{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:33:05Z","timestamp":1787020385078,"version":"build-2736575974"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lateral ankle sprain (LAS) is a common and burdensome injury. However, the quality of its management is scant. Nowadays, physiotherapy management of musculoskeletal diseases seems to be generally not based on research evidence. Studies that investigated the knowledge-to-practice gap in LAS management are yet to be carried out. Therefore, this research investigated physiotherapists\u2019 knowledge of and adherence to LAS Clinical Practice Guidelines (CPGs) and recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study based on an online survey structured in three sections. The first section collected demographic data. The second section showed two clinical cases (with positive and negative Ottawa Ankle Rules (OAR), respectively). The participants indicated which treatments they would adopt to manage them. Participants were classified as \u2018following\u2019, \u2018partially following\u2019, \u2018partially not following\u2019 and \u2018not following\u2019 the CPGs and recommendations. In the third section, participants expressed their agreement with different CPG and recommendation statements through a 1-5 Likert scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 483 physiotherapists (age: 34\u2009\u00b1\u200910; female 38%, male 61.5%, other 0.5%) answered the survey: 85% completed the first two sections, 76% completed all three sections. In a case of acute LAS with negative OAR, 4% of the participants were considered as \u2018following\u2019 recommended treatments, 68% as \u2018partially following\u2019, 23% as \u2018partially not following\u2019, and 5% as \u2018not following\u2019. In a case of acute LAS with positive OAR, 37% were considered \u2018following\u2019 recommended treatments, 35% as \u2018partially following\u2019, and 28% as \u2018not following\u2019. In the third section, the consensus was achieved for 73% of the statements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study showed that although there is a good knowledge about first-line recommended treatments, a better use of CPGs and recommendations should be fostered among physiotherapists. Our results identify an evidence-to-practice gap in LAS management, which may lead to non-evidence-based practice behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12891-022-05914-5","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T02:35:26Z","timestamp":1668134126000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Physiotherapists\u2019 knowledge of and adherence to evidence-based practice guidelines and recommendations for ankle sprains management: a cross-sectional study"],"prefix":"10.1186","volume":"23","author":[{"given":"Giulia","family":"Caffini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Battista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Raschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Testa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"issue":"20","key":"5914_CR1","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1136\/bjsports-2017-098885","volume":"52","author":"E Delahunt","year":"2018","unstructured":"Delahunt E, Bleakley CM, Bossard DS, Caulfield BM, Docherty CL, Doherty C, et al. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med. 2018;52(20):1304\u201310.","journal-title":"Br J Sports Med"},{"issue":"24","key":"5914_CR2","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1136\/bjsports-2016-096189","volume":"50","author":"PA Gribble","year":"2016","unstructured":"Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med. 2016;50(24):1496\u2013505.","journal-title":"Br J Sports Med"},{"issue":"1","key":"5914_CR3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-018-2378-y","volume":"20","author":"T Green","year":"2019","unstructured":"Green T, Willson G, Martin D, Fallon K. What is the quality of clinical practice guidelines for the treatment of acute lateral ankle ligament sprains in adults? Syst Rev BMC Musculoskelet Disord. 2019;20(1):1\u201313.","journal-title":"Syst Rev BMC Musculoskelet Disord"},{"key":"5914_CR4","unstructured":"David L, Rosenberg SW, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn\u2019t. BMJ. 1996."},{"issue":"6","key":"5914_CR5","doi-asserted-by":"publisher","first-page":"671","DOI":"10.4085\/1062-6050-428-17","volume":"54","author":"T Hubbard-Turner","year":"2019","unstructured":"Hubbard-Turner T. Lack of medical treatment from a medical professional after an ankle sprain. J Athl Train. 2019;54(6):671\u20135.","journal-title":"J Athl Train"},{"key":"5914_CR6","doi-asserted-by":"crossref","unstructured":"Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ. Ankle stability and movement coordination impairments: Ankle ligament sprains. J Orthop Sports Phys Ther. 2013;43(9).","DOI":"10.2519\/jospt.2013.0305"},{"issue":"2","key":"5914_CR7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ptsp.2008.02.001","volume":"9","author":"C Eechaute","year":"2008","unstructured":"Eechaute C, Vaes P, Duquet W. The chronic ankle instability scale: Clinimetric properties of a multidimensional, patient-assessed instrument. Phys Ther Sport. 2008;9(2):57\u201366.","journal-title":"Phys Ther Sport"},{"issue":"15","key":"5914_CR8","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1136\/bjsports-2017-098106","volume":"52","author":"G Vuurberg","year":"2018","unstructured":"Vuurberg G, Hoorntje A, Wink LM, Van Der Doelen BFW, Van Den Bekerom MP, Dekker R, et al. Diagnosis, treatment and prevention of ankle sprains: Update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956.","journal-title":"Br J Sports Med"},{"issue":"11","key":"5914_CR9","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1177\/107110070502601113","volume":"26","author":"RRL Martin","year":"2005","unstructured":"Martin RRL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26(11):968\u201383.","journal-title":"Foot Ankle Int"},{"issue":"4","key":"5914_CR10","first-page":"371","volume":"79","author":"JM Binkley","year":"1999","unstructured":"Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): Scale development, measurement properties, and clinical application. Phys Ther. 1999;79(4):371\u201383.","journal-title":"Phys Ther"},{"key":"5914_CR11","doi-asserted-by":"crossref","unstructured":"Bachmann LM, Kolb E, Koller MT, Steurer J, Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. 2003;1\u20137.","DOI":"10.1136\/bmj.326.7386.417"},{"issue":"5","key":"5914_CR12","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.bjpt.2020.04.002","volume":"24","author":"JR Zadro","year":"2020","unstructured":"Zadro JR, Ferreira G. Has physical therapists\u2019 management of musculoskeletal conditions improved over time? Brazilian J Phys Ther [Internet]. 2020;24(5):458\u201362. Available from:. https:\/\/doi.org\/10.1016\/j.bjpt.2020.04.002.","journal-title":"Brazilian J Phys Ther [Internet]"},{"issue":"1","key":"5914_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12891-021-04250-4","volume":"22","author":"S Battista","year":"2021","unstructured":"Battista S, Salvioli S, Millotti S, Testa M, Dell\u2019Isola A. Italian physiotherapists\u2019 knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study. BMC Musculoskelet Disord. 2021;22(1):1\u201312.","journal-title":"BMC Musculoskelet Disord"},{"key":"5914_CR14","doi-asserted-by":"crossref","unstructured":"Clarice Y, Pile TR, Croft A, Watson NJ. Exploring Physical Therapist Adherence to Clinical Guidelines When Treating Patients With Knee Osteoarthritis in Australia: A Mixed Methods Study, Phys Ther Vol. 2020;100(7):1084.","DOI":"10.1093\/ptj\/pzaa049"},{"key":"5914_CR15","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.math.2016.10.010","volume":"27","author":"D Spitaels","year":"2017","unstructured":"Spitaels D, Hermens R, Van Assche D, Verschueren S, Luyten F, Vankrunkelsven P. Are physiotherapists adhering to quality indicators for the management of knee osteoarthritis? An observational study Musculoskelet Sci Pract. 2017;27:112\u201323.","journal-title":"An observational study Musculoskelet Sci Pract"},{"issue":"4","key":"5914_CR16","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1002\/msc.1176","volume":"15","author":"SF Andersson","year":"2017","unstructured":"Andersson SF, Bergman S, Henriksson EW, Bremander A. Arthritis management in primary care \u2013 A study of physiotherapists\u2019 current practice, educational needs and adherence to national guidelines. Musculoskeletal Care. 2017;15(4):333\u201340.","journal-title":"Musculoskeletal Care"},{"issue":"3","key":"5914_CR17","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1002\/msc.1067","volume":"12","author":"WF Peter","year":"2014","unstructured":"Peter WF, Nelissen RGHH, Vliet Vlieland TPM. Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: Are they used in daily clinical practice? Musculoskeletal Care. 2014;12(3):125\u201331.","journal-title":"Musculoskeletal Care."},{"issue":"1","key":"5914_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12891-021-04527-8","volume":"22","author":"T Yokoe","year":"2021","unstructured":"Yokoe T, Tajima T, Yamaguchi N, Morita Y, Chosa E. The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan. BMC Musculoskelet Disord [Internet]. 