{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:10:59Z","timestamp":1792012259933,"version":"4.4.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018936","name":"Universit\u00e4tsklinikum Heidelberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018936","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with musculoskeletal tumors who undergo amputation show reduced physical function. To give these patients better expectations of their future physical capabilities and to enhance the evaluation and development of postoperative rehabilitation, we investigated high-level activity and access to sport using objective measurements and questionnaires. We then compared the results to those of amputees who had undergone amputation due to trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In a prospective, monocentric study, we evaluated and correlated the results of the conventional mobility tests such as \u201ctimed-up-and-go\u201d test (TUG), \u201c2-Minute-Walk-Test\u201d (2MWT), as well as the \u201c10-Meter-Walk-Test\u201d (10MWT) with a test for high-level activity. In this contribution, the Comprehensive High-Level Activity Mobility Predictor (CHAMP), originally developed for male servicemembers, was tested for feasibility in our cohort. We examined eleven patients who underwent amputation due to primary malignant bone or soft-tissue sarcomas and compared the results with ten patients who experienced traumatic amputation, along with seventeen patients in the healthy control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with lower leg amputations due to malignant musculoskeletal tumors exhibited superior outcomes in general mobility and high-level activity mobility compared to those with traumatic amputations. Using a questionnaire, we were able to demonstrate that patients suffering after amputation because of musculoskeletal tumor exhibited higher motivation and a greater sense of health and well-being compared to participants who had undergone traumatic amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CHAMP can be utilized as a complementary tool in the rehabilitation of amputees to objectively assess high-level mobility and to guide targeted training and therapeutic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-06037-x","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T06:54:00Z","timestamp":1755759240000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High-level activity and access to sport following lower limb amputation due to malignant musculoskeletal tumors versus trauma: a prospective comparative study"],"prefix":"10.1007","volume":"145","author":[{"given":"Astrid","family":"Schenker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian I.","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merkur","family":"Alimusaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Putz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhard","family":"Lehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Block","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"6037_CR1","unstructured":"World Health Organisation (2010) Global Recommendations on Physical Activity for Health. Geneva"},{"issue":"2","key":"6037_CR2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.2340\/1650198419915159","volume":"23","author":"RJ Shephard","year":"1991","unstructured":"Shephard RJ (1991) Benefits of sport and physical activity for the disabled: implications for the individual and for society. Scand J Rehabil Med 23(2):51\u201359","journal-title":"Scand J Rehabil Med"},{"key":"6037_CR3","doi-asserted-by":"crossref","unstructured":"Wong CK et al (2021) A scoping review of physical activity in people with Lower-Limb loss: 10,000 steps per day?? Phys Ther 101(8)","DOI":"10.1093\/ptj\/pzab115"},{"issue":"6","key":"6037_CR4","first-page":"258","volume":"61","author":"B Kegel","year":"1980","unstructured":"Kegel B, Webster JC, Burgess EM (1980) Recreational activities of lower extremity amputees: a survey. Arch Phys Med Rehabil 61(6):258\u2013264","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"6037_CR5","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3109\/03093640902984579","volume":"33","author":"C Kars","year":"2009","unstructured":"Kars C et al (2009) Participation in sports by lower limb amputees in the Province of drenthe, the Netherlands. Prosthet Orthot Int 33(4):356\u2013367","journal-title":"Prosthet Orthot Int"},{"issue":"6","key":"6037_CR6","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1302\/0301-620X.90B6.19805","volume":"90","author":"LH Aksnes","year":"2008","unstructured":"Aksnes LH et al (2008) Limb-sparing surgery preserves more function than amputation: a Scandinavian sarcoma group study of 118 patients. J Bone Joint Surg Br 90(6):786\u2013794","journal-title":"J Bone Joint Surg Br"},{"issue":"9","key":"6037_CR7","doi-asserted-by":"crossref","first-page":"721","DOI":"10.2165\/11590420-000000000-00000","volume":"41","author":"M Bragaru","year":"2011","unstructured":"Bragaru M et al (2011) Amputees and sports: a