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Uthaikhup S, Sremakaew M, Treleaven J, Jull G, Barbero M, Falla D, Cescon C. Changes in Multiple Aspects of Pain Outcomes After Rehabilitation: Analysis of Pain Data in a Randomized Controlled Trial Evaluating the Effects of Adding Sensorimotor Training to Manual Therapy and Exercise for Chronic Neck Pain. Clin J Pain 2024; 40:212-220. [PMID: 38297452 DOI: 10.1097/ajp.0000000000001194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES To examine changes in pain outcomes to fully evaluate the effect of adding sensorimotor training to manual therapy and exercise in patients with chronic neck pain and sensorimotor deficits. Concordance was examined between pain distribution and pain intensity and patient-reported outcomes. METHODS Participants (n=152) were randomly allocated into 4 intervention groups: One group received local neck treatment (NT) comprising manual therapy and exercise and the other 3 groups received additional sensorimotor training (either joint position sense/oculomotor exercises, balance exercises or both). Treatment was delivered twice a week for 6 weeks. Pain and patient-reported outcomes were measured at baseline, posttreatment, and 3-, 6- and 12-month follow-ups. RESULTS There were greater changes in pain location, extent, and intensity at 6- and 12-month follow-ups in the sensorimotor training groups compared with the NT group ( P <0.05). A greater number of patients in the sensorimotor training groups gained ≥50% reduction in pain extent and intensity relative to the NT group at 6 and 12 months ( P <0.05). Clinical improvement in pain extent was concordant with pain intensity (adjusted kappa=056 to 0.66, %agreement=78.3 to 82.9, P <0.001) and disability (adjusted kappa=0.47 to 0.58, % agreement=73.7 to 79.0, P <0.01) at 3-, 6- and 12-month follow-ups, but not with function and well-being. The concordance tended to decline with time. DISCUSSION Multiple aspects of the pain experience improved in the longer term by adding sensorimotor training to NT for patients with neck pain and sensorimotor deficits. The concordance between pain and patient-reported outcomes was not always evident and varied over time, suggesting the need for multidimensional assessments of pain.
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Affiliation(s)
- Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Julia Treleaven
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Gwendolen Jull
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Marco Barbero
- Department of Business Economics Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Corrado Cescon
- Department of Business Economics Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Leungbootnak A, Puntumetakul R, Chatprem T, Sae-Jung S, Boucaut R. Validity and reliability of the Balance Error Score System (BESS) Thai version in patients with chronic non-specific neck pain. PLoS One 2024; 19:e0301386. [PMID: 38547308 PMCID: PMC10977775 DOI: 10.1371/journal.pone.0301386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Neck pain has been found to affect the somatosensory system, which can lead to impaired balance control. To assess the balance of patients with neck pain and other conditions, the balance error scoring system (BESS) is commonly used as a static balance measurement tool. However, this tool is seldom used in Thailand due to its English language format. OBJECTIVE To translate and determine the content, convergent validity, and reliability of a Thai version of the BESS tool. MATERIAL AND METHODS A process of cross-cultural adaptation was utilized to translate BESS into a Thai version, called BESS-TH. To assess content validity, five physical therapy lecturers specializing in the musculoskeletal field used BESS to measure balance in participants with neck pain. For the convergent validity process, 130 patients diagnosed with chronic non-specific neck pain (CNSNP) were randomly assessed using four static balance tests (BESS, Single-leg balance test (SLBT), Romberg test, and Tandem stance test). For reliability, two assessors with varying years of work experience independently assessed videos of the participants twice using the BESS-TH, with a minimum 7-day interval between assessments. RESULTS The BESS-TH used to assess balance of patients with neck pain demonstrated acceptable content validity (index of item objective congruence (IOC) = 0.87). The Spearman's Rank Correlation Coefficient was calculated between the BESS-TH and three other measures: the SLBT with eyes open and eyes closed, the Romberg test with eyes open and eyes closed, and the Tandem stance test with eyes open and Tandem stance test with eyes closed. The values obtained were as follows: -0.672, -0.712, -0.367, -0.529, -0.570, and -0.738, respectively. The inter-rater and intra-rater reliability were 0.922 (95% CI = 0.864-0.956) and 0.971 (95% CI = 0.950-0.983), respectively. Minimum detectable change (MDC) for the total BESS score of inter-rater and intra-rater reliability were 7.16 and 4.34 points, respectively. CONCLUSION The BESS-Thai version was acceptable, reliable, and valid for evaluating balance performance in patients with CNSNP. This tool can be used and applied to clinically evaluate postural control in Thailand.