2021;22(1):1\u20137. Available from:. https:\/\/doi.org\/10.1186\/s12891-021-04527-8.","journal-title":"BMC Musculoskelet Disord [Internet]"},{"key":"5914_CR19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-8-45","volume":"8","author":"PJ Van Der Wees","year":"2007","unstructured":"Van Der Wees PJ, Hendriks EJM, Jansen MJ, Van Beers H, De Bie RA, Dekker J. Adherence to physiotherapy clinical guideline acute ankle injury and determinants of adherence: A cohort study. BMC Musculoskelet Disord. 2007;8:1\u20137.","journal-title":"BMC Musculoskelet Disord"},{"issue":"5","key":"5914_CR20","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1111\/j.1365-2753.2006.00699.x","volume":"12","author":"GMJ Rutten","year":"2006","unstructured":"Rutten GMJ, Harting J, Rutten STJ, Bekkering GE, Kremers SPJ. Measuring physiotherapists\u2019 guideline adherence by means of clinical vignettes: A validation study. J Eval Clin Pract. 2006;12(5):491\u2013500.","journal-title":"J Eval Clin Pract"},{"key":"5914_CR21","volume-title":"International Handbook of Survey Methodology (European Association of Methodology Series)","author":"D de Leeuw","year":"2008","unstructured":"de Leeuw D, Hox JDD. International Handbook of Survey Methodology (European Association of Methodology Series): Taylor and Francis group; 2008."},{"issue":"4","key":"5914_CR22","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"E von Elm","year":"2008","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344\u20139.","journal-title":"J Clin Epidemiol"},{"key":"5914_CR23","doi-asserted-by":"crossref","unstructured":"Martin RRL, Davenport TE, Fraser JJ, Sawdon-Bea J, Carcia CR, Carroll LA, et al. Ankle stability and movement coordination impairments: Lateral ankle ligament sprains revision 2021. J Orthop Sports Phys Ther. 2021;51(4):CPG1\u201380.","DOI":"10.2519\/jospt.2021.0302"},{"key":"5914_CR24","unstructured":"Blackmer WS. EU general data protection regulation. Am Fuel Petrochemical Manuf AFPM. Labor Relations\/Human Resour Conf. 2018:45\u201362."},{"issue":"5","key":"5914_CR25","doi-asserted-by":"publisher","first-page":"347","DOI":"10.2519\/jospt.2017.6561","volume":"47","author":"CE Ladeira","year":"2017","unstructured":"Ladeira CE, Cheng MS, Da Silva RA. Clinical specialization and adherence to evidence-based practice guidelines for low back pain management: A survey of US physical therapists. J Orthop Sports Phys Ther. 2017;47(5):347\u201358.","journal-title":"J Orthop Sports Phys Ther."},{"issue":"4","key":"5914_CR26","doi-asserted-by":"publisher","first-page":"396","DOI":"10.9734\/BJAST\/2015\/14975","volume":"7","author":"A Joshi","year":"2015","unstructured":"Joshi A, Kale S, Chandel S, Pal D. Likert Scale: Explored and Explained. Br J Appl Sci Technol. 2015;7(4):396\u2013403.","journal-title":"Br J Appl Sci Technol"},{"issue":"2","key":"5914_CR27","first-page":"149","volume":"30","author":"J Su\u00e1rez-Alvarez","year":"2018","unstructured":"Su\u00e1rez-Alvarez J, Pedrosa I, Lozano LM, Garc\u00eda-Cueto E, Cuesta M, Mu\u00f1iz J. Using reversed items in likert scales: A questionable practice. Psicothema. 2018;30(2):149\u201358.","journal-title":"Psicothema."},{"issue":"1","key":"5914_CR28","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1080\/00913847.2018.1409604","volume":"46","author":"TM Miklovic","year":"2018","unstructured":"Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA. Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed [Internet]. 2018;46(1):116\u201322. Available from:. https:\/\/doi.org\/10.1080\/00913847.2018.1409604.","journal-title":"Phys Sportsmed [Internet]"},{"issue":"3","key":"5914_CR29","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.berh.2016.08.004","volume":"30","author":"KS Dziedzic","year":"2016","unstructured":"Dziedzic KS, French S, Davis AM, Geelhoed E, Porcheret M. Implementation of musculoskeletal Models of Care in primary care settings: Theory, practice, evaluation and outcomes for musculoskeletal health in high-income economies. Best Pract Res Clin Rheumatol [Internet]. 2016;30(3):375\u201397. Available from:. https:\/\/doi.org\/10.1016\/j.berh.2016.08.004.","journal-title":"Best Pract Res Clin Rheumatol [Internet]"},{"issue":"2","key":"5914_CR30","first-page":"237","volume":"2","author":"H Taherdoost","year":"2017","unstructured":"Taherdoost H. Determining sample size; How to calculate survey sample size. Int J Econ Manag Syst [Internet]. 2017;2(2):237\u20139 Available from: http:\/\/www.iaras.org\/iaras\/journals\/ijems.","journal-title":"Int J Econ Manag Syst [Internet]"},{"key":"5914_CR31","doi-asserted-by":"crossref","unstructured":"Zadro J, O\u2019Keeffe M, Maher C. Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review. BMJ Open. 2019;9(10).","DOI":"10.1136\/bmjopen-2019-032329"},{"issue":"2","key":"5914_CR32","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1097\/JSM.0000000000000321","volume":"27","author":"MA Feger","year":"2017","unstructured":"Feger MA, Glaviano NR, Donovan L, Hart JM, Saliba SA, Park JS, et al. Current trends in the management of lateral ankle sprain in the United States. Clin J Sport Med. 2017;27(2):145\u201352.","journal-title":"Clin J Sport Med"},{"issue":"1","key":"5914_CR33","doi-asserted-by":"publisher","first-page":"121","DOI":"10.4085\/1062-6050-49.1.14","volume":"49","author":"PA Gribble","year":"2014","unstructured":"Gribble PA, Delahunt E, Bleakley CM, Caulfield B, Docherty CL, Fong DTP, et al. Selection criteria for patients with chronic ankle instability in controlled research: A position statement of the international ankle consortium. J Athl Train. 2014;49(1):121\u20137.","journal-title":"J Athl Train"},{"key":"5914_CR34","doi-asserted-by":"publisher","first-page":"61","DOI":"10.2147\/RMHP.S7500","volume":"3","author":"RJ Adams","year":"2010","unstructured":"Adams RJ. Improving health outcomes with better patient understanding and education. Risk Manag Healthc Policy. 2010;3:61\u201372.","journal-title":"Risk Manag Healthc Policy"},{"key":"5914_CR35","doi-asserted-by":"crossref","unstructured":"Maselli F, Piano L, Cecchetto S, Storari L, Rossettini G, Mourad F. Direct Access to Physical Therapy: Should Italy Move Forward? Int J Environ Res Public Health. 2022;19(1).","DOI":"10.3390\/ijerph19010555"},{"issue":"7 July","key":"5914_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0235364","volume":"15","author":"OO Babatunde","year":"2020","unstructured":"Babatunde OO, Bishop A, Cottrell E, Jordan JL, Corp N, Humphries K, et al. A systematic review and evidence synthesis of non-medical triage, self-referral and direct access services for patients with musculoskeletal pain. PLoS One [Internet]. 2020;15(7 July):1\u201329. Available from:. https:\/\/doi.org\/10.1371\/journal.pone.0235364.","journal-title":"PLoS One [Internet]"},{"issue":"12","key":"5914_CR37","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1080\/09638288.2019.1674388","volume":"43","author":"A Demont","year":"2021","unstructured":"Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil [Internet]. 2021;43(12):1637\u201348. Available from:. https:\/\/doi.org\/10.1080\/09638288.2019.1674388.","journal-title":"Disabil Rehabil [Internet]"},{"issue":"3","key":"5914_CR38","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.math.2014.10.009","volume":"20","author":"T Mota da Silva","year":"2015","unstructured":"Mota da Silva T, da Cunha Menezes Costa L, Garcia AN, LOP C. What do physical therapists think about evidence-based practice? A systematic review. Man Ther [Internet]. 2015;20(3):388\u2013401. Available from:. https:\/\/doi.org\/10.1016\/j.math.2014.10.009.","journal-title":"Man Ther [Internet]"},{"issue":"9","key":"5914_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/healthcare9091135","volume":"9","author":"R Cutolo","year":"2021","unstructured":"Cutolo R, Battista S, Testa M. Actual and perceived level of scientific english across italian physiotherapy courses: A cross-sectional study. Healthc. 2021;9(9):1\u201311.","journal-title":"Healthc."},{"issue":"6","key":"5914_CR40","doi-asserted-by":"publisher","first-page":"e037133","DOI":"10.1136\/bmjopen-2020-037133","volume":"10","author":"G Castellini","year":"2020","unstructured":"Castellini G, Corbetta D, Cecchetto S, Gianola S. Twenty-five years after the introduction of Evidence-based Medicine: knowledge, use, attitudes and barriers among physiotherapists in Italy - a cross-sectional study. BMJ Open. 2020;10(6):e037133.","journal-title":"BMJ Open"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-022-05914-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-022-05914-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-022-05914-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T02:36:20Z","timestamp":1668134180000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-022-05914-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,11]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["5914"],"URL":"https:\/\/doi.org\/10.1186\/s12891-022-05914-5","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,11]]},"assertion":[{"value":"17 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Research Ethics Committee of the University of Genoa (CERA: Comitato Etico per la Ricerca di Ateneo, approval date: 05\/04\/2021; n. 2021.40). The participants signed digital informed consent before participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors report no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"975"}}