{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:31:55Z","timestamp":1772166715259,"version":"3.50.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"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 Pharmacol Toxicol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to examine the efficiency of fixed daily dose enoxaparin (40 mg) thromboprophylaxis strategy for patients undergoing inpatient rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational, prospective, cohort study that included 63 hospitalized patients undergoing rehabilitative treatment following sub-acute ischemic stroke (SAIS) or spinal cord injury (SCI), with an indication for thromboprophylaxis. Anti-Xa level measured three hours post-drug administration (following three consecutive days of enoxaparin treatment or more) was utilised to assess in vivo enoxaparin activity. An anti-Xa level between 0.2-0.5 U\/ml was considered evidence of effective antithrombotic activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found sub-prophylactic levels of anti-Xa (&lt;0.2 U\/ml) in 19% (12\/63). Results were within the recommended prophylactic range (0.2-0.5 U\/ml) in 73% (46\/63) and were supra-prophylactic (&gt;0.5 U\/ml) in 7.9% (5\/63) of patients. Anti-Xa levels were found to inversely correlate with patients\u2019 weight and renal function as defined by creatinine clearance (CrCl) (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study confirmed that a one-size-fits-all approach for venous thromboembolism (VTE) prophylaxis may be inadequate for rehabilitation patient populations. The efficacy of fixed-dose enoxaparin prophylaxis is limited and may be influenced by renal function and weight. This study suggests that anti-Xa studies and prophylactic enoxaparin dose adjustments should be considered in certain patients, such as those who are underweight, overweight and or have suboptimal renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>No. NCT103593291, registered August 2018.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40360-023-00728-0","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T09:03:33Z","timestamp":1704877413000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enoxaparin for VTE thromboprophylaxis during inpatient rehabilitation care: assessment of the standard fixed dosing regimen"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0022-3023","authenticated-orcid":false,"given":"Amir","family":"Haim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orli","family":"Avnery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Rubin-Asher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagay","family":"Amir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaifa","family":"Hashem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harel Ben","family":"Zvi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motti","family":"Ratmansky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"728_CR1","first-page":"e1982","volume":"9","author":"MT Khan","year":"2017","unstructured":"Khan MT, Ikram A, Saeed O, Afridi T, Sila CA, Smith MS, et al. Deep vein thrombosis in acute stroke - a systemic review of the literature. Cureus. 2017;9:e1982.","journal-title":"Cureus"},{"key":"728_CR2","first-page":"971","volume":"50","author":"KH Kong","year":"2009","unstructured":"Kong KH, Chua SG. Deep vein thrombosis based on D-dimer screening in ischaemic stroke patients undergoing rehabilitation. Singapore Med J. 2009;50:971\u20135.","journal-title":"Singapore Med J"},{"key":"728_CR3","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","volume":"47","author":"CJ Winstein","year":"2016","unstructured":"Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2016;47:e98\u2013169.","journal-title":"Stroke"},{"key":"728_CR4","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1177\/1076029616677802","volume":"24","author":"F Ye","year":"2018","unstructured":"Ye F, Bell LN, Mazza J, Lee A, Yale SH. Variation in definitions of immobility in pharmacological thromboprophylaxis clinical trials in medical inpatients: a systematic review. Clin Appl Thromb Hemost. 2018;24:13\u201321.","journal-title":"Clin Appl Thromb Hemost"},{"key":"728_CR5","first-page":"1877","volume":"13","author":"Z Zhao","year":"2021","unstructured":"Zhao Z, Tian Q, Zhang B. Effects of rehabilitation nursing care on deep vein thrombosis of the lower limbs following spinal fractures. Am J Transl Res. 2021;13:1877\u201383.","journal-title":"Am J Transl Res"},{"key":"728_CR6","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1159\/000502385","volume":"243","author":"JT Kim","year":"2020","unstructured":"Kim JT, Chun YS, Lee JK, Moon NJ, Yi DY. Comparison of vessel density reduction in the deep and superficial capillary plexuses in branch retinal vein occlusion. Ophthalmologica. 