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Affiliation(s)
- Arisa Leungbootnak
- Faculty of Associated Medical Science, Human Movement Sciences, School of Physical Therapy, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- Faculty of Associated Medical Science, School of Physical Therapy, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Science, Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
| | - Thiwaphon Chatprem
- Faculty of Associated Medical Science, School of Physical Therapy, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Science, Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
| | - Surachai Sae-Jung
- Faculty of Medicine, Department of Orthopedics, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Ragnarsdóttir H, Briem K, Oddsdóttir GL. Effects of a Novel Web-Based Sensorimotor Exercise Program for Patients With Subacute Whiplash-Associated Disorders: Protocol for a Randomized Clinical Trial. Phys Ther 2023; 103:pzad063. [PMID: 37338163 DOI: 10.1093/ptj/pzad063] [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: 09/19/2022] [Revised: 01/18/2023] [Accepted: 03/12/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Whiplash-associated disorder (WAD) often becomes a persistent problem and is one of the leading causes of disability in the world. It is a costly condition for individuals, for insurance companies, and for society. Guidelines for the management of WAD have not been updated since 2014, and the use of computer-based sensorimotor exercise programs in treatment for this patient group has not been well documented. The purpose of this randomized clinical trial is to explore the degree of association between self-reported and clinical outcome measures in WAD. METHODS Individuals (n = 180) with subacute WAD grades I and II will be randomized into 3 groups using block randomization. The 2 primary intervention groups (A and B) will receive physical therapy involving manual therapy and either a remote, novel, computer-based cervical kinesthetic exercise (CKE) program starting at visit 2 (Group A) or neck exercises provided by the corresponding physical therapist (Group B). These groups will be compared to a "treatment as usual" Group C. Movement control, proprioception, and cervical range of motion will be measured. Neck disability and pain intensity, general health, self-perceived handicap, and physical, emotional, and functional difficulties due to dizziness will be measured using questionnaires. The short-term effects will be measured 10 to 12 weeks after the baseline measurements, and the long-term effects will be measured 6 to 12 months after the baseline measurements. IMPACT The successful completion of this trial will help guide clinicians in the selection of outcome measures for patients with subacute WAD in the assessment of the short- and long-term effectiveness of treatment combining manual therapy with computer-based CKE compared with manual therapy and non-computer-based exercises. This trial will also demonstrate the potential of using a computer-based intervention to increase the exercise dose for this patient group and how this influences outcomes such as levels of pain and disability in the short and long term.
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Affiliation(s)
- Harpa Ragnarsdóttir
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
- KIM Rehabilitation, Kópavogur, Iceland
| | - Kristín Briem
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Guðný Lilja Oddsdóttir
- Department of Physiotherapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
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Cetin H, Kose N, Gurses E, Turkmen C, Aksoy S, Oge HK. Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study. J Manipulative Physiol Ther 2023; 46:191-200. [PMID: 38944805 DOI: 10.1016/j.jmpt.2024.02.006] [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: 05/29/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.