systematic review. Sports Med 41(9):721\u2013740","journal-title":"Sports Med"},{"issue":"3","key":"6037_CR8","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2340\/16501977-0921","volume":"44","author":"L Nolan","year":"2012","unstructured":"Nolan L (2012) A training programme to improve hip strength in persons with lower limb amputation. J Rehabil Med 44(3):241\u2013248","journal-title":"J Rehabil Med"},{"issue":"7","key":"6037_CR9","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1682\/JRRD.2012.05.0099","volume":"50","author":"RS Gailey","year":"2013","unstructured":"Gailey RS et al (2013) Development and reliability testing of the comprehensive High-Level activity mobility predictor (CHAMP) in male servicemembers with traumatic lower-limb loss. J Rehabil Res Dev 50(7):905\u2013918","journal-title":"J Rehabil Res Dev"},{"key":"6037_CR10","doi-asserted-by":"crossref","unstructured":"Putz Cea (2017) Exo-Prothesenregister: qualit\u00e4tsmanagement Nach beinamputation. Trauma und Berufskrankheit","DOI":"10.1007\/s10039-017-0346-7"},{"issue":"12","key":"6037_CR11","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/0003-9993(94)90278-X","volume":"75","author":"C Gauthier-Gagnon","year":"1994","unstructured":"Gauthier-Gagnon C, Grise MC (1994) Prosthetic profile of the amputee questionnaire: validity and reliability. Arch Phys Med Rehabil 75(12):1309\u20131314","journal-title":"Arch Phys Med Rehabil"},{"issue":"10","key":"6037_CR12","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1053\/apmr.2001.25987","volume":"82","author":"WC Miller","year":"2001","unstructured":"Miller WC, Deathe AB, Speechley M (2001) Lower extremity prosthetic mobility: a comparison of 3 self-report scales. Arch Phys Med Rehabil 82(10):1432\u20131440","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"6037_CR13","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1080\/03093640701253952","volume":"31","author":"F Franchignoni","year":"2007","unstructured":"Franchignoni F et al (2007) Rasch analysis of the locomotor capabilities Index-5 in people with lower limb amputation. Prosthet Orthot Int 31(4):394\u2013404","journal-title":"Prosthet Orthot Int"},{"issue":"7","key":"6037_CR14","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/S0003-9993(99)90234-4","volume":"80","author":"T Schoppen","year":"1999","unstructured":"Schoppen T et al (1999) The timed up and go test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil 80(7):825\u2013828","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"6037_CR15","doi-asserted-by":"crossref","first-page":"256","DOI":"10.2340\/16501977-1916","volume":"47","author":"L Reid","year":"2015","unstructured":"Reid L et al (2015) Going places: does the two-minute walk test predict the six-minute walk test in lower extremity amputees? J Rehabil Med 47(3):256\u2013261","journal-title":"J Rehabil Med"},{"issue":"2","key":"6037_CR16","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3109\/03093649309164360","volume":"17","author":"AM Boonstra","year":"1993","unstructured":"Boonstra AM, Fidler V, Eisma WH (1993) Walking speed of normal subjects and amputees: aspects of validity of gait analysis. Prosthet Orthot Int 17(2):78\u201382","journal-title":"Prosthet Orthot Int"},{"issue":"7","key":"6037_CR17","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1682\/JRRD.2012.05.0100","volume":"50","author":"RS Gailey","year":"2013","unstructured":"Gailey RS et al (2013) Construct validity of comprehensive High-Level activity mobility predictor (CHAMP) for male servicemembers with traumatic lower-limb loss. J Rehabil Res Dev 50(7):919\u2013930","journal-title":"J Rehabil Res Dev"},{"issue":"5","key":"6037_CR18","first-page":"377","volume":"14","author":"GA Borg","year":"1982","unstructured":"Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14(5):377\u2013381","journal-title":"Med Sci Sports Exerc"},{"issue":"6","key":"6037_CR19","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1111\/sms.12218","volume":"24","author":"EA Jaarsma","year":"2014","unstructured":"Jaarsma EA et al (2014) Barriers to and facilitators of sports participation for people with physical disabilities: a systematic review. Scand J Med Sci Sports 24(6):871\u2013881","journal-title":"Scand J Med Sci Sports"},{"issue":"5","key":"6037_CR20","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1111\/sms.12071","volume":"24","author":"EA Jaarsma","year":"2014","unstructured":"Jaarsma EA et al (2014) Barriers and facilitators of sports in Dutch paralympic athletes: an explorative study. Scand J Med Sci Sports 24(5):830\u2013836","journal-title":"Scand J Med Sci Sports"},{"issue":"5","key":"6037_CR21","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1177\/0309364616683818","volume":"41","author":"CA Miller","year":"2017","unstructured":"Miller CA et al (2017) The effect of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation. Prosthet Orthot Int 41(5):446\u2013454","journal-title":"Prosthet Orthot Int"},{"issue":"1","key":"6037_CR22","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1177\/0269215519880295","volume":"34","author":"L