1096f632dae69eadd63dfa726d19191e 256451.pdf ed96f852b6a7fe8e45e92256c095dbf4e5f0f5f3 256451.pdf e0fab5455916f416fc55ad49ff376b455619db4adfc782f5c2c28853e9be6d9a 256451.pdf Title: The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial Subject: Background: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention). Keywords: stroke; exercise therapy; sitting position; postural balance; gait; core stability training; trunk exercises Author: Rosa Cabanas-Valdés, Lídia Boix-Sala, Montserrat Grau-Pellicer, Juan Antonio Guzmán-Bernal, Fernanda Maria Caballero-Gómez and Gerard Urrútia Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Jun 21 11:21:29 2021 CEST ModDate: Mon Jun 21 11:26:42 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3387491 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UYSRNW+URWPalladioL-Ital Type 1 Custom yes yes no 10 0 FMEKMO+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 YUTIFY+URWPalladioL-Roma Type 1 Custom yes yes no 19 0 DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes no 23 0 QZXXST+VnURWPalladioL Type 1 Custom yes yes no 28 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 DPVIRE+CMSY10 Type 1 Builtin yes yes no 90 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 97 0 LCHILL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 107 0 LCHILN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 110 0 LCHILP+PalatinoLinotype TrueType WinAnsi yes yes no 113 0 LCHILL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 124 0 LCHILN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 127 0 LCHILP+PalatinoLinotype TrueType WinAnsi yes yes no 130 0 LCHILL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 140 0 LCHILN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 143 0 LCHILP+PalatinoLinotype TrueType WinAnsi yes yes no 146 0 LCHNFD+Arial CID TrueType Identity-H yes yes yes 149 0 OHGNNL+Symbol Type 1C Custom yes yes yes 166 0 OHGLIF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 171 0 OHGLIH+PalatinoLinotype TrueType WinAnsi yes yes no 174 0 OHGLJI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 177 0 OHGNNN+Arial TrueType WinAnsi yes yes no 180 0 CRUZTT+VnURWPalladioL-Italic Type 1 Custom yes yes no 200 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-31 02:32:19 CEST RepresentationInformation: 256451.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-05-30 14:51:37 CEST Size: 3387491 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 436 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Study Design and Setting Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Recruitment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Blinding Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Selection Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Interventions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Participant Timeline Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Outcomes Measures Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Info: Title: The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial Author: Rosa Cabanas-Valdés, Lídia Boix-Sala, Montserrat Grau-Pellicer, Juan Antonio Guzmán-Bernal, Fernanda Maria Caballero-Gómez and Gerard Urrútia Subject: Background: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention). Keywords: stroke; exercise therapy; sitting position; postural balance; gait; core stability training; trunk