Multidimensional evaluation of changes in limb function following botulinum toxin injection in persons with stroke.
Identifieur interne : 000196 ( Main/Curation ); précédent : 000195; suivant : 000197Multidimensional evaluation of changes in limb function following botulinum toxin injection in persons with stroke.
Auteurs : B. Amatya [Australie] ; L E Cofré Lizama [Australie] ; A. Elmalik [Australie] ; A. Bastani [Australie] ; M P Galea [Australie] ; F. Khan [Australie]Source :
- NeuroRehabilitation [ 1878-6448 ] ; 2019.
Descripteurs français
- KwdFr :
- Accident vasculaire cérébral (complications), Adulte (MeSH), Adulte d'âge moyen (MeSH), Agents neuromusculaires (administration et posologie), Agents neuromusculaires (usage thérapeutique), Démarche (MeSH), Exercice physique (MeSH), Femelle (MeSH), Humains (MeSH), Membre inférieur (physiopathologie), Membre supérieur (physiopathologie), Mâle (MeSH), Spasticité musculaire (traitement médicamenteux), Spasticité musculaire (étiologie), Toxines botuliniques de type A (administration et posologie), Toxines botuliniques de type A (usage thérapeutique).
- MESH :
- administration et posologie : Agents neuromusculaires, Toxines botuliniques de type A.
- physiopathologie : Membre inférieur, Membre supérieur.
- traitement médicamenteux : Spasticité musculaire.
- usage thérapeutique : Accident vasculaire cérébral, Agents neuromusculaires, Toxines botuliniques de type A.
- étiologie : Spasticité musculaire.
- Adulte, Adulte d'âge moyen, Démarche, Exercice physique, Femelle, Humains, Mâle.
English descriptors
- KwdEn :
- Adult (MeSH), Botulinum Toxins, Type A (administration & dosage), Botulinum Toxins, Type A (therapeutic use), Exercise (MeSH), Female (MeSH), Gait (MeSH), Humans (MeSH), Lower Extremity (physiopathology), Male (MeSH), Middle Aged (MeSH), Muscle Spasticity (drug therapy), Muscle Spasticity (etiology), Neuromuscular Agents (administration & dosage), Neuromuscular Agents (therapeutic use), Stroke (complications), Upper Extremity (physiopathology).
- MESH :
- chemical , administration & dosage : Botulinum Toxins, Type A, Neuromuscular Agents.
- chemical , therapeutic use : Botulinum Toxins, Type A, Neuromuscular Agents.
- complications : Stroke.
- drug therapy : Muscle Spasticity.
- etiology : Muscle Spasticity.
- physiopathology : Lower Extremity, Upper Extremity.
- Adult, Exercise, Female, Gait, Humans, Male, Middle Aged.
Abstract
BACKGROUND
There are limited evidence of instrumented measures of gait and balance to determine the functional effects of botulinum toxin injections (BoNT-A) in spasticity after stroke.
OBJECTIVE
To evaluate the functional changes in gait and balance following upper limb and lower limb BoNT-A in persons with stroke.
METHODS
A pre-post prospective study of 35 stroke patients with upper and/or lower limb spasticity after focal treatment with BoNT-A. Assessments were at baseline (T0), 6-weeks (T1) and 12-weeks (T2), using validated subjective and objective physical activity measures.
RESULTS
After BoNT-A injections, significant improvements in most measures of impairments, activity and participation domains were found at T1 (p < 0.05, effect sizes (r) = 0.5-0.9). There was a significant increase in low intensity physical activity (at T1) and sedentary time reductions at both follow-up periods. Instrumented gait/balance measures showed a significant increase in cadence and turn velocity, but no changes in sway measures were found using posturography. Improvements in most outcome measures were maintained at 12-weeks.
CONCLUSION
BONT-A improved scores in most clinical measures but only in some of the objective gait/balance and physical activity measures. Further robust studies should utilize a larger sample size to better determine the benefits of BoNT-A for stroke-related spasticity.
DOI: 10.3233/NRE-192722
PubMed: 31403954
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Amatya</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Australian Rehabilitation Research Centre, VIC</wicri:regionArea></affiliation></author><author><name sortKey="Cofre Lizama, L E" sort="Cofre Lizama, L E" uniqKey="Cofre Lizama L" first="L E" last="Cofré Lizama">L E Cofré Lizama</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Australian Rehabilitation Research Centre, VIC</wicri:regionArea></affiliation></author><author><name sortKey="Elmalik, A" sort="Elmalik, A" uniqKey="Elmalik A" first="A" last="Elmalik">A. 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Bastani</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Australian Rehabilitation Research Centre, VIC</wicri:regionArea></affiliation></author><author><name sortKey="Galea, M P" sort="Galea, M P" uniqKey="Galea M" first="M P" last="Galea">M P Galea</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Australian Rehabilitation Research Centre, VIC</wicri:regionArea></affiliation></author><author><name sortKey="Khan, F" sort="Khan, F" uniqKey="Khan F" first="F" last="Khan">F. Khan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Australian Rehabilitation Research Centre, VIC</wicri:regionArea></affiliation></author></analytic><series><title level="j">NeuroRehabilitation</title><idno type="eISSN">1878-6448</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Botulinum Toxins, Type A (administration & dosage)</term><term>Botulinum Toxins, Type A (therapeutic use)</term><term>Exercise (MeSH)</term><term>Female (MeSH)</term><term>Gait (MeSH)</term><term>Humans (MeSH)</term><term>Lower Extremity (physiopathology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Muscle Spasticity (drug therapy)</term><term>Muscle Spasticity (etiology)</term><term>Neuromuscular Agents (administration & dosage)</term><term>Neuromuscular Agents (therapeutic use)</term><term>Stroke (complications)</term><term>Upper Extremity (physiopathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral (complications)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Agents neuromusculaires (administration et posologie)</term><term>Agents neuromusculaires (usage thérapeutique)</term><term>Démarche (MeSH)</term><term>Exercice physique (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Membre inférieur (physiopathologie)</term><term>Membre supérieur (physiopathologie)</term><term>Mâle (MeSH)</term><term>Spasticité musculaire (traitement médicamenteux)</term><term>Spasticité musculaire (étiologie)</term><term>Toxines botuliniques de type A (administration et posologie)</term><term>Toxines botuliniques de type A (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Botulinum Toxins, Type A</term><term>Neuromuscular Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Botulinum Toxins, Type A</term><term>Neuromuscular Agents</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents neuromusculaires</term><term>Toxines botuliniques de type A</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Membre inférieur</term><term>Membre supérieur</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Lower Extremity</term><term>Upper Extremity</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Spasticité musculaire</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Accident vasculaire cérébral</term><term>Agents neuromusculaires</term><term>Toxines botuliniques de type A</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Spasticité musculaire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Exercise</term><term>Female</term><term>Gait</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Démarche</term><term>Exercice physique</term><term>Femelle</term><term>Humains</term><term>Mâle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>There are limited evidence of instrumented measures of gait and balance to determine the functional effects of botulinum toxin injections (BoNT-A) in spasticity after stroke.