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Affiliation(s)
- Hatice Cetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Nezire Kose
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Emre Gurses
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ceyhun Turkmen
- Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey
| | - Songül Aksoy
- Department of Audiology, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | - Halil Kamil Oge
- Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey
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Chaikla R, Sremakaew M, Kothan S, Saekho S, Wantanajittikul K, Uthaikhup S. Effects of manual therapy combined with therapeutic exercise versus routine physical therapy on brain biomarkers in patients with chronic non-specific neck pain in Thailand: a study protocol for a single-blinded randomised controlled trial. BMJ Open 2023; 13:e072624. [PMID: 37094892 PMCID: PMC10151953 DOI: 10.1136/bmjopen-2023-072624] [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] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION Structural brain alterations in pain-related areas have been demonstrated in patients with non-specific neck pain. While manual therapy combined with therapeutic exercise is an effective management for neck pain, its underlying mechanisms are poorly understood. The primary objective of this trial is to investigate the effects of manual therapy combined with therapeutic exercise on grey matter volume and thickness in patients with chronic non-specific neck pain. The secondary objectives are to assess changes in white matter integrity, neurochemical biomarkers, clinical features of neck pain, cervical range of motion and cervical muscle strength. METHODS AND ANALYSIS This study is a single-blinded, randomised controlled trial. Fifty-two participants with chronic non-specific neck pain will be recruited into the study. Participants will be randomly allocated to either an intervention or control group (1:1 ratio). Participants in the intervention group will receive manual therapy combined with therapeutic exercise for 10 weeks (two visits per week). The control group will receive routine physical therapy. Primary outcomes are whole-brain and regional grey matter volume and thickness. Secondary outcomes are white matter integrity (fractional anisotropy and mean diffusivity), neurochemical biomarkers (N-acetylaspartate, creatine, glutamate/glutamine, myoinositol and choline), clinical features (neck pain intensity, duration, neck disability and psychological symptoms), cervical range of motion and cervical muscle strength. All outcome measures will be taken at baseline and postintervention. ETHICS AND DISSEMINATION Ethical approval of this study has been granted by Faculty of Associated Medical Science, Chiang Mai University. The results of this trial will be disseminated through a peer-reviewed publication. TRIAL REGISTRATION NUMBER NCT05568394.
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Affiliation(s)
- Rungtawan Chaikla
- Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Munlika Sremakaew
- Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Suchart Kothan
- Department of Radiologic Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Suwit Saekho
- Department of Radiologic Technology, Chiang Mai University, Chiang Mai, Thailand
| | | | - S Uthaikhup
- Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
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Türkmen C, Köse N, Bal E, Bilgin S, Çetin H, Zengin HY, Gümeler E, Mut M. Effects of Two Exercise Regimes on Patients with Chiari Malformation Type 1: a Randomized Controlled Trial. CEREBELLUM (LONDON, ENGLAND) 2023; 22:305-315. [PMID: 35325392 DOI: 10.1007/s12311-022-01397-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
This study aims to measure the effects of two different exercise programs on neck pain, proprioception, balance, coordination, posture, and quality of life in patients with Chiari malformation (CM) type 1. Sixteen patients were randomized to two different exercise programs: a tailored exercise protocol for CM (TEP-CM) and cervical spinal stabilization exercises (CSSE). Both exercise programs were implemented by a physiotherapist 3 days a week for 6 weeks. The primary outcome was Neck Disability Index. Secondary outcomes were visual analogue scale for pain, joint position sense error measurement, Berg Balance Scale, Time Up and Go Test, International Coordination Ataxia Rating Scale, PostureScreen Mobile, and Short Form-36. Assessments were done immediately before and after the intervention programs. Both groups showed significant improvement in Neck Disability Index, and some secondary outcome measures (P < 0.05). However, there were no statistical differences in post-intervention changes between the groups (P > 0.05). This is the first study to examine the effects of different exercise programs on symptoms in patients with CM type 1. Our preliminary findings indicate that exercise programs can improve pain, balance, proprioception, posture, coordination, and quality of life in CM type 1. Therefore, exercise should be considered safe, beneficial, and low-cost treatment option for CM type 1 patients without surgical indications.
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Affiliation(s)
- Ceyhun Türkmen
- Faculty of Health Sciences, Çankırı Karatekin University, 18200 Sıhhiye St., Çankırı, Turkey.
