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(1)BACK TO ONESELF – Sensory Motor Learning – applied in patients with nonspecific chronic low back pain. Christina Schön-Ohlsson. Department of Clinical Neuroscience and Rehabilitation Institute of Neuroscience and Physiology Sahlgrenska Academy, University of Gothenburg Sweden 2010.

(2) COPYRIGHT © Christina Schön - Ohlsson ISBN 978 – 91 – 628 – 7959 – 4 Printed by Intellecta Infolog AB, Göteborg, Sweden, 2009 Photo on front page by Rosalie O’Conner www.rosalieoconner.com Images by Elin Fälthammar elin@falthammar.com Text design by R o u n d a b o u t.

(3) ABSTRACT Back pain is an endemic problem affecting one in five adults every year. Even though only 10 % of all cases of back pain become chronic it is one of the largest health problems in industrialized societies. The term nonspecific chronic low back pain (NSCLBP) refers to cases in which neither the persistent pain symptoms nor the related physical dysfunction are related to structural impairment or disease. NSCLBP accounts for 80 % of cases of chronic low back pain. The overall purpose of this thesis was to generate knowledge in order to evaluate the Sensory Motor Learning (SML) intervention when applied in patients with NSCLBP. To achieve the purpose the conceptual framework behind the SML intervention was outlined and the investigation implemented through four separate studies. Patients with NSCLBP who previously had not been helped by any treatment and who were not expected to be helped by spinal surgery participated in the studies. Study I investigated if the optoelectronic Posturo-Locomotion-Manipulation (PLM) test was a valid and reliable measurement tool, able to objectively assess the quality of a dynamic goal directed action in freely moving patients with NSCLBP. Study II evaluated how the SML intervention influenced movement capacity in patients with NSCLBP as assessed by the PLM test. Study III used individual interviews to evaluate how the SML intervention influenced the patients regarding their subjective, cognitive perspectives. Study IV was designed as a qualitative randomized clinical trial using focus groups to compare how two comparable groups of NSCLBP patients expressed their experiences from two different interventions based on different conceptual frameworks; SML and exercise therapy (ET). The result showed the PLM test to be a valid and reliable outcome measure. Compared with an age and gender matched control group without back pain, the NSCLBP patients’ performance was significantly less efficient before the SML intervention. After the intervention there were no differences between the movement capacity of the patient group and the control group. The results were maintained after one year. The patients described that they had learned to reduce pain, to diminish psychological distress and to improve physical ability. Major differences were indentified when comparing how the two patient groups with NSCLBP experienced SML and ET. The patients in the SML group expressed that they had learned to trust in themselves and now felt able to handle their low back pain themselves. This was in contrast to the patients in the ET group who expressed insecurity and dependence on advice from back-pain experts. Based on the results; a hypothesis was generated stating that SML– an embodied, empathic, therapeutic approach to health behaviour change - enables patients with NSCLBP to increase control over back pain and promotes health by guiding them – back to oneself – implying that patients learn to rely on themselves and their bodily awareness. The hypothesis was based on the fact that the patients’ felt able to handle their low back pain themselves and their subjectively experienced positive physical and psychological changes coincided with objectively assessed improvements in movement capacity. Key words: Chronic nonspecific low back pain, Sensory Motor Learning, SML, PosturoLocomotion-Manipulation (PLM) test, Qualitative method, Focus group study, Health promotion, Feldenkrais method, Exercise therapy..

(4) ABBREVIATIONS. ATM. Awareness Through Movement. ET. Exercise Therapy. FI. Functional Integration. FM. Feldenkrais Method. GMP. Global Movement Pattern. ICF. ȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱ˜›•ȱ ŽŠ•‘ Classification on Functioning, Disability and Healthȱǻ ȱŘŖŖŗǼ. KSP. Karolinska Scale of Personality. MG. Movement Gestalt. NSCLBP. Nonspecific Chronic Low Back Pain. PLM test. Posturo - Locomotion – Manipulation test. PT. Physical Therapy/ Therapist. RoM. Joint range of motion. SF 36. The 36-item Short Form Health Survey. SML. Sensory Motor Learning. TIPPA. Test Instrument Physical Performance Ability. WHO. World Health Organisation.

