Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study

Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is sti...

Full description

Saved in:
Bibliographic Details
Published in:Journal of orthopaedic surgery and research 2022-04, Vol.17 (1), p.199-199, Article 199
Main Authors: Zhai, Meiling, Huang, Yongchao, Zhou, Shi, Feng, Jiayun, Pei, Chaolei, Wen, Li
Format: Article
Language:English
Subjects:
Age
Aged
Analysis
Back pain
Backache
Body mass index
Care and treatment
Cervical anterior angle
Chin tuck
Computer simulation
Digital cameras
Female
Head and neck
Humans
Kyphosis
Lordosis
Low back pain
Lumbar lordosis angle
Male
Neck
Older people
Orthopedics
Pelvis
Posture
Posture - physiology
Rehabilitation
Software
Spine - physiology
Thorax
University students
Variance analysis
Young Adult
Young adults
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c514t-fbe2cdb7b7b9190bb2f282acb222df9e4bacee9fe72aae6b5942750cbda63d023
container_end_page 199
container_issue 1
container_start_page 199
container_title Journal of orthopaedic surgery and research
container_volume 17
creator Zhai, Meiling
Huang, Yongchao
Zhou, Shi
Feng, Jiayun
Pei, Chaolei
Wen, Li
description Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy. Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles-cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, "inclining head backward and performing chin tuck," on lumbar lordosis angle. In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P 
doi_str_mv 10.1186/s13018-022-03090-9
format article
fullrecord <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_f2745dd5df164fac8b9fa8e16424235c</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A699416740</galeid><doaj_id>oai_doaj_org_article_f2745dd5df164fac8b9fa8e16424235c</doaj_id><sourcerecordid>A699416740</sourcerecordid><originalsourceid>FETCH-LOGICAL-c514t-fbe2cdb7b7b9190bb2f282acb222df9e4bacee9fe72aae6b5942750cbda63d023</originalsourceid><addsrcrecordid>eNptks2OFCEUhStG4_zoC7gwJG7c1AgUVBUuTCaTGZ1kEjeauCMUXLppKWihyqSfwNeWmm7HaWNY8HfOd-HmVNUrgi8I6dt3mTSY9DWmtMYNFrgWT6pT0jFRd0J8e_pofVKd5bzBmGPes-fVScObTlDen1a_rq0FPWUULVJoG_M0J-WRnsGFFbIxoTUog1QwKID-flAAigH5eRxUQj4mE7PLRbPykJELi8VP6x3axblAFm_0BhJSZvZTfr8USuDd6IJKO1SAZveiemaVz_DyMJ9XX2-uv1x9qu8-f7y9uryrNSdsqu0AVJuhK0MQgYeBWtpTpQdKqbEC2KA0gLDQUaWgHbhgtONYD0a1jcG0Oa9u91wT1UZukxvLE2RUTt4fxLSSKk1Oe5CWdowbw40lLbNK94OwqoeyoYw2XBfWhz1rOw8jGA1hKr07gh7fBLeWq_hT9qJfKAXw9gBI8ccMeZKjyxq8VwHinCVtWUcJbVhTpG_-kW7inEJpVVFxSnjbNfivaqXKB1ywsdTVC1RetkIw0nZsUV38R1WGgdHpGMC6cn5koHuDTjHnBPbhjwTLJYpyH0VZoijvoyhFMb1-3J0Hy5_sNb8BrcbcKg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2652156730</pqid></control><display><type>article</type><title>Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study</title><source>ProQuest - Publicly Available Content Database</source><source>PubMed Central</source><creator>Zhai, Meiling ; Huang, Yongchao ; Zhou, Shi ; Feng, Jiayun ; Pei, Chaolei ; Wen, Li</creator><creatorcontrib>Zhai, Meiling ; Huang, Yongchao ; Zhou, Shi ; Feng, Jiayun ; Pei, Chaolei ; Wen, Li</creatorcontrib><description>Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy. Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles-cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, "inclining head backward and performing chin tuck," on lumbar lordosis angle. In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P &lt; 0.001, by ANOVA) than that in the young adult group and increased significantly (P &lt; 0.001) in response to the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced in response to the postural cueing. However, the lumbar lordosis angle in response to the postural cueing increased significantly in both the standing position (P &lt; 0.001) and sitting position (P &lt; 0.001). The results suggest that increasing the cervical anterior angle can increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic forward inclination to improve the lumbar lordosis angle. Furthermore, the change in head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new noninvasive body posture rehabilitation strategy.