| | - Nezire Köse
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Ercan Bal
- Department of Neurosurgery, Ankara Yıldırım Beyazıt University, Ankara, 06100, Turkey
| | - Sevil Bilgin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Hatice Çetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Hatice Yağmur Zengin
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Ekim Gümeler
- Department of Radiology, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Melike Mut
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
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Sremakaew M, Jull G, Treleaven J, Uthaikhup S. Effectiveness of adding rehabilitation of cervical related sensorimotor control to manual therapy and exercise for neck pain: A randomized controlled trial. Musculoskelet Sci Pract 2023; 63:102690. [PMID: 36414518 DOI: 10.1016/j.msksp.2022.102690] [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: 05/19/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Local neck treatments and sensorimotor training can improve cervical proprioception and balance, but it remains unclear what treatments and treatment combination achieve the best outcomes. OBJECTIVES To investigate the most effective interventions to improve disturbances in joint position sense (JPS) and balance and their effects on neck pain, dizziness and related features in the short- and long-terms. DESIGN 2x2 factorial, randomized controlled trial. METHODS Participants with neck pain (n = 152) were randomly allocated to one of four intervention groups: i) local neck treatment (NT), ii) NT + JPS/oculomotor exercises (JPS/OC), iii) NT + balance exercises, and iv) all treatments. Participants received 12 treatments over 6 weeks. Primary outcomes were postural sway and joint position error. Secondary outcomes included gait speed, dizziness, pain intensity and disability, cervical range of motion, functional ability, and quality of life. Outcome measures were taken at baseline, posttreatment and 3-, 6- and 12-month follow-ups. RESULTS All four interventions resulted in short- and long-term improvements in primary and secondary outcomes with medium to large effect sizes, but JPS and balance in neck torsion improved most with the addition of a combined program of JPS/OC + balance exercises to NT while balance in neck neutral improved most with the addition of balance exercises. Adding sensorimotor training was also more effective in maintaining levels of improvement in neck pain and disability at 6- and 12-months. Effect sizes of additional treatment benefits were medium to large. CONCLUSIONS Adding specific training of JPS/OC and balance to NT best addresses deficits in cervical proprioception and balance. CLINICAL TRIAL REGISTRATION NUMBER xxxxx.
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Affiliation(s)
- Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Gwendolen Jull
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia
| | - Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
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Peng J, Yang J, Feng J, Zhou G, Dong L, Lin R, Wang D. The Effect of Fu's Subcutaneous Needling Combined with Reperfusion Approach on Surface Electromyography Signals in Patients with Cervical Spondylosis and Neck Pain: A Clinical Trial Protocol. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1761434. [PMID: 36193322 PMCID: PMC9526609 DOI: 10.1155/2022/1761434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/06/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
Background Neck pain is one of the most common musculoskeletal diseases. Fu's subcutaneous needling therapy is a special acupuncture method that targets muscle trigger points. It has been proven to have a positive effect on the treatment of neck pain. The access to its curative effect may be related to the improvement of muscle and soft tissue condition. The purpose of this study is to evaluate the outcome of Fu's subcutaneous needling therapy for patients with neck pain by collecting changes in the sEMG of the patient's neck muscles and related data from evaluation scales and explore the feasibility and safety of Fu's subcutaneous needling therapy for neck pain. Methods 72 patients meeting the inclusion criteria were randomly divided into FSN group and acupuncture group for corresponding treatment. FSN group was treated once every other day for 5 consecutive treatments; the acupuncture group was treated once a day for 10 consecutive treatments. Result Outcome indicators were measured at baseline, after the first treatment and the end of the treatment. Primary outcome indicators: average EMG (AEMG) and (mean power frequency) MPF of sternocleidomastoid muscle and superior trapezius muscle. Secondary outcome indicators: Mc Gill pain questionnaire (MPQ), neck disability index (NDI), and adverse reactions. Conclusions This study will explore the efficacy, safety, and possible mechanism of Fu's subcutaneous needling therapy for patients with neck pain, thus to provide more evidence support for clinical decision-making. This trial is registered with Chinese Clinical Trial Register Center (registration number ChiCTR2100043529).