Godlwana","year":"2020","unstructured":"Godlwana L, Stewart A, Musenge E (2020) The effect of a home exercise intervention on persons with lower limb amputations: a randomized controlled trial. Clin Rehabil 34(1):99\u2013110","journal-title":"Clin Rehabil"},{"issue":"3","key":"6037_CR23","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s11764-018-0681-0","volume":"12","author":"CS Kampshoff","year":"2018","unstructured":"Kampshoff CS et al (2018) Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors. J Cancer Surviv 12(3):417\u2013429","journal-title":"J Cancer Surviv"},{"issue":"7","key":"6037_CR24","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3109\/09638289709166538","volume":"19","author":"H Burger","year":"1997","unstructured":"Burger H, Marincek C, Isakov E (1997) Mobility of persons after traumatic lower limb amputation. Disabil Rehabil 19(7):272\u2013277","journal-title":"Disabil Rehabil"},{"issue":"1","key":"6037_CR25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/j.2048-7940.1990.tb01147.x","volume":"15","author":"A Medhat","year":"1990","unstructured":"Medhat A, Huber PM, Medhat MA (1990) Factors that influence the level of activities in persons with lower extremity amputation. Rehabil Nurs 15(1):13\u201318","journal-title":"Rehabil Nurs"},{"issue":"12","key":"6037_CR26","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1097\/PHM.0b013e31829b4b7a","volume":"92","author":"M Kamali","year":"2013","unstructured":"Kamali M et al (2013) Influential factors in stability of lower-limb amputees. Am J Phys Med Rehabil 92(12):1110\u20131118","journal-title":"Am J Phys Med Rehabil"},{"issue":"10","key":"6037_CR27","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1249\/01.mss.0000230211.60957.2e","volume":"38","author":"L Nolan","year":"2006","unstructured":"Nolan L, Patritti BL, Simpson KJ (2006) A Biomechanical analysis of the long-jump technique of elite female amputee athletes. Med Sci Sports Exerc 38(10):1829\u20131835","journal-title":"Med Sci Sports Exerc"},{"issue":"4","key":"6037_CR28","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1080\/02640410600717931","volume":"25","author":"L Nolan","year":"2007","unstructured":"Nolan L, Lees A (2007) The influence of lower limb amputation level on the approach in the amputee long jump. J Sports Sci 25(4):393\u2013401","journal-title":"J Sports Sci"},{"issue":"3","key":"6037_CR29","first-page":"109","volume":"59","author":"B Kegel","year":"1978","unstructured":"Kegel B, Carpenter ML, Burgess EM (1978) Functional capabilities of lower extremity amputees. Arch Phys Med Rehabil 59(3):109\u2013120","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"6037_CR30","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0003-9993(95)80528-1","volume":"76","author":"SM Jaegers","year":"1995","unstructured":"Jaegers SM, Arendzen JH, de Jongh HJ (1995) Prosthetic gait of unilateral transfemoral amputees: a kinematic study. Arch Phys Med Rehabil 76(8):736\u2013743","journal-title":"Arch Phys Med Rehabil"},{"issue":"6","key":"6037_CR31","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00590-017-1929-5","volume":"27","author":"C Putz","year":"2017","unstructured":"Putz C et al (2017) Structural changes in the thigh muscles following trans-femoral amputation. Eur J Orthop Surg Traumatol 27(6):829\u2013835","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"2","key":"6037_CR32","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jvn.2016.11.002","volume":"35","author":"E Torbjornsson","year":"2017","unstructured":"Torbjornsson E et al (2017) The patient\u2019s experience of amputation due to peripheral arterial disease. J Vasc Nurs 35(2):57\u201363","journal-title":"J Vasc Nurs"},{"issue":"4","key":"6037_CR33","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/S0885-3924(02)00511-0","volume":"24","author":"CP van der Schans","year":"2002","unstructured":"van der Schans CP et al (2002) Phantom pain and health-related quality of life in lower limb amputees. J Pain Symptom Manage 24(4):429\u2013436","journal-title":"J Pain Symptom Manage"},{"issue":"12","key":"6037_CR34","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.injury.2011.07.005","volume":"42","author":"JG Penn-Barwell","year":"2011","unstructured":"Penn-Barwell JG (2011) Outcomes in lower limb amputation following trauma: a systematic review and meta-analysis. Injury 42(12):1474\u20131479","journal-title":"Injury"},{"issue":"2","key":"6037_CR35","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1053\/apmr.2001.18231","volume":"82","author":"T Schoppen","year":"2001","unstructured":"Schoppen T et al (2001) Employment status, job characteristics, and work-related health experience of people with a lower limb amputation in the Netherlands. Arch Phys Med Rehabil 82(2):239\u2013245","journal-title":"Arch Phys Med Rehabil"},{"issue":"10","key":"6037_CR36","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1053\/apmr.2001.26074","volume":"82","author":"T Schoppen","year":"2001","unstructured":"Schoppen