</description><identifier>ISSN: 1749-799X</identifier><identifier>EISSN: 1749-799X</identifier><identifier>DOI: 10.1186/s13018-022-03090-9</identifier><identifier>PMID: 35379258</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Age ; Aged ; Analysis ; Back pain ; Backache ; Body mass index ; Care and treatment ; Cervical anterior angle ; Chin tuck ; Computer simulation ; Digital cameras ; Female ; Head and neck ; Humans ; Kyphosis ; Lordosis ; Low back pain ; Lumbar lordosis angle ; Male ; Neck ; Older people ; Orthopedics ; Pelvis ; Posture ; Posture - physiology ; Rehabilitation ; Software ; Spine - physiology ; Thorax ; University students ; Variance analysis ; Young Adult ; Young adults</subject><ispartof>Journal of orthopaedic surgery and research, 2022-04, Vol.17 (1), p.199-199, Article 199</ispartof><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 BioMed Central Ltd.</rights><rights>2022. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c514t-fbe2cdb7b7b9190bb2f282acb222df9e4bacee9fe72aae6b5942750cbda63d023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981642/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2652156730?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35379258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhai, Meiling</creatorcontrib><creatorcontrib>Huang, Yongchao</creatorcontrib><creatorcontrib>Zhou, Shi</creatorcontrib><creatorcontrib>Feng, Jiayun</creatorcontrib><creatorcontrib>Pei, Chaolei</creatorcontrib><creatorcontrib>Wen, Li</creatorcontrib><title>Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study</title><title>Journal of orthopaedic surgery and research</title><addtitle>J Orthop Surg Res</addtitle><description>Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy. Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles-cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, "inclining head backward and performing chin tuck," on lumbar lordosis angle. In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P &lt; 0.001, by ANOVA) than that in the young adult group and increased significantly (P &lt; 0.001) in response to the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced in response to the postural cueing. However, the lumbar lordosis angle in response to the postural cueing increased significantly in both the standing position (P &lt; 0.001) and sitting position (P &lt; 0.001). The results suggest that increasing the cervical anterior angle can increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic forward inclination to improve the lumbar lordosis angle. Furthermore, the change in head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new noninvasive body posture rehabilitation strategy.</description><subject>Age</subject><subject>Aged</subject><subject>Analysis</subject><subject>Back pain</subject><subject>Backache</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Cervical anterior angle</subject><subject>Chin tuck</subject><subject>Computer simulation</subject><subject>Digital cameras</subject><subject>Female</subject><subject>Head and neck</subject><subject>Humans</subject><subject>Kyphosis</subject><subject>Lordosis</subject><subject>Low back pain</subject><subject>Lumbar lordosis angle</subject><subject>Male</subject><subject>Neck</subject><subject>Older people</subject><subject>Orthopedics</subject><subject>Pelvis</subject><subject>Posture</subject><subject>Posture - physiology</subject><subject>Rehabilitation</subject><subject>Software</subject><subject>Spine - physiology</subject><subject>Thorax</subject><subject>University students</subject><subject>Variance analysis</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1749-799X</issn><issn>1749-799X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptks2OFCEUhStG4_zoC7gwJG7c1AgUVBUuTCaTGZ1kEjeauCMUXLppKWihyqSfwNeWmm7HaWNY8HfOd-HmVNUrgi8I6dt3mTSY9DWmtMYNFrgWT6pT0jFRd0J8e_pofVKd5bzBmGPes-fVScObTlDen1a_rq0FPWUULVJoG_M0J-WRnsGFFbIxoTUog1QwKID-flAAigH5eRxUQj4mE7PLRbPykJELi8VP6x3axblAFm_0BhJSZvZTfr8USuDd6IJKO1SAZveiemaVz_DyMJ9XX2-uv1x9qu8-f7y9uryrNSdsqu0AVJuhK0MQgYeBWtpTpQdKqbEC2KA0gLDQUaWgHbhgtONYD0a1jcG0Oa9u91wT1UZukxvLE2RUTt4fxLSSKk1Oe5CWdowbw40lLbNK94OwqoeyoYw2XBfWhz1rOw8jGA1hKr07gh7fBLeWq_hT9qJfKAXw9gBI8ccMeZKjyxq8VwHinCVtWUcJbVhTpG_-kW7inEJpVVFxSnjbNfivaqXKB1ywsdTVC1RetkIw0nZsUV38R1WGgdHpGMC6cn5koHuDTjHnBPbhjwTLJYpyH0VZoijvoyhFMb1-3J0Hy5_sNb8BrcbcKg</recordid><startdate>20220404</startdate><enddate>20220404</enddate><creator>Zhai, Meiling</creator><creator>Huang, Yongchao</creator><creator>Zhou, Shi</creator><creator>Feng, Jiayun</creator><creator>Pei, Chaolei</creator><creator>Wen, Li</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20220404</creationdate><title>Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study</title><author>Zhai, Meiling ; Huang, Yongchao ; Zhou, Shi ; Feng, Jiayun ; Pei, Chaolei ; Wen, Li</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-fbe2cdb7b7b9190bb2f282acb222df9e4bacee9fe72aae6b5942750cbda63d023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Aged</topic><topic>Analysis</topic><topic>Back