2020;243:66\u201374.","journal-title":"Ophthalmologica"},{"key":"728_CR7","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1080\/10790268.2019.1585134","volume":"43","author":"B Hon","year":"2020","unstructured":"Hon B, Botticello A, Kirshblum S. Duplex ultrasound surveillance for deep vein thrombosis after acute traumatic spinal cord injury at rehabilitation admission. J Spinal Cord Med. 2020;43:298\u2013305.","journal-title":"J Spinal Cord Med"},{"key":"728_CR8","doi-asserted-by":"publisher","first-page":"e14501","DOI":"10.1097\/MD.0000000000014501","volume":"98","author":"A Garcia-Rudolph","year":"2019","unstructured":"Garcia-Rudolph A, Sanchez-Pinsach E, Salleras EO, Tormos JM. Subacute stroke physical rehabilitation evidence in activities of daily living outcomes: a systematic review of meta-analyses of randomized controlled trials. Medicine (Baltimore). 2019;98:e14501.","journal-title":"Medicine (Baltimore)"},{"key":"728_CR9","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1111\/cns.12227","volume":"20","author":"LP Liu","year":"2014","unstructured":"Liu LP, Zheng HG, Wang DZ, Wang YL, Hussain M, Sun HX, et al. Risk assessment of deep-vein thrombosis after acute stroke: a prospective study using clinical factors. CNS Neurosci Ther. 2014;20:403\u201310.","journal-title":"CNS Neurosci Ther"},{"key":"728_CR10","doi-asserted-by":"crossref","unstructured":"Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.: Consortium for Spinal Cord Medicine (2016) Top Spinal Cord Inj Rehabil. 22:209-40.","DOI":"10.1310\/sci2203-209"},{"key":"728_CR11","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.apmr.2008.09.557","volume":"90","author":"RW Teasell","year":"2009","unstructured":"Teasell RW, Hsieh JT, Aubut JA, Eng JJ, Krassioukov A, Tu L. Spinal Cord Injury Rehabilitation Evidence Review Research Team. Venous thromboembolism after spinal cord injury. Arch Phys Med Rehabil. 2009;90:232\u201345.","journal-title":"Arch Phys Med Rehabil"},{"key":"728_CR12","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/S0140-6736(07)60633-3","volume":"369","author":"DG Sherman","year":"2007","unstructured":"Sherman DG, Albers GW, Bladin C, Fieschi C, Gabbai AA, Kase CS, et al. PREVAIL Investigators. The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison. Lancet. 2007;369:1347\u201355.","journal-title":"Lancet"},{"key":"728_CR13","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s42466-020-00089-7","volume":"2","author":"N Weidner","year":"2020","unstructured":"Weidner N, M\u00fcller OJ, Hach-Wunderle V, Schwerdtfeger K, Krauspe R, Pauschert R, et al. Prevention of thromboembolism in spinal cord injury -S1 guideline. Neurol Res Pract. 2020;2:43.","journal-title":"Neurol Res Pract"},{"key":"728_CR14","doi-asserted-by":"publisher","first-page":"972","DOI":"10.4184\/asj.2016.10.5.972","volume":"10","author":"S Alabed","year":"2016","unstructured":"Alabed S, Belci M, Van Middendorp JJ, Al Halabi A, Meagher TM. Thromboembolism in the sub-acute phase of spinal cord injury: a systematic review of the literature. Asian Spine J. 2016;10:972\u201381.","journal-title":"Asian Spine J"},{"key":"728_CR15","doi-asserted-by":"publisher","first-page":"3198","DOI":"10.1182\/bloodadvances.2018022954","volume":"2","author":"HJ Sch\u00fcnemann","year":"2018","unstructured":"Sch\u00fcnemann HJ, Cushman M, Burnett AE, Kahn SR, Beyer-Westendorf J, Spencer FA, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv. 2018;2:3198\u2013225.","journal-title":"Blood Adv"},{"key":"728_CR16","first-page":"CD000119","volume":"4","author":"PA Sandercock","year":"2017","unstructured":"Sandercock PA, Leong TS. Low-molecular-weight heparins or heparinoids versus standard unfractionated heparin for acute ischaemic stroke. Cochrane Database Syst Rev. 2017;4:CD000119.","journal-title":"Cochrane Database Syst Rev"},{"key":"728_CR17","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.2165\/00003088-200342120-00003","volume":"42","author":"J Fareed","year":"2003","unstructured":"Fareed J, Hoppensteadt D, Walenga J, Iqbal O, Ma Q, Jeske W, Sheikh T. Pharmacodynamic and pharmacokinetic properties of enoxaparin: implications for clinical practice. Clin Pharmacokinet. 2003;42:1043\u201357.","journal-title":"Clin Pharmacokinet"},{"key":"728_CR18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.injury.2019.10.066","volume":"51","author":"S Rakhra","year":"2020","unstructured":"Rakhra S, Martin EL, Fitzgerald M, Udy A. The ATLANTIC study: Anti-Xa level assessment in trauma intensive care. Injury. 