exercises Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Jun 21 11:21:29 CEST 2021 ModDate: Mon Jun 21 11:26:42 CEST 2021 ID: 0xe19a3c9f9da8acb24024da19c83f1978, 0xe19a3c9f9da8acb24024da19c83f1978 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: OVNEXW+EURM10 FontSubset: true FirstChar: 22 LastChar: 22 FontDescriptor: FontName: OVNEXW+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true Font: BaseFont: YUTIFY+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 250 FontDescriptor: FontName: YUTIFY+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: DGBDNV+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 243 FontDescriptor: FontName: DGBDNV+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CRUZTT+VnURWPalladioL-Italic FontSubset: true FirstChar: 189 LastChar: 189 FontDescriptor: FontName: CRUZTT+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: UYSRNW+URWPalladioL-Ital FontSubset: true FirstChar: 46 LastChar: 121 FontDescriptor: FontName: UYSRNW+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: DPVIRE+CMSY10 FontSubset: true FirstChar: 6 LastChar: 25 FontDescriptor: FontName: DPVIRE+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: QZXXST+VnURWPalladioL FontSubset: true FirstChar: 128 LastChar: 243 FontDescriptor: FontName: QZXXST+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: FMEKMO+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: FMEKMO+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 181, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 145, 622, 156, 635 Annotation: Subtype: Link Rect: 242, 622, 253, 635 Annotation: Subtype: Link Rect: 55, 358, 154, 367 Annotation: Subtype: Link Rect: 35, 346, 82, 355 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 280, 96, 287, 105 ActionDest: 194 Annotation: Subtype: Link Rect: 197, 83, 204, 92 ActionDest: 194 Annotation: Subtype: Link Rect: 201, 17, 346, 28 Annotation: Subtype: Link Rect: 414, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 518, 87, 537 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 423, 724, 430, 733 ActionDest: 194 Annotation: Subtype: Link Rect: 417, 686, 424, 695 ActionDest: 194 Annotation: Subtype: Link Rect: 520, 674, 527, 683 ActionDest: 194 Annotation: Subtype: Link Rect: 443, 661, 450, 670 ActionDest: 194 Annotation: Subtype: Link Rect: 475, 649, 482, 658 ActionDest: 194 Annotation: Subtype: Link Rect: 380, 611, 387, 620 ActionDest: 194 Annotation: Subtype: Link Rect: 443, 598, 450, 608 ActionDest: 194 Annotation: Subtype: Link Rect: 378, 586, 390, 595 ActionDest: 194 Annotation: Subtype: Link Rect: 533, 574, 545, 582 ActionDest: 194 Annotation: Subtype: Link Rect: 432, 511, 444, 520 ActionDest: 194 Annotation: Subtype: Link Rect: 511, 473, 523, 482 ActionDest: 194 Annotation: Subtype: Link Rect: 348, 410, 355, 419 ActionDest: 194 Annotation: Subtype: Link Rect: 496, 385, 508, 394 ActionDest: 194 Annotation: Subtype: Link Rect: 340, 335, 352, 344 ActionDest: 194 Annotation: Subtype: Link Rect: 408, 272, 420, 281 ActionDest: 194 Annotation: Subtype: Link Rect: 256, 235, 268, 244 ActionDest: 194 Annotation: Subtype: Link Rect: 375, 222, 387, 231 ActionDest: 194 Annotation: Subtype: Link Rect: 388, 222, 400, 231 ActionDest: 194 Annotation: Subtype: Link Rect: 220, 197, 232, 206 ActionDest: 194 Annotation: Subtype: Link Rect: 507, 172, 518, 181 ActionDest: 194 Annotation: Subtype: Link Rect: 276, 147, 288, 156 ActionDest: 194 