pain</topic><topic>Backache</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Cervical anterior angle</topic><topic>Chin tuck</topic><topic>Computer simulation</topic><topic>Digital cameras</topic><topic>Female</topic><topic>Head and neck</topic><topic>Humans</topic><topic>Kyphosis</topic><topic>Lordosis</topic><topic>Low back pain</topic><topic>Lumbar lordosis angle</topic><topic>Male</topic><topic>Neck</topic><topic>Older people</topic><topic>Orthopedics</topic><topic>Pelvis</topic><topic>Posture</topic><topic>Posture - physiology</topic><topic>Rehabilitation</topic><topic>Software</topic><topic>Spine - physiology</topic><topic>Thorax</topic><topic>University students</topic><topic>Variance analysis</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhai, Meiling</creatorcontrib><creatorcontrib>Huang, Yongchao</creatorcontrib><creatorcontrib>Zhou, Shi</creatorcontrib><creatorcontrib>Feng, Jiayun</creatorcontrib><creatorcontrib>Pei, Chaolei</creatorcontrib><creatorcontrib>Wen, Li</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>ProQuest_Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of orthopaedic surgery and research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhai, Meiling</au><au>Huang, Yongchao</au><au>Zhou, Shi</au><au>Feng, Jiayun</au><au>Pei, Chaolei</au><au>Wen, Li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study</atitle><jtitle>Journal of orthopaedic surgery and research</jtitle><addtitle>J Orthop Surg Res</addtitle><date>2022-04-04</date><risdate>2022</risdate><volume>17</volume><issue>1</issue><spage>199</spage><epage>199</epage><pages>199-199</pages><artnum>199</artnum><issn>1749-799X</issn><eissn>1749-799X</eissn><abstract>Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy. Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles-cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, "inclining head backward and performing chin tuck," on lumbar lordosis angle. In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P &lt; 0.001, by ANOVA) than that in the young adult group and increased significantly (P &lt; 0.001) in response to the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced in response to the postural cueing. However, the lumbar lordosis angle in response to the postural cueing increased significantly in both the standing position (P &lt; 0.001) and sitting position (P &lt; 0.001). The results suggest that increasing the cervical anterior angle can increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic forward inclination to improve the lumbar lordosis angle. Furthermore, the change in head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new noninvasive body posture rehabilitation strategy.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>35379258</pmid><doi>10.1186/s13018-022-03090-9</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1749-799X
ispartof Journal of orthopaedic surgery and research, 2022-04, Vol.17 (1), p.199-199, Article 199
issn 1749-799X
1749-799X
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_f2745dd5df164fac8b9fa8e16424235c
source ProQuest - Publicly Available Content Database; PubMed Central
subjects Age
Aged
Analysis
Back pain
Backache
Body mass index
Care and treatment
Cervical anterior angle
Chin tuck
Computer simulation
Digital cameras
Female
Head and neck
Humans
Kyphosis
Lordosis
Low back pain
Lumbar lordosis angle
Male
Neck
Older people
Orthopedics
Pelvis
Posture
Posture - physiology
Rehabilitation
Software
Spine - physiology
Thorax
University students
Variance analysis
Young Adult
Young adults
title Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T07%3A42%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20a%20postural%20cueing%20for%20head%20and%20neck%20posture%20on%20lumbar%20lordosis%20angles%20in%20healthy%20young%20and%20older%20adults:%20a%20preliminary%20study&rft.jtitle=Journal%20of%20orthopaedic%20surgery%20and%20research&rft.au=Zhai,%20Meiling&rft.date=2022-04-04&rft.volume=17&rft.issue=1&rft.spage=199&rft.epage=199&rft.pages=199-199&rft.artnum=199&rft.issn=1749-799X&rft.eissn=1749-799X&rft_id=info:doi/10.1186/s13018-022-03090-9&rft_dat=%3Cgale_doaj_%3EA699416740%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c514t-fbe2cdb7b7b9190bb2f282acb222df9e4bacee9fe72aae6b5942750cbda63d023%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2652156730&rft_id=info:pmid/35379258&rft_galeid=A699416740&rfr_iscdi=true