID: 29065164 PMCID: PMC5655433 DOI: 10.1371/journal.pone.0186894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/18/2017] [Indexed: 12/02/2022] Open
Abstract
Background People with stroke have a low peak aerobic capacity and experience increased effort during performance of daily activities. The purpose of this study was to examine test-retest reliability of a portable ergospirometry system in people with stroke during performance of functional activities in a field-test. Secondary aims were to examine the proportion of oxygen consumed during the field-test in relation to the peak-test and to analyse the correlation between the oxygen uptake during the field-test and peak-test in order to support the validity of the field-test. Methods With simultaneous measurement of oxygen consumption, participants performed a standardized field-test consisting of five activities; walking over ground, stair walking, stepping over obstacles, walking slalom between cones and from a standing position lifting objects from one height to another. All activities were performed in self-selected speed. Prior to the field-test, a peak aerobic capacity test was performed. The field-test was repeated minimum 2 and maximum 14 days between the tests. ICC2,1 and Bland Altman tests (Limits of Agreement, LoA) were used to analyse test-retest reliability. Results In total 31 participants (39% women, mean (SD) age 54.5 (12.7) years and 21.1 (14.3) months’ post-stroke) were included. The ICC2,1 was ≥ 0.80 for absolute V̇O2, relative V̇O2, minute ventilation, CO2, respiratory exchange ratio, heart rate and Borgs rating of perceived exertion. ICC2,1 for total time to complete the field-test was 0.99. Mean difference in steady state V̇O2 during Test 1 and Test 2 was -0.40 (2.12) The LoAs were -3.75 and 4.51. Participants spent 60.7% of their V̇O2peak performing functional activities. Correlation between field-test and peak-test was 0.689, p = 0.001 for absolute and 0.733, p = 0.001 for relative V̇O2. Conclusions This study presents first evidence on reliability of oxygen uptake during performance of functional activities after stroke, showing very good test-retest reliability. The secondary analysis showed that the amount of energy spent during the field-test relative to the peak-test was high and the correlation between the two test was good, supporting the validity of this method.
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Affiliation(s)
- Tor Ivar Gjellesvik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olav’s University Hospital, Trondheim, Norway
- * E-mail:
| | - Berit Brurok
- Department of Physical Medicine and Rehabilitation, St. Olav’s University Hospital, Trondheim, Norway
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arnt Erik Tjønna
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- NeXt Move, NTNU, Trondheim, Norway
| | - Tom Tørhaug
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olav’s University Hospital, Trondheim, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Xanthos PD, Gordon BA, Kingsley MIC. Implementing resistance training in the rehabilitation of coronary heart disease: A systematic review and meta-analysis. Int J Cardiol 2016; 230:493-508. [PMID: 28040292 DOI: 10.1016/j.ijcard.2016.12.076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy. METHODS Six electronic databases were searched to identify studies investigating RT, coronary heart disease and physical function. The overall quality of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible and qualitative analysis was performed for the remaining data. RESULTS Improvements in peak oxygen uptake (WMD: 0.61, 95% CI: 0.20-1.10), peak work capacity (SMD: 0.38, 95% CI: 0.11-0.64) and muscular strength (SMD: 0.65, 95% CI: 0.43-0.87) significantly favoured CT over AT with moderate quality evidence. There was no evidence of a difference in effect when comparing RT and AT. Shorter duration CT was superior to shorter duration AT for improving peak oxygen uptake and muscular strength (low quality evidence) while longer duration CT was only superior to longer duration AT in improving muscular strength (moderate quality evidence). CONCLUSIONS CT is more beneficial than AT alone for improving physical function. Although preliminary findings are promising, more high-quality evidence is required to determine the efficacy of high intensity resistance training. Shorter duration interventions that include resistance training might allow patients to return to their normal activities of daily living earlier.
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Affiliation(s)
- Paul D Xanthos
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Brett A Gordon
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Michael I C Kingsley
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
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ter Hoeve N, van Geffen ME, Post MW, Stam HJ, Sunamura M, van Domburg RT, van den Berg-Emons RJ. Participation in Society in Patients With Coronary Artery Disease Before and After Cardiac Rehabilitation. Arch Phys Med Rehabil 2015; 96:1110-6. [DOI: 10.1016/j.apmr.2015.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/21/2015] [Indexed: 02/06/2023]
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