(5) LIST OF PAPERS. This thesis is based on the following studies, which will be referred to in the text by their Roman numerals. Reprints of published papers were made with the kind permission from the publishers.. I.. Schön-Ohlsson Christina, Willén Jan, Johnels Bo. Optoelectronic movement analysis to measure motor performance in patients with chronic low back pain: test of reliability. J Rehabil Med 2006;38(6):360-7.. II.. Schön-Ohlsson Christina, Willén Jan, Johnels Bo. Sensory motor learning in patients with chronic low back pain: a prospective pilot study using optoelectronic movement analysis. Spine 2005;30(17):E509-16.. III.. Schön-Ohlsson Christina, Willén Jan, Räisänen Christine, Johnels Bo, Willén Carin. Rehabilitation of patients with nonspecific chronic low back pain: a qualitative study of patients’ experiences of Sensory Motor Learning intervention. Manuscript submitted.. IV.. Schön-Ohlsson Christina, Willén Jan, Rydén Lisbeth, Willén Carin, Hane Monica. Using focus groups to compare how patients with nonspecific chronic low back pain express their experiences of sensory motor learning and exercise therapy interventions; a randomized, qualitative study. Manuscript..

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(7) Dare to do right! Dare to speak the truth! You have a duty that no one else can fulfill! Do even the smallest duty well and when the day is ended you will have nothing to regret, no time will have been lost and you will feel content and happy! To Christina from Kindergarten teacher.

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(10) ȱ Žœž•œȱœž¢ȱ  ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŗ ˜–™Š›Š‹’•’¢ȱ‹Ž ŽŽ—ȱ‘Žȱ ˜ȱ›Š—˜–’œŽȱ›˜ž™œǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŗ. ŽŠ•‘ȱ›Ž•ŠŽȱšžŠ•’¢ȱ˜ȱ•’Ž ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŗ Ž›œ˜—Š•’¢ȱ›Š’œ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŘ ›˜’•Žȱ˜ȱ‘¢œ’ŒŠ•ȱ‹’•’¢ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŘ ›˜™Ȭ˜žœȱŠ—ȱ—ž–‹Ž›ȱ˜ȱ›ŽŠ–Ž—œȱ’—ȱ‘Žȱ ˜ȱ’—Ž›ŸŽ—’˜—œǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŘ Žœž•ȱ˜ȱ˜Œžœȱ›˜ž™ȱŒ˜—ŸŽ›œŠ’˜—œ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŚ ‘Ž–ŽȱŗDZȱŠŒ”ȱ™Š’—ȱȮȱ ‘ŠȱŒŠ—ȱ‹Žȱ˜—Ž ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŚ ‘Ž–ŽȱŘDZȱ‘ŽȱŠ’–ȱ˜ȱ‘Žȱ’—Ž›ŸŽ—’˜— ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŜ ‘Ž–ŽȱřDZȱ‘Žȱ›Ž•Š’˜—ȱ˜ȱ‘Žȱ™‘¢œ’ŒŠ•ȱ‘Ž›Š™’œȱŠ—ȱ˜ȱœŽ•ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŝ ‘Ž–ŽȱŚDZȱ‘Žȱ™Š’Ž—œȂȱœŽ•ȱ’–ŠŽ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚŞ ž––Š›¢ȱ˜ȱ›Žœž•œǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŚş    ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŖ ‘ŽȱŸŠ•’’¢ȱ˜ȱ‘ŽȱȱŽœǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŖ ‘Žȱ›Ž•’Š‹’•’¢ȱ˜ȱ‘ŽȱȱŽœ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŘ žŒ˜–Žȱ˜ȱȱ’—Ž›ŸŽ—’˜—ȱ–ŽŠœž›Žȱ‹¢ȱ‘ŽȱȱŽœǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśř žŒ˜–Žȱ˜ȱȱ’—Ž›ŸŽ—’˜—ȱŠœœŽœœŽȱ‹¢ȱ™Š’Ž—œ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŚ ˜–™Š›’—ȱ™Š’Ž—œȂȱŽ¡™Ž›’Ž—ŒŽœȱ˜ȱȱŠ—ȱȱ’—Ž›ŸŽ—’˜—œ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśś Ž‘˜˜•˜’ŒŠ•ȱŠœ™ŽŒœ ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŝ žž›Žȱœž’ŽœǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśŞ  ȱȱ  ȱ   ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯśş  ȱ  ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŜŗ   ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŜŘ  ǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯǯŜś. ȱ. ȱ.