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Affiliation(s)
- Junliang Peng
- Department of Rehabilitation Medicine, Affiliated TaiHe Hospital of Hubei University of Medicine, Shiyan, 442000 Hubei, China
| | - Jiaen Yang
- Department of TCM Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Foshan, 528000 Guangdong, China
| | - Jiaqi Feng
- Department of TCM Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Foshan, 528000 Guangdong, China
| | - Guangjin Zhou
- Department of TCM Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Foshan, 528000 Guangdong, China
| | - Li Dong
- Department of Rehabilitation Medicine, Affiliated Hospital of Chengdu University, Chengdu, 610000 Sichuan, China
| | - Rong Lin
- Department of Rehabilitation Medicine, The Second People's Hospital of Longquanyi District, Chengdu, 610000 Sichuan, China
| | - Dong Wang
- Department of Rehabilitation Medicine, Affiliated Hospital of Chengdu University, Chengdu, 610000 Sichuan, China
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Igbokwe EO, Taube W, Beinert K. A Comparison of the Effects of Stochastic Resonance Therapy, Whole-Body Vibration and Balance Training on Pain Perception and Sensorimotor Function in Patients with Chronic Non-Specific Neck Pain: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34430. [PMID: 35656706 PMCID: PMC9270712 DOI: 10.2196/34430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Neck pain is a prevalent pathological condition, and together with low back pain, it presents as the leading cause of years lived with disability worldwide in 2015 and continues to contribute substantially to the global burden of disease. Objective This study will investigate and compare the effects of stochastic resonance therapy (SRT), whole-body vibration (WBV), and balance training (BLT) in the management of chronic nonspecific neck pain. Methods In total, 45 participants with chronic neck pain will be randomly allocated into SRT, WBV, and BLT groups. Pain intensity, pressure pain threshold, neck disability, and cervical joint position sense will be measured before, immediately after, and 15 minutes after the first intervention session and after 4 weeks of intervention. A follow-up postintervention measurement would be taken after 4 weeks. The SRT group will train on an SRT device (SRT Zeptor Medical plus noise, Zeptoring). The WBV group will train on a Galileo vibration device (Novotec Medical), while the BLT group will perform balance exercises. All participants shall train 3 times a week for a period of 4 weeks. Mixed ANOVA will be used to determine the main and effects of interactions within (before intervention, post intervention 1, post intervention 2, post intervention 3, and follow-up) and between (SRT, WBV, and BLT) factors on the study outcome variables. Results Recruitment of participants started in May 2021, and as of May 2022, a total of 20 patients have been enrolled in the study. All participants are expected to have completed the trial by the end of 2022, and data analysis will commence thereafter. Conclusions The outcome of this study will shed closer light on the effects of SRT, WBV, and BLT on pain and function in patients with chronic neck pain. Trial Registration German Clinical Trials Register DRKS00023881; https://tinyurl.com/ycxuhj37 International Registered Report Identifier (IRRID) DERR1-10.2196/34430
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Affiliation(s)
- Emmanuel Osinachi Igbokwe
- University of Fribourg, Faculty of Science and Medicine, Department of Neurosciences and Movement Science, Fribourg, CH.,Reha Center Michaeliskarree, Jahnstr. 42, Hof, DE
| | - Wolfgang Taube
- University of Fribourg, Faculty of Science and Medicine, Department of Neurosciences and Movement Science, Fribourg, CH
| | - Konstantin Beinert
- Department of Physiotherapy, Deutsche Hochschule fuer Gesundheit und Sport, Mannheim, DE
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Lee D, Sung PS. Comparison of kinematic similarity index during gait between adults with and without nonspecific chronic neck pain. Gait Posture 2022; 91:99-104. [PMID: 34673448 DOI: 10.1016/j.gaitpost.2021.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with nonspecific chronic neck pain (NP) walk with a stiffer spine. However, there is a lack of understanding on kinematic similarities on the limbs during gait between individuals with and without NP. RESEARCH QUESTION Are there differences in gait parameters and the kinematic similarity index (SI) between individuals with and without NP? METHODS Eighteen individuals with NP and 17 controls participated in this study. A three-dimensional motion capture system and two force plates were utilized to measure kinematic changes of the upper and lower limbs during gait. The gait parameters included cadence, speed, stride length, and step width. The SI calculations were compared based on the response vectors from the NP group and the prototype response vectors from the control participants. The SI values at 5% intervals of the entire gait cycle were compared between groups. RESULTS Although the gait parameters were not significantly different between groups, the SI values of the control group were significantly higher than the NP group during gait (0.98 ± 0.02 vs. 0.95 ± 0.03), especially at the midstance (10-30 %) and swing (80-90 %) phases. Also, the standard deviation of the SI decreased in the control group when compared to the NP group (0.02 ± 0.01 vs. 0.04 ± 0.02). SIGNIFICANCE The SI was a useful measure to differentiate similarities between groups in the gait cycle at specific phases. These results indicated that the NP group demonstrated a greater variation of walking patterns during the midstance and swing phases and displayed altered compensatory gait. Clinicians need to consider the similarities of the kinematic changes for the NP group to aid in detection of limb motion differences and the resulting gait dysfunction.