T et al (2001) Factors related to successful job reintegration of people with a lower limb amputation. Arch Phys Med Rehabil 82(10):1425\u20131431","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"6037_CR37","first-page":"631","volume":"52","author":"DWW Heitzmann","year":"2023","unstructured":"Heitzmann DWW et al (2023) Motion analysis in lower limb exoprosthetics-possibilities and limitations. Orthopadie (Heidelb) 52(8):631\u2013642","journal-title":"Orthopadie (Heidelb)"},{"key":"6037_CR38","unstructured":"Block J (2015) Objektive Funktionsdokumentation nach Beinamputation, in Medizinische-Orthop\u00e4dische Technik pp 35\u201340"},{"issue":"5","key":"6037_CR39","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1177\/02692155211069323","volume":"36","author":"RS Gailey","year":"2022","unstructured":"Gailey RS et al (2022) A comparison of the Two-Minute walk test (2MWT) and comprehensive High-level activity mobility predictor (CHAMP) in people with a leg prosthesis. Clin Rehabil 36(5):703\u2013712","journal-title":"Clin Rehabil"},{"issue":"1","key":"6037_CR40","doi-asserted-by":"crossref","first-page":"2143053","DOI":"10.1080\/17482631.2022.2143053","volume":"18","author":"SH Olsen","year":"2023","unstructured":"Olsen SH et al (2023) Exploring motivations to be active among amputees: a phenomenological approach to leisure time physical activity. Int J Qual Stud Health Well-being 18(1):2143053","journal-title":"Int J Qual Stud Health Well-being"},{"issue":"8","key":"6037_CR41","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1177\/0269215507077361","volume":"21","author":"R Singh","year":"2007","unstructured":"Singh R, Hunter J, Philip A (2007) The rapid resolution of depression and anxiety symptoms after lower limb amputation. Clin Rehabil 21(8):754\u2013759","journal-title":"Clin Rehabil"},{"issue":"8","key":"6037_CR42","first-page":"e17440","volume":"13","author":"L Pran","year":"2021","unstructured":"Pran L et al (2021) Quality of life experienced by major lower extremity amputees. Cureus 13(8):e17440","journal-title":"Cureus"},{"issue":"2","key":"6037_CR43","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/03093640802016514","volume":"32","author":"SA Deans","year":"2008","unstructured":"Deans SA, McFadyen AK, Rowe PJ (2008) Physical activity and quality of life: A study of a lower-limb amputee population. Prosthet Orthot Int 32(2):186\u2013200","journal-title":"Prosthet Orthot Int"},{"issue":"10","key":"6037_CR44","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/j.apmr.2020.04.026","volume":"101","author":"MP Dillon","year":"2020","unstructured":"Dillon MP et al (2020) Factors associated with Health-Related quality of life in people living with partial foot or transtibial amputation. Arch Phys Med Rehabil 101(10):1711\u20131719","journal-title":"Arch Phys Med Rehabil"},{"key":"6037_CR45","doi-asserted-by":"crossref","unstructured":"Calabrese L et al (2023) What is hidden behind amputation?? Quanti-Qualitative systematic review on psychological adjustment and quality of life in lower limb amputees for Non-Traumatic reasons. Healthc (Basel) 11(11)","DOI":"10.3390\/healthcare11111661"},{"issue":"8","key":"6037_CR46","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0003-9993(98)90090-9","volume":"79","author":"MW Legro","year":"1998","unstructured":"Legro MW et al (1998) Prosthesis evaluation questionnaire for persons with lower limb amputations: assessing prosthesis-related quality of life. Arch Phys Med Rehabil 79(8):931\u2013938","journal-title":"Arch Phys Med Rehabil"},{"issue":"7","key":"6037_CR47","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1097\/01.phm.0000166885.16180.63","volume":"84","author":"DM Desmond","year":"2005","unstructured":"Desmond DM, MacLachlan M (2005) Factor structure of the trinity amputation and prosthesis experience scales (TAPES) with individuals with acquired upper limb amputations. Am J Phys Med Rehabil 84(7):506\u2013513","journal-title":"Am J Phys Med Rehabil"},{"key":"6037_CR48","doi-asserted-by":"crossref","first-page":"604376","DOI":"10.3389\/fnbot.2020.604376","volume":"14","author":"R Bekrater-Bodmann","year":"2020","unstructured":"Bekrater-Bodmann R (2020) Factors associated with prosthesis embodiment and its importance for prosthetic satisfaction in lower limb amputees. Front Neurorobot 14:604376","journal-title":"Front Neurorobot"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06037-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-025-06037-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06037-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T08:17:48Z","timestamp":1767169068000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-025-06037-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6037"],"URL":"https:\/\/doi.org\/10.1007\/s00402-025-06037-x","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]},"assertion":[{"value":"19 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patient(s) to publish this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"418"}}