(11) ȱ. ȱ.  ȱ. ȱ INTRODUCTION ȱ ŠŒ”ȱ™Š’—ȱ’œȱŠ—ȱŽ—Ž–’Œȱ™›˜‹•Ž–ȱŠŽŒ’—ȱ˜—Žȱ’—ȱ’ŸŽȱŠž•œȱŽŸŽ›¢ȱ¢ŽŠ›ǯȱŸŽ—ȱ‘˜ž‘ȱ ˜—•¢ȱŗŖȱƖȱ˜ȱŠ••ȱŒŠœŽœȱ˜ȱ‹ŠŒ”ȱ™Š’—ȱ‹ŽŒ˜–ŽȱŒ‘›˜—’Œȱ’ȱ’œȱ˜—Žȱ˜ȱ‘Žȱ•Š›Žœȱ‘ŽŠ•‘ȱ™›˜‹Ȭ •Ž–œȱ ’—ȱ ’—žœ›’Š•’£Žȱ œ˜Œ’Ž’Žœǯȱ ‘Žȱ Ž›–ȱ —˜—œ™ŽŒ’’Œȱ Œ‘›˜—’Œȱ •˜ ȱ ‹ŠŒ”ȱ ™Š’—ȱ ǻǼȱ›ŽŽ›œȱ˜ȱŒŠœŽœȱ’—ȱ ‘’Œ‘ȱ—Ž’‘Ž›ȱ‘Žȱ™Ž›œ’œŽ—ȱ™Š’—ȱœ¢–™˜–œȱ—˜›ȱ‘Žȱ›ŽȬ •ŠŽȱ ™‘¢œ’ŒŠ•ȱ ¢œž—Œ’˜—ȱ Š›Žȱ ›Ž•ŠŽȱ ˜ȱ œ›žŒž›Š•ȱ ’–™Š’›–Ž—ȱ ˜›ȱ ’œŽŠœŽǯȱ ˜—œ™ŽȬ Œ’’Œȱœ™’—Š•ȱ’œ˜›Ž›œȱŠ›ŽȱŒŠŽ˜›’£ŽȱŠœȱŒ‘›˜—’Œȱ’ȱ‘Ž¢ȱ˜ŒŒž›ȱŽ™’œ˜’ŒŠ••¢ȱ ’‘’—ȱŠȱœ’¡ȱ –˜—‘ȱ™Ž›’˜ȱ˜›ȱ•Šœȱ˜›ȱ–˜›Žȱ‘Š—ȱ‘›ŽŽȱ–˜—‘œǯȱ‘Ž¢ȱŠ›ŽȱžœžŠ••¢ȱŠŒŒ˜–™Š—’Žȱ‹¢ȱ ˜‘Ž›ȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ™Š’—œǰȱ‹˜’•¢ȱŒ˜–™•Š’—œǰȱ™œ¢Œ‘˜•˜’ŒŠ•ȱ’œ›ŽœœȱŠ—ȱŠ–™•’’Žȱ ¢œž—Œ’˜—Š•ȱ Œ˜—’’˜—ȱ Š—ȱ ™Š’—ȱ ‹Ž‘ŠŸ’˜ž›ǯȱ ȱ ŠŒŒ˜ž—œȱ ˜›ȱ ŞŖȱ Ɩȱ ˜ȱ ‘Žȱ Œ‘›˜—’Œȱ•˜ ȱ‹ŠŒ”ȱ™Š’—ȱŒŠœŽœȱǽŗȬŚǾȱȱ ȱȱ —ȱŘŖŖŖȱȁ‘Žȱ Ž’œ‘ȱ˜ž—Œ’•ȱ˜—ȱŽŒ‘—˜•˜¢ȱœœŽœœ–Ž—ȱ’—ȱ ŽŠ•‘ȱŠ›ŽȂȱǻǼȱ™ž‹Ȭ •’œ‘Žȱ Š—ȱ Ž¡Ž—œ’ŸŽȱ ›ŽŸ’Ž ȱ ˜—ȱ ‘ŽȱœŒ’Ž—’’Œȱ ŽŸ’Ž—ŒŽȱ ˜ȱ ŒŠžœŽœǰȱ ’Š—˜œ’œȱ Š—ȱ ›ŽŠȬ –Ž—ȱ˜ȱ‹ŠŒ”ȱ™Š’—ǯȱȱ›˜ž™ȱ˜ȱ’—Ž›—Š’˜—Š•ȱŽ¡™Ž›œȱ‘Šȱ˜—Žȱ‘›˜ž‘ȱŘśȱŖŖŖȱŠ›’Œ•Žœȱ Š—ȱœŽ•ŽŒŽȱŠ›˜ž—ȱŘŖŖŖȱœž’Žœȱ˜—ȱ‹ŠŒ”ȱŠ—ȱ—ŽŒ”ȱ™Š’—ȱ˜ȱ‘Žȱ‘’‘ŽœȱœŒ’Ž—’’ŒȱšžŠ•Ȭ ’¢ǯȱ —ȱ‘ŽȱŒ˜—Œ•žœ’˜—œȱ’ȱ ŠœȱœŠŽȱ‘Šȱ‹ŠŒ”ȱ™Š’—ȱŠ—ȱ’œȱŒ˜—œŽšžŽ—ŒŽœȱŠ›Žȱ—˜ȱ’œ˜Ȭ •ŠŽȱ ™‘¢œ’ŒŠ•ȱ ™›˜‹•Ž–œȱ ‹žȱ Š›Žȱ Šœœ˜Œ’ŠŽȱ  ’‘ȱ œ›Žœœǰȱ  ˜››¢ȱ Š—ȱ Š—¡’Ž¢ǯȱ ‘Žȱ ™ŠȬ ’Ž—Ȃœȱ˜ —ȱ™Ž›ŒŽ™’˜—œȱ˜ȱŠ—ȱŠ‹’•’¢ȱ˜ȱ–Š—ŠŽȱ‘Žȱ™›˜‹•Ž–ȱŒŠ—ȱ‘ŠŸŽȱŽŒ’œ’ŸŽȱ’–Ȭ ™ŠŒȱ˜—ȱ‘Žȱ›Š—œ’’˜—ȱ›˜–ȱŠŒžŽȱ˜ȱ–˜›ŽȱŒ‘›˜—’Œȱ™Š’—ǯȱŠ—¢ȱ›ŽŠ–Ž—ȱ–Ž‘˜œȱŠ›Žȱ Œž››Ž—•¢ȱžœŽȱ‹žȱ‘Ž›Žȱ’œȱ•’•ŽȱœŒ’Ž—’’ŒȱŽŸ’Ž—ŒŽȱŠ‹˜žȱ‘Ž’›ȱ‹Ž—Ž’œǯȱŒŒ˜›’—ȱ˜ȱ ‘Žȱ Ž’œ‘ȱȱ›Ž™˜›ǰȱ™›˜›Žœœ’ŸŽȱ›Žœž–™’˜—ȱ˜ȱŠŒ’Ÿ’’Žœȱ˜ȱŠ’•¢ȱ•’Ÿ’—ȱŠ—ȱ‹ŠŒ”ȱ ™›˜›Š–œȱ Œ˜–‹’—’—ȱ –žœŒ•Žȱ œ›Ž—‘Ȭȱ Š—ȱ œ›ŽŒ‘ȱ ›Š’—’—ȱ ™•žœȱ ŠŽ›˜‹’Œȱ ’—Žœœȱ Š›Žȱ ›ŽŒ˜––Ž—ŽȱŠœȱŽŽŒ’ŸŽȱ›ŽŠ–Ž—ȱ˜›ȱ‘Žȱ›ŽžŒ’˜—ȱ˜ȱ’œŠ‹’•’¢ȱŠ—ȱ’–™›˜ŸŽ–Ž—ȱ ˜ȱ™‘¢œ’ŒŠ•ȱž—Œ’˜—ǰȱ’—ȱ™Š’Ž—œȱ ’‘ȱȱǽřǾǯȱ ȱ Žœ™’Žȱ ‘Žȱ ŠŒȱ ‘ŠȱœŽŸŽ›Š•ȱ Œ•’—’ŒŠ•ȱ ™›ŠŒ’ŒŽȱ ž’Ž•’—Žœȱ‘Šȱ ‹ŽŽ—ȱŽŸŽ•˜™Žȱ ˜›ȱ ‘Žȱ –Š—ŠŽ–Ž—ȱ˜ȱ•˜ ȱ‹ŠŒ”ȱ™Š’—ǰȱ’ȱ ŠœȱŒ˜—Œ•žŽȱ‘Šȱ‘Žȱ˜ŸŽ›Š••ȱšžŠ•’¢ȱ Šœȱ’œŠ™Ȭ ™˜’—’—ȱǽŗȬřǾǯȱ‘Ž›Ž˜›Žȱ’—ȱŘŖŖŜǰȱ‘Žȱž›˜™ŽŠ—ȱ˜––’œœ’˜—ȱȱŗřȱ™›˜›Š–ȱ™ž‹Ȭ •’œ‘Žȱ ‘Žȱ ž›˜™ŽŠ—ȱ ž’Ž•’—Žœȱ ˜›ȱ ‘Žȱ –Š—ŠŽ–Ž—ȱ ˜ȱ •˜ ȱ ‹ŠŒ”ȱ ™Š’—ǰȱ ’—Œ•ž’—ȱ ž’Ž•’—Žœȱ˜›ȱǯȱ —ȱŒ˜—Œ•žœ’˜—ȱ’ȱ ŠœȱœŠŽȱ‘Šȱ‘ŽȱŽ ȱ‘Ž›Š™’Žœȱ‘Šȱ–Š¢ȱ‹Žȱ ›ŽŒ˜––Ž—Žȱ˜›ȱ™Š’Ž—œȱ ’‘ȱȱ‘ŠŸŽȱ˜—•¢ȱ–˜ŽœȱŽŽŒœȱžŽȱ˜ȱ‘Žȱ‘ŽŽ›˜Ȭ Ž—Ž˜žœȱ Š—ȱ –ž•’’–Ž—œ’˜—Š•ȱ —Šž›Žȱ ˜ȱ ‘Žȱž—Ž›•¢’—ȱ ™›˜‹•Ž–ǯȱŒŒ˜›’—ȱ ˜ȱ ‘Žȱ ž’Ž•’—Žœȱ ¡Ž›Œ’œŽȱ ‘Ž›Š™¢ȱ ǻǼȱ ˜Ž‘Ž›ȱ  ’‘ȱ Œ˜—’’ŸŽȱ ‹Ž‘ŠŸ’˜ž›Š•ȱ ’—Ž›ŸŽ—’˜—ȱ Š›Žȱ‘Žȱ–˜œȱ™›˜–’œ’—ȱ’—Ž›ŸŽ—’˜—œȱ˜›ȱ‘’œȱ›˜ž™ȱ˜ȱ™Š’Ž—œǰȱŽŸŽ—ȱ‘˜ž‘ȱ‘ŽȱȃŠŒȬ ’ŸŽȱ’—›Ž’Ž—Ȅȱ’—ȱȱ™›˜›Š–œȱ’œȱ•Š›Ž•¢ȱž—”—˜ —ǯȱȱŽ—Œ˜–™ŠœœŽœȱŠȱ‘ŽŽ›˜Ž—ŽȬ ˜žœȱ ›˜ž™ȱ ˜ȱ ’—Ž›ŸŽ—’˜—œȱ ‘Šȱ ŸŠ›¢ȱ ’—ȱ ¢™Žǰȱ ’—Ž—œ’¢ǰȱ ›ŽšžŽ—Œ¢ȱ Š—ȱ ž›Š’˜—ȱ ˜ȱ Ž¡Ž›Œ’œŽȱ Š—ȱ ‘Žȱ œŽ’—ȱ ’—ȱ  ‘’Œ‘ȱ ’ȱ ’œȱ ™›˜Ÿ’Žǯȱ ‘Žȱ ™›’–Š›¢ȱ Š’–ȱ ’œȱ ˜ȱ Ž—ŠŽȱ ™ŠȬ ’Ž—œȱ˜ȱ’—Œ›ŽŠœŽȱ‘Ž’›ȱŠ–˜ž—ȱ˜ȱŽ—Ž›Š•ȱ™‘¢œ’ŒŠ•ȱŠŒ’Ÿ’¢ǰȱ˜ȱœ›Ž—‘Ž—ȱ–žœŒ•ŽœȱŠ—ȱ ’—Œ›ŽŠœŽȱ“˜’—œȱ•Ž¡’‹’•’¢ȱ’—ȱ˜›Ž›ȱ˜ȱ’–™›˜ŸŽȱ™‘¢œ’ŒŠ•ȱŒŠ™ŠŒ’¢ȱ•ŽŸŽ•ȱǽŘǰȱśǰȱŜǾǯȱȱ ȱ ŗȱ.