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Affiliation(s)
| | - Paul S Sung
- Department of Physical Therapy, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN 46953, USA.
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Jung JW, Kim YK. Scapular Dyskinesis in Elite Boxers with Neck Disability and Shoulder Malfunction. Medicina (B Aires) 2021; 57:medicina57121347. [PMID: 34946291 PMCID: PMC8709063 DOI: 10.3390/medicina57121347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Neck and shoulder injuries commonly occur during boxing, and scapular dyskinesis is related to those injuries. This study investigated scapular dyskinesis with neck disability and shoulder malfunction in elite boxers. Materials and Methods: Seventy-two elite boxers participated in this study. Scapular dyskinesis was evaluated as normal, subtle, and obvious. Neck disability index (NDI), shoulder internal (IR), and external (ER) range of motion (ROM), isometric strength of IR and ER, and pectoralis minor length were measured and compared with the severity of scapular dyskinesis. Results: Thirty-eight boxers (52.7%) showed scapular dyskinesis. NDI score was significantly different (normal = 3.89 ± 3.08, obvious = 7.36 ± 4.95, p = 0.025). Isometric IR strength was significantly different (normal = 10.48 ± 2.86, obvious = 8.46 ± 1.74, p = 0.01). The length of the pectoralis minor was significantly different (normal = 10.17 ± 0.67, subtle = 9.87 ± 0.79, obvious = 9.47 ± 0.85; p = 0.001), and the dominant and non-dominant arm IR ROM was significantly different (dominant = 57.43 ± 11.98, non-dominant = 64.62 ± 10.3, p = 0.001). Conclusions: The prevalence of scapular dyskinesis is high among elite boxers. Boxers with scapular dyskinesis presented shoulder malfunction as well as neck disability. Further investigation is necessary to examine the relationship between scapular dyskinesis and neck disability in boxers.
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Affiliation(s)
| | - Young Kyun Kim
- Correspondence: ; Tel.: +82-31-728-7918; Fax: +82-31-544-9051
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Mendes-Fernandes T, Puente-González AS, Márquez-Vera MA, Vila-Chã C, Méndez-Sánchez R. Effects of Global Postural Reeducation versus Specific Therapeutic Neck Exercises on Pain, Disability, Postural Control, and Neuromuscular Efficiency in Women with Chronic Nonspecific Neck Pain: Study Protocol for a Randomized, Parallel, Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010704. [PMID: 34682453 PMCID: PMC8535440 DOI: 10.3390/ijerph182010704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022]
Abstract
Background: Chronic nonspecific neck pain is the most frequent form of neck pain. It is more prevalent in women, and a costly public health issue. It is commonly associated with biomechanical, functional, proprioceptive, and postural impairments. The aim of this trial is to compare the effects of global postural exercises versus specific therapeutic exercises on neck pain, disability, mobility, pressure pain threshold, kinesiophobia, pain catastrophizing, postural control, and neuromuscular efficiency in women with chronic nonspecific neck pain. Methods and analysis: This study is a randomized, parallel-group and single blinded clinical trial. Sixty-two women with nonspecific chronic neck pain were recruited from the community of Guarda, Portugal, and randomly assigned to one of two intervention groups: (1) global postural reeducation (GPR group), (2) specific therapeutic exercises (STE group). The intervention was carried out over 4 weeks, with two sessions per week (eight sessions), and applied by a physiotherapist and paired with a daily individual at-home-exercise program. Primary outcomes are neck pain intensity and disability (Numerical Pain Rating Scale, Neck Disability Index). Secondary outcomes are cervical mobility and pressure pain threshold (CROM, algometry), attitude to pain (kinesiophobia, pain catastrophizing), standing postural control (Center of Pressure (COP) displacements), and neuromuscular efficiency (electromyography). There are four points of evaluation where the outcomes were assessed twice before the intervention, 1 week apart, and the two post-intervention assessments will be carried out after four and eight sessions. The objective was to increase scientific knowledge of different exercise modalities, such as global postural reeducation, in musculoskeletal disorders. Trial registration: ClínicalTrials.gov (NCT04402463), prospectively registered (data 22 May 2020).