Annotation: Subtype: Link Rect: 545, 147, 556, 156 ActionDest: 194 Annotation: Subtype: Link Rect: 477, 122, 489, 131 ActionDest: 194 Annotation: Subtype: Link Rect: 492, 122, 504, 131 ActionDest: 194 Annotation: Subtype: Link Rect: 210, 109, 222, 118 ActionDest: 197 Annotation: Subtype: Link Rect: 544, 109, 556, 118 ActionDest: 197 Annotation: Subtype: Link Rect: 316, 71, 328, 80 ActionDest: 197 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 330, 722, 342, 731 ActionDest: 197 Annotation: Subtype: Link Rect: 510, 659, 522, 669 ActionDest: 197 Annotation: Subtype: Link Rect: 523, 659, 535, 669 ActionDest: 197 Annotation: Subtype: Link Rect: 437, 634, 449, 643 ActionDest: 197 Annotation: Subtype: Link Rect: 461, 609, 473, 618 ActionDest: 197 Annotation: Subtype: Link Rect: 366, 559, 378, 568 ActionDest: 197 Annotation: Subtype: Link Rect: 396, 534, 408, 543 ActionDest: 197 Annotation: Subtype: Link Rect: 402, 459, 414, 468 ActionDest: 197 Annotation: Subtype: Link Rect: 391, 396, 403, 405 ActionDest: 197 Annotation: Subtype: Link Rect: 460, 383, 472, 392 ActionDest: 197 Annotation: Subtype: Link Rect: 395, 358, 407, 367 ActionDest: 197 Annotation: Subtype: Link Rect: 476, 169, 488, 178 ActionDest: 197 Annotation: Subtype: Link Rect: 216, 156, 228, 165 ActionDest: 197 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 270, 305, 282, 314 ActionDest: 197 Annotation: Subtype: Link Rect: 543, 267, 555, 276 ActionDest: 197 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 328, 529, 340, 538 ActionDest: 197 Annotation: Subtype: Link Rect: 340, 529, 352, 538 ActionDest: 197 Annotation: Subtype: Link Rect: 545, 516, 557, 525 ActionDest: 197 Annotation: Subtype: Link Rect: 292, 468, 304, 478 ActionDest: 197 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 269, 508, 281, 518 ActionDest: 197 Annotation: Subtype: Link Rect: 352, 443, 359, 455 ActionDest: 101 Annotation: Subtype: Link Rect: 507, 295, 519, 304 ActionDest: 197 Annotation: Subtype: Link Rect: 276, 270, 288, 279 ActionDest: 197 Annotation: Subtype: Link Rect: 431, 270, 443, 279 ActionDest: 204 Annotation: Subtype: Link Rect: 545, 257, 557, 267 ActionDest: 204 Page: Sequence: 7 Page: Sequence: 8 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 296, 151, 303, 163 ActionDest: 156 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 484, 356, 496, 365 ActionDest: 197 Annotation: Subtype: Link Rect: 468, 344, 480, 353 ActionDest: 204 Annotation: Subtype: Link Rect: 467, 193, 479, 202 ActionDest: 204 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 247, 722, 259, 731 ActionDest: 204 Annotation: Subtype: Link Rect: 531, 609, 543, 618 ActionDest: 204 Annotation: Subtype: Link Rect: 544, 609, 556, 618 ActionDest: 204 Annotation: Subtype: Link Rect: 260, 484, 272, 493 ActionDest: 204 Annotation: Subtype: Link Rect: 454, 408, 466, 417 ActionDest: 204 Annotation: Subtype: Link Rect: 310, 358, 322, 367 ActionDest: 204 Annotation: Subtype: Link Rect: 306, 295, 318, 304 ActionDest: 204 Annotation: Subtype: Link Rect: 319, 295, 331, 304 ActionDest: 204 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 213, 345, 225, 354 ActionDest: 204 Annotation: Subtype: Link Rect: 263, 307, 275, 316 ActionDest: 204 Annotation: Subtype: Link Rect: 198, 270, 210, 279 ActionDest: 204 Annotation: Subtype: Link Rect: 190, 245, 201, 254 ActionDest: 204 Annotation: Subtype: Link Rect: 202, 245, 214, 254 ActionDest: 