2020;51:10\u20134.","journal-title":"Injury"},{"key":"728_CR19","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/j.amjsurg.2016.08.010","volume":"213","author":"CJ Pannucci","year":"2017","unstructured":"Pannucci CJ, Prazak AM, Scheefer M. Utility of anti-factor Xa monitoring in surgical patients receiving prophylactic doses of enoxaparin for venous thromboembolism prophylaxis. Am J Surg. 2017;213:1143\u201352.","journal-title":"Am J Surg"},{"key":"728_CR20","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1345\/aph.1L194","volume":"43","author":"EA Nutescu","year":"2009","unstructured":"Nutescu EA, Spinler SA, Wittkowsky A, Dager WE. Low-molecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings. Ann Pharmacother. 2009;43:1064\u201383.","journal-title":"Ann Pharmacother"},{"key":"728_CR21","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1007\/s11239-015-1231-5","volume":"41","author":"JW Vandiver","year":"2016","unstructured":"Vandiver JW, Ritz LI, Lalama JT. Chemical prophylaxis to prevent venous thromboembolism in morbid obesity: literature review and dosing recommendations. J Thromb Thrombolysis. 2016;41:475\u201381.","journal-title":"J Thromb Thrombolysis"},{"key":"728_CR22","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1007\/s11239-020-02128-1","volume":"50","author":"C Maurice-Dror","year":"2020","unstructured":"Maurice-Dror C, Litvak M, Keren-Politansky A, Ackerman S, Haim N, Nadir Y. Circulating heparan sulfate chains and body weight contribute to anti-Xa levels in cancer patients using the prophylactic dose of enoxaparin. J Thromb Thrombolysis. 2020;50:112\u201322.","journal-title":"J Thromb Thrombolysis"},{"key":"728_CR23","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1046\/j.1365-2141.1999.01153.x","volume":"104","author":"L Bara","year":"1999","unstructured":"Bara L, Planes A, Samama MM. Occurrence of thrombosis and haemorrhage, relationship with anti-Xa, anti-IIa activities, and D-dimer plasma levels in patients receiving a low molecular weight heparin, enoxaparin or tinzaparin, to prevent deep vein thrombosis after hip surgery. Br J Haematol. 1999;104:230\u201340.","journal-title":"Br J Haematol."},{"key":"728_CR24","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.jss.2017.08.053","volume":"221","author":"JM Baumgartner","year":"2018","unstructured":"Baumgartner JM, McKenzie S, Block S, Costantini TW, Lowy AM. Prophylactic enoxaparin doses may be inadequate in patients undergoing abdominal cancer surgery. J Surg Res. 2018;221:183\u20139.","journal-title":"J Surg Res"},{"key":"728_CR25","first-page":"874","volume":"68","author":"D Malinoski","year":"2010","unstructured":"Malinoski D, Jafari F, Ewing T, Ardary C, Conniff H, Baje M, et al. Standard prophylactic enoxaparin dosing leads to inadequate anti-Xa levels and increased deep venous thrombosis rates in critically ill trauma and surgical patients. J Trauma. 2010;68:874\u201380.","journal-title":"J Trauma"},{"key":"728_CR26","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1016\/j.burns.2019.02.011","volume":"45","author":"BJ Cronin","year":"2019","unstructured":"Cronin BJ, Godat LN, Berndtson AE, Pham A, Kolan S, Box K, et al. Anti-Xa guided enoxaparin dose adjustment improves pharmacologic deep venous thrombosis prophylaxis in burn patients. Burns. 2019;45:818\u201324.","journal-title":"Burns"},{"key":"728_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/BCR.0b013e318204b346","volume":"32","author":"H Lin","year":"2011","unstructured":"Lin H, Faraklas I, Cochran A, Saffle J. Enoxaparin and antifactor Xa levels in acute burn patients. J Burn Care Res. 2011;32:1\u20135.","journal-title":"J Burn Care Res"},{"key":"728_CR28","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/TA.0b013e3182788fa7","volume":"74","author":"TW Costantini","year":"2013","unstructured":"Costantini TW, Min E, Box K, Tran V, Winfield RD, Fortlage D, et al. Dose adjusting enoxaparin is necessary to achieve adequate venous thromboembolism prophylaxis in trauma patients. J Trauma Acute Care Surg. 2013;74:128\u201335.","journal-title":"J Trauma Acute Care Surg"},{"key":"728_CR29","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/j.thromres.2013.10.005","volume":"132","author":"L Rojas","year":"2013","unstructured":"Rojas L, Aizman A, Ernst D, Acu\u00f1a MP, Moya P, Mellado R, Cerda J. Anti-Xa activity after enoxaparin prophylaxis in hospitalized patients weighing less than fifty-five kilograms. Thromb Res. 2013;132:761\u20134.","journal-title":"Thromb Res"},{"key":"728_CR30","first-page":"119","volume":"125","author":"JA Millar","year":"2012","unstructured":"Millar JA. The Cockroft and Gault formula for estimation of creatinine clearance: a friendly deconstruction. N Z Med J. 2012;125:119\u201322.","journal-title":"N Z Med J"},{"key":"728_CR31","unstructured":"HermosIL Liquid Anti-Xa \u2013 0020302601 (2021) Instrumentation Laboratory, a Werfen Company."