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Affiliation(s)
- Tânia Mendes-Fernandes
- Centro EMA, 6300-537 Guarda, Portugal;
- Doctoral Programme in Health, Disability, Dependency and Welfare, University of Salamanca, 37007 Salamanca, Spain;
| | - Ana Silvia Puente-González
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Manuel Antonio Márquez-Vera
- Doctoral Programme in Health, Disability, Dependency and Welfare, University of Salamanca, 37007 Salamanca, Spain;
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Physiotherapy Unit, Universitary Hospital of Salamanca, 37007 Salamanca, Spain
| | - Carolina Vila-Chã
- Polytechnic Institute of Guarda, 6300-559 Guarda, Portugal;
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Correspondence:
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Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther 2021; 10:143-164. [PMID: 33464539 PMCID: PMC8119582 DOI: 10.1007/s40122-020-00230-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
Neck pain is very common, but most of the causes are unknown, making diagnosis and treatment extremely challenging. Current studies have found that one of the main problems in patients with neck pain is the impairment of cervical proprioception, which subsequently leads to cervical sensorimotor control disturbances. Cervical spine has a very delicate proprioceptive system that plays a crucial role in controlling posture and balance. Cervical proprioceptive impairment in neck pain occurs through a variety of mechanisms. Experimental neck muscle pain induced by injection of hypertonic saline results in inhibition of the activation of painful muscle; chronic neck pain causes structural and functional impairment of cervical muscles; excessive activation of mechanoreceptors in degenerative cervical discs and facet joints produces a large number of erroneous sensory signals. Clinical examinations to assess the link between structural pathology and neck pain have been unsuccessful, opening the way for the development of function-based tests. To date, eight neck sensorimotor control tests have been reported to evaluate patients with chronic neck pain. Although some tests may involve different subsystems (such as oculomotor system and vestibular system), all tests measure sensorimotor control in the neck, and the most commonly used is cervical joint position error (JPE) test. Current studies support the effectiveness of exercises targeting different aspects of sensorimotor function, in particular retraining aimed at improving cervical proprioception and muscle coordination. Based on the available evidence, it is recommended that patients with neck pain should be assessed and managed for cervical proprioceptive impairment and sensorimotor control disturbances.
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Affiliation(s)
- Baogan Peng
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China.
| | - Liang Yang
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Yongchao Li
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Tanghua Liu
- Department of Algology, Lizhuang Tongji Hospital, Yibin, Sichuan, China
| | - Yanqing Liu
- Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Yalçinkaya G, Kara B, Arda MN. Cross-cultural adaptation, reliability and validity of the Turkish version of Patient-Specific Functional Scale in patients with chronic neck pain. Turk J Med Sci 2020; 50:824-831. [PMID: 32233180 PMCID: PMC7379470 DOI: 10.3906/sag-1905-91] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 03/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background/aim Current clinical guidelines recommend to use both clinical and self-reported measurements for evaluation of chronic neck pain. Among the self-reported outcomes, Neck disability index and patient-specific functional scale are the most widely used and recommended instruments. The purpose of our study was to determine the test-retest reliability and validity of patient-specific functional scale which was not validated in Turkish language previously. Materials and methods Translation and adaptation process had conducted according to the Beaton et al. Sociodemographic data, Turkish version of patient-specific functional scale and neck disability index were recorded at the initial assessment. Retest assessment was produced for reliability analyses and intraclass correlation coefficient (ICC3,2) was determined. The correlations between patient-specific functional scale and neck disability index and hypothesis testing were examined for the convergent and construct validity analysis. Results The final form was completed by 110 chronic neck pain patients (Male: 33; mean ages: 43.13 ± 13.75 years, Female: 77; mean ages: 44.45 ± 14.38). Test-retest reliability of patient-specific functional scale was found good level (ICC: 0.85). The relationship between patient-specific functional scale and neck disability index was found moderate level (P < 0.05, rho: –0.578). The median score of PSFS-T in the low disability group was significantly higher than the high disability group in the hypothesis testing of construct validity (P < 0.001). Conclusion The Turkish version of the patient-specific functional scale is a valid and reliable scale for evaluating functional status in patients with chronic neck pain.