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To evaluate the functional changes in gait and balance following upper limb and lower limb BoNT-A in persons with stroke.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A pre-post prospective study of 35 stroke patients with upper and/or lower limb spasticity after focal treatment with BoNT-A. Assessments were at baseline (T0), 6-weeks (T1) and 12-weeks (T2), using validated subjective and objective physical activity measures.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>After BoNT-A injections, significant improvements in most measures of impairments, activity and participation domains were found at T1 (p < 0.05, effect sizes (r) = 0.5-0.9). There was a significant increase in low intensity physical activity (at T1) and sedentary time reductions at both follow-up periods. Instrumented gait/balance measures showed a significant increase in cadence and turn velocity, but no changes in sway measures were found using posturography. Improvements in most outcome measures were maintained at 12-weeks.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>BONT-A improved scores in most clinical measures but only in some of the objective gait/balance and physical activity measures. Further robust studies should utilize a larger sample size to better determine the benefits of BoNT-A for stroke-related spasticity.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">31403954</PMID><DateCompleted><Year>2019</Year><Month>12</Month><Day>26</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>26</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1878-6448</ISSN><JournalIssue CitedMedium="Internet"><Volume>45</Volume><Issue>1</Issue><PubDate><Year>2019</Year></PubDate></JournalIssue><Title>NeuroRehabilitation</Title><ISOAbbreviation>NeuroRehabilitation</ISOAbbreviation></Journal><ArticleTitle>Multidimensional evaluation of changes in limb function following botulinum toxin injection in persons with stroke.</ArticleTitle><Pagination><MedlinePgn>67-78</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3233/NRE-192722</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">There are limited evidence of instrumented measures of gait and balance to determine the functional effects of botulinum toxin injections (BoNT-A) in spasticity after stroke.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To evaluate the functional changes in gait and balance following upper limb and lower limb BoNT-A in persons with stroke.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A pre-post prospective study of 35 stroke patients with upper and/or lower limb spasticity after focal treatment with BoNT-A. Assessments were at baseline (T0), 6-weeks (T1) and 12-weeks (T2), using validated subjective and objective physical activity measures.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">After BoNT-A injections, significant improvements in most measures of impairments, activity and participation domains were found at T1 (p < 0.05, effect sizes (r) = 0.5-0.9). There was a significant increase in low intensity physical activity (at T1) and sedentary time reductions at both follow-up periods. Instrumented gait/balance measures showed a significant increase in cadence and turn velocity, but no changes in sway measures were found using posturography. Improvements in most outcome measures were maintained at 12-weeks.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">BONT-A improved scores in most clinical measures but only in some of the objective gait/balance and physical activity measures. Further robust studies should utilize a larger sample size to better determine the benefits of BoNT-A for stroke-related spasticity.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Amatya</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cofré Lizama</LastName><ForeName>L E</ForeName><Initials>LE</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Elmalik</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bastani</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Galea</LastName><ForeName>M P</ForeName><Initials>MP</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Australian Rehabilitation Research Centre, VIC, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>NeuroRehabilitation</MedlineTA><NlmUniqueID>9113791</NlmUniqueID><ISSNLinking>1053-8135</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D009465">Neuromuscular Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.24.69</RegistryNumber><NameOfSubstance UI="D019274">Botulinum Toxins, Type A</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.24.69</RegistryNumber><NameOfSubstance UI="C545476">incobotulinumtoxinA</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019274" MajorTopicYN="N">Botulinum Toxins, Type A</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015444" MajorTopicYN="N">Exercise</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005684" MajorTopicYN="Y">Gait</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D035002" MajorTopicYN="N">Lower Extremity</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009128" MajorTopicYN="N">Muscle Spasticity</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009465" MajorTopicYN="N">Neuromuscular Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D034941" MajorTopicYN="N">Upper Extremity</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Spasticity</Keyword><Keyword MajorTopicYN="N">balance</Keyword><Keyword MajorTopicYN="N">disability</Keyword><Keyword MajorTopicYN="N">gait</Keyword><Keyword MajorTopicYN="N">impairment</Keyword><Keyword MajorTopicYN="N">participation</Keyword><Keyword MajorTopicYN="N">stroke</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>8</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>12</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>8</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31403954</ArticleId><ArticleId IdType="pii">NRE192722</ArticleId><ArticleId IdType="doi">10.3233/NRE-192722</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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