},{"key":"728_CR32","doi-asserted-by":"publisher","first-page":"204","DOI":"10.5507\/bp.2021.031","volume":"166","author":"J Benes","year":"2022","unstructured":"Benes J, Skulec R, Jobanek J, Cerny V. Fixed-dose enoxaparin provides efficient DVT prophylaxis in mixed ICU patients despite low anti-Xa levels: a prospective opbservational cohort study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022;166:204\u201310.","journal-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub"},{"key":"728_CR33","doi-asserted-by":"publisher","first-page":"5844","DOI":"10.4081\/hr.2015.5844","volume":"7","author":"MY Wei","year":"2015","unstructured":"Wei MY, Ward SM. The anti-factor Xa range for low molecualar weight heparin thromboprophylaxis. Hematol Rep. 2015;7:5844.","journal-title":"Hematol Rep"},{"key":"728_CR34","unstructured":"Sanofi Limited. Enoxaparin Sodium Injection I.P (Clexane) Approved Product Information. Updated 14 October 2018."},{"key":"728_CR35","doi-asserted-by":"publisher","first-page":"R41","DOI":"10.1186\/cc8924","volume":"14","author":"S Robinson","year":"2010","unstructured":"Robinson S, Zincuk A, Str\u00f8m T, Larsen TB, Rasmussen B, Toft P. Enoxaparin, effective dosage for intensive care patients: double-blinded, randomised clinical trial. Crit Care. 2010;14:R41.","journal-title":"Crit Care"},{"key":"728_CR36","doi-asserted-by":"publisher","first-page":"R75","DOI":"10.1186\/cc12684","volume":"17","author":"S Robinson","year":"2013","unstructured":"Robinson S, Zincuk A, Larsen UL, Ekstr\u00f8m C, Nybo M, Rasmussen B, Toft P. A comparative study of varying doses of enoxaparin for thromboprophylaxis in critically ill patients: a double-blinded, randomised controlled trial. Crit Care. 2013;17:R75.","journal-title":"Crit Care"},{"key":"728_CR37","doi-asserted-by":"crossref","first-page":"1179545X1986381","DOI":"10.1177\/1179545X19863814","volume":"12","author":"D Dybdahl","year":"2019","unstructured":"Dybdahl D, Walliser G, Pershing M, Collins C, Robinson D. Enoxaparin dosing for venous thromboembolism prophylaxis in low body weight patients. Clin Med Insights Blood Disord. 2019;12:1179545X19863814.","journal-title":"Clin Med Insights Blood Disord"},{"key":"728_CR38","first-page":"609","volume":"43","author":"T Ahuja","year":"2018","unstructured":"Ahuja T, Mousavi KM, Klejmont L, Desai S. Enoxaparin dosing and antixa monitoring in specialty populations: a case series of renal-impaired, extremes of body weight, pregnant, and pediatric patients. P T. 2018;43:609\u201314.","journal-title":"P T"},{"key":"728_CR39","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00068-019-01215-0","volume":"47","author":"SG Rodier","year":"2021","unstructured":"Rodier SG, Bukur M, Moore S, Frangos SG, Tandon M, DiMaggio CJ, et al. Weight-based enoxaparin with anti-factor Xa assay-based dose adjustment for venous thromboembolic event prophylaxis in adult trauma patients results in improved prophylactic range targeting. Eur J Trauma Emerg Surg. 2021;47:145\u201351.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"728_CR40","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1097\/TA.0000000000001193","volume":"81","author":"GA Singer","year":"2016","unstructured":"Singer GA, Riggi G, Karcutskie CA, Vaghaiwalla TM, Lieberman HM, Ginzburg E, et al. Anti-Xa-guided enoxaparin thromboprophylaxis reduces rate of deep venous thromboembolism in high-risk trauma patients. J Trauma Acute Care Surg. 2016;81:1101\u20138.","journal-title":"J Trauma Acute Care Surg"}],"container-title":["BMC Pharmacology and Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40360-023-00728-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40360-023-00728-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40360-023-00728-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:55:54Z","timestamp":1730994954000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpharmacoltoxicol.biomedcentral.com\/articles\/10.1186\/s40360-023-00728-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["728"],"URL":"https:\/\/doi.org\/10.1186\/s40360-023-00728-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2605384\/v1","asserted-by":"object"}]},"ISSN":["2050-6511"],"issn-type":[{"value":"2050-6511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,10]]},"assertion":[{"value":"19 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was an observational, prospective cohort study approved by the Institutional Ethics Committee on Human Research at the Loewenstein Rehabilitation Medical Center (No. NCT103593291). Informed consent was obtained from all individual participants included in the study and all methods were performed in accordance with relevant guidelines in the Declaration of Helsinki.","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 declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"8"}}