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Affiliation(s)
- Gamze Yalçinkaya
- Institute of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Bilge Kara
- School of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Mehmet Nuri Arda
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Variability of neck and trunk movement during single- and dual-task gait in people with chronic neck pain. Clin Biomech (Bristol, Avon) 2020; 72:31-36. [PMID: 31809920 DOI: 10.1016/j.clinbiomech.2019.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/10/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous findings reported that people with chronic neck pain walk with reduced range trunk rotation, especially when walking in more challenging conditions. Quantification of the quality of neck and trunk movement during gait could provide further insight into biomechanical changes that occur in people with neck pain. This study uniquely compared the variability of trunk and neck rotation during single-task and dual-task gait in people with chronic neck pain and asymptomatic individuals. METHODS An observational case-control study was conducted on 20 asymptomatic individuals and 24 people with chronic neck pain of idiopathic or traumatic origin. Participants performed rectilinear walking whilst keeping the head in a neutral position (single-task) and whilst rotating the head at a natural speed (dual-task). Trunk and head rotation angles were averaged across gait cycles for the task trials. The data were normalised in time, and the average variability of angular distribution along the normalised cycle was extracted. The Tampa Scale for Kinesiophobia was used to assess fear of movement. FINDINGS During single-task gait, there were no group differences for the variability of trunk (p = 0.862) or neck (p = 0.427) rotation. For dual-task gait, there was no difference between groups for the variability of neck rotation (p = 0.636), however, the participants with neck pain displayed reduced variability of trunk rotation (p = 0.021). The neck pain group also walked at a significantly slower speed during dual-task gait (p = 0.043) compared to asymptomatic individuals and the speed of their gait was associated with the extent of fear of movement. INTERPRETATION The strategy observed in participants with chronic neck pain likely reflects adaptive behaviour when faced with more challenging conditions for postural control.
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Alsultan F, Cescon C, De Nunzio AM, Barbero M, Heneghan NR, Rushton A, Falla D. Variability of the helical axis during active cervical movements in people with chronic neck pain. Clin Biomech (Bristol, Avon) 2019; 62:50-57. [PMID: 30690409 DOI: 10.1016/j.clinbiomech.2019.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent work described parameters of the helical axis in asymptomatic people with potential for investigating kinematic changes in the cervical region. This approach could provide novel information on movement variability in people with neck pain, however this has never been investigated. This study aimed to investigate movement variability during active neck movements performed at different speeds in people with and without chronic neck pain. METHODS This observational case-control study examined 18 participants with chronic neck pain of either idiopathic or traumatic origin and 18 gender-matched asymptomatic participants. Cervical kinematics were captured with 3D motion capture as people with and without chronic neck pain performed flexion-extension, bilateral lateral flexion and bilateral rotation at different speeds (natural, slow, and fast). The mean distance and mean angle parameters of the helical axis were extracted to describe 3D motion and quantify movement variability. FINDINGS A smaller mean distance was observed in those with neck pain compared to the asymptomatic participants during flexion-extension (P = 0.019) and rotation movements (P = 0.007). The neck pain group displayed smaller values for the mean angle during rotation movements with different speeds (P = 0.01). These findings indicate less variable movement for those with neck pain relative to the asymptomatic participants. No difference in the mean angle was observed between groups for flexion-extension and lateral flexion. INTERPRETATION The findings reiterate the importance of data derived from kinematic measures, and its potential for providing clinicians with further insight into the quality of active neck movements in people with chronic neck pain.
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Affiliation(s)
- Feras Alsultan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK; Physical Therapy Department, College of Medical Rehabilitation, Qassim University, Buraidah, Saudi Arabia
| | - Corrado Cescon
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Alessandro Marco De Nunzio
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
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