204 Annotation: Subtype: Link Rect: 258, 232, 270, 241 ActionDest: 204 Annotation: Subtype: Link Rect: 291, 207, 303, 216 ActionDest: 204 Annotation: Subtype: Link Rect: 196, 182, 208, 191 ActionDest: 204 Annotation: Subtype: Link Rect: 544, 157, 556, 166 ActionDest: 204 Annotation: Subtype: Link Rect: 508, 144, 520, 153 ActionDest: 204 Annotation: Subtype: Link Rect: 298, 119, 310, 128 ActionDest: 204 Annotation: Subtype: Link Rect: 343, 106, 355, 116 ActionDest: 204 Annotation: Subtype: Link Rect: 378, 81, 390, 90 ActionDest: 204 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 475, 722, 487, 731 ActionDest: 204 Annotation: Subtype: Link Rect: 443, 710, 455, 719 ActionDest: 207 Annotation: Subtype: Link Rect: 328, 659, 340, 669 ActionDest: 207 Annotation: Subtype: Link Rect: 297, 647, 309, 656 ActionDest: 207 Annotation: Subtype: Link Rect: 219, 634, 231, 643 ActionDest: 207 Annotation: Subtype: Link Rect: 254, 622, 266, 631 ActionDest: 207 Annotation: Subtype: Link Rect: 403, 572, 415, 581 ActionDest: 207 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 104, 707, 142, 717 Annotation: Subtype: Link Rect: 517, 695, 555, 706 Annotation: Subtype: Link Rect: 341, 672, 378, 683 Annotation: Subtype: Link Rect: 482, 649, 519, 660 Annotation: Subtype: Link Rect: 341, 626, 378, 637 Annotation: Subtype: Link Rect: 280, 603, 317, 614 Annotation: Subtype: Link Rect: 59, 569, 97, 579 Annotation: Subtype: Link Rect: 103, 569, 139, 579 Annotation: Subtype: Link Rect: 352, 545, 390, 556 Annotation: Subtype: Link Rect: 294, 511, 331, 522 Annotation: Subtype: Link Rect: 59, 489, 97, 499 Annotation: Subtype: Link Rect: 59, 454, 97, 464 Annotation: Subtype: Link Rect: 103, 454, 139, 464 Annotation: Subtype: Link Rect: 300, 430, 337, 441 Annotation: Subtype: Link Rect: 343, 430, 379, 441 Annotation: Subtype: Link Rect: 294, 407, 331, 418 Annotation: Subtype: Link Rect: 219, 385, 256, 395 Annotation: Subtype: Link Rect: 259, 361, 296, 372 Annotation: Subtype: Link Rect: 302, 361, 338, 372 Annotation: Subtype: Link Rect: 440, 350, 478, 361 Annotation: Subtype: Link Rect: 484, 350, 520, 361 Annotation: Subtype: Link Rect: 279, 327, 317, 338 Annotation: Subtype: Link Rect: 136, 305, 173, 315 Annotation: Subtype: Link Rect: 270, 281, 307, 292 Annotation: Subtype: Link Rect: 314, 281, 350, 292 Annotation: Subtype: Link Rect: 315, 258, 352, 269 Annotation: Subtype: Link Rect: 358, 258, 395, 269 Annotation: Subtype: Link Rect: 497, 235, 534, 246 Annotation: Subtype: Link Rect: 485, 212, 522, 223 Annotation: Subtype: Link Rect: 189, 178, 226, 188 Annotation: Subtype: Link Rect: 308, 143, 345, 154 Annotation: Subtype: Link Rect: 95, 120, 131, 131 Annotation: Subtype: Link Rect: 307, 97, 344, 108 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 438, 721, 476, 732 Annotation: Subtype: Link Rect: 519, 698, 557, 709 Annotation: Subtype: Link Rect: 59, 687, 95, 697 Annotation: Subtype: Link Rect: 435, 652, 472, 663 Annotation: Subtype: Link Rect: 479, 652, 515, 663 Annotation: Subtype: Link Rect: 367, 629, 404, 640 Annotation: Subtype: Link Rect: 59, 607, 97, 617 Annotation: Subtype: Link Rect: 103, 607, 139, 617 Annotation: Subtype: Link Rect: 405, 594, 442, 605 Annotation: Subtype: Link Rect: 519, 583, 557, 594 Annotation: Subtype: Link Rect: 59, 572, 95, 582 Annotation: Subtype: Link Rect: 131, 549, 169, 559 Annotation: Subtype: Link Rect: 175, 549, 211, 559 Annotation: Subtype: Link Rect: 148, 514, 186, 525 Annotation: Subtype: Link Rect: 338, 492, 375, 502 Annotation: Subtype: Link Rect: 382, 492, 418, 502 Annotation: Subtype: Link Rect: 100, 469, 137, 479 Annotation: Subtype: Link Rect: 143, 469, 179, 479 Annotation: Subtype: Link Rect: 392, 445, 430, 456 Annotation: Subtype: Link Rect: 519, 434, 557, 444 Annotation: Subtype: Link Rect: 59, 423, 95, 433 Annotation: Subtype: Link Rect: 326, 387, 363, 398 Annotation: Subtype: Link Rect: 59, 342, 97, 352 Annotation: Subtype: Link Rect: 95, 308, 133, 318 Annotation: Subtype: Link Rect: 335, 284, 373, 295 Annotation: Subtype: Link Rect: 377, 261, 414, 272 Annotation: Subtype: Link Rect: 104, 238, 141, 249 Annotation: Subtype: Link Rect: 312, 203, 350, 214 Annotation: Subtype: Link Rect: 356, 203, 392, 214 Annotation: Subtype: Link Rect: 131, 181, 167, 191 Annotation: Subtype: Link Rect: 519, 157, 557, 168 Annotation: Subtype: Link Rect: 59, 146, 95, 157 Annotation: Subtype: Link Rect: 420, 123, 457, 134 Annotation: Subtype: Link Rect: 299, 100, 336, 111 Annotation: Subtype: Link Rect: 343, 100, 379, 111 Annotation: Subtype: Link Rect: 354, 65, 391, 76 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 258, 721, 295, 732 Annotation: Subtype: Link Rect: 302, 721, 338, 732 Annotation: Subtype: Link Rect: 59, 687, 97, 697 Annotation: Subtype: Link Rect: 103, 687, 139, 697 Annotation: Subtype: Link Rect: 203, 664, 241, 674 Annotation: Subtype: Link Rect: 59, 641, 97, 651 Annotation: Subtype: Link Rect: 103, 641, 139, 651 Annotation: Subtype: Link Rect: 350, 606, 388, 617 Annotation: Subtype: Link Rect: 131, 584, 169, 594 Annotation: Subtype: Link Rect: 59, 561, 97, 571 Annotation: Subtype: Link Rect: 203, 525, 240, 536 Annotation: Subtype: Link Rect: 306, 503, 343, 513 Annotation: Subtype: Link Rect: 188, 468, 226, 479 Annotation: Subtype: Link Rect: 232, 468, 268, 479 Annotation: Subtype: Link Rect: 519, 445, 557, 456 Annotation: Subtype: Link Rect: 59, 434, 95, 444 Annotation: Subtype: Link Rect: 292, 410, 329, 421 Annotation: Subtype: Link Rect: 335, 410, 372, 421 Annotation: Subtype: Link Rect: 474, 387, 512, 398 Annotation: Subtype: Link Rect: 308, 353, 345, 364 Annotation: Subtype: Link Rect: 59, 331, 97, 341 Annotation: Subtype: Link Rect: 479, 307, 517, 318 Annotation: Subtype: Link Rect: 59, 273, 97, 283 Annotation: Subtype: Link Rect: 95, 238, 133, 249 Annotation: Subtype: Link Rect: 131, 204, 169, 214 Annotation: Subtype: Link Rect: 520, 180, 557, 191 Annotation: Subtype: Link Rect: 59, 169, 95, 180 Annotation: Subtype: Link Rect: 440, 146, 478, 157 Annotation: Subtype: Link Rect: 484, 146, 520, 157 Annotation: Subtype: Link Rect: 469, 123, 506, 134 Annotation: Subtype: Link Rect: 452, 100, 489, 111 Annotation: Subtype: Link Rect: 495, 100, 531, 111 Annotation: Subtype: Link Rect: 483, 65, 521, 76 Page: Sequence: 17 Annotations: Annotation: Subtype: Link Rect: 158, 710, 195, 720 Annotation: Subtype: Link Rect: 176, 687, 214, 697 Annotation: Subtype: Link Rect: 172, 664, 210, 674 Annotation: Subtype: Link Rect: 371, 640, 407, 651 Annotation: Subtype: Link Rect: 104, 607, 141, 617 Annotation: Subtype: Link Rect: 148, 607, 184, 617 Annotation: Subtype: Link Rect: 350, 583, 388, 594 Annotation: Subtype: Link Rect: 394, 583, 430, 594 Checksum: 2cf39fc8 Type: CRC32 Checksum: 1096f632dae69eadd63dfa726d19191e Type: MD5 Checksum: ed96f852b6a7fe8e45e92256c095dbf4e5f0f5f3 Type: SHA-1