(12)  ȱ ȱ ȱœ¢œŽ–Š’Œȱ›ŽŸ’Ž ȱŒ˜—žŒŽȱ ’‘’—ȱ‘Žȱ›Š–Ž ˜›”ȱ˜ȱ‘Žȱ˜Œ‘›Š—Žȱ˜••Š‹˜›Š’˜—ȱ ˜ž—ȱ‘Šȱȱ’œȱœ•’‘•¢ȱŽŽŒ’ŸŽȱŠȱŽŒ›ŽŠœ’—ȱ™Š’—ȱŠ—ȱ’–™›˜Ÿ’—ȱž—Œ’˜—ȱŠ—ȱ’œȱ Šȱ •ŽŠœȱ Šœȱ ŽŽŒ’ŸŽȱ Šœȱ ˜‘Ž›ȱ Œ˜—œŽ›ŸŠ’ŸŽȱ ’—Ž›ŸŽ—’˜—œȱ ˜›ȱ ™Š’Ž—œȱ  ’‘ȱ ǯȱ ‘Žȱ ȱ ™›˜›Š–ȱ œ‘˜ž•ȱ ‹Žȱ ’—’Ÿ’žŠ••¢ȱ Žœ’—Žǰȱ ‘Žȱ ™Ž›˜›–Š—ŒŽȱ œž™Ž›Ÿ’œŽȱ Š—ȱ Š‘Ž›Ž—ŒŽȱ Ž—Œ˜ž›ŠŽȱ ˜ȱ ŠŒ‘’ŽŸŽȱ Šȱ ‘’‘ȱ Š–˜ž—ȱ ˜ȱ Ž¡Ž›Œ’œŽǯȱ ˜›Ž˜ŸŽ›ǰȱ œ›ŽŒ‘’—ȱ Ž¡Ž›Œ’œŽœȱ œ‘˜ž•ȱ ‹Žȱ ’—Œ•žŽȱ ’—ȱ ‘Žȱ ™›˜›Š–ȱ ˜ȱ ›ŽžŒŽȱ ™Š’—ȱ Šœȱ  Ž••ȱ Šœȱ –žœŒ•ŽȬ œ›Ž—‘Ž—’—ȱŽ¡Ž›Œ’œŽœȱ˜ȱ’–™›˜ŸŽȱž—Œ’˜—ȱǽŜȬŞǾȱ ȱ Protective pain behaviour ȱ‘Šœȱ ‹ŽŽ—ȱ œ‘˜ —ȱ ‘Šȱ ™Š’Ž—œȱ  ’‘ȱ ȱ ‘ŠŸŽȱ ¢œž—Œ’˜—Š•ȱ ™˜œž›Žœǰȱ ‘Š‹’žȬ ŠŽȱ›Žœ›’ŒŽȱ–˜ŸŽ–Ž—ȱ›Ž™Ž›˜’›Žœǰȱ›ŽžŒŽȱ”’—Žœ‘Žœ’ŠȱŠ—ȱ’–™Š’›Žȱ™›˜™›’˜ŒŽ™Ȭ ’˜—ȱǽşȬŗřǾȱǯȱȱ ȱ ŽŸŽ›Š•ȱœž’ŽœȱŒ˜—’›–ȱ‘ŠȱœŽ—œ˜›¢ȱ–˜˜›ȱ’œž›‹Š—ŒŽœȱŠ›Žȱ˜ž—ȱ›ŽšžŽ—•¢ȱ’—ȱ™ŠȬ ’Ž—œȱ ’‘ȱŒ‘›˜—’Œȱ™Š’—ȱǽŗŚȬŗŜǾǯȱ›˜–ȱŠȱŒ•’—’ŒŠ•ȱ™Ž›œ™ŽŒ’ŸŽȱ‘Žȱ›Ž•Š’˜—œ‘’™ȱ‹Ž ŽŽ—ȱ Œ‘›˜—’Œȱ ™Š’—ȱ Š—ȱ –˜ŸŽ–Ž—ȱ ›Ž•ŠŽȱ ’œŠ‹’•’’Žœȱ ’œȱ ž—Š–‹’ž˜žœǯȱ ’œŠ‹’•’’Žœȱ ’—ȱ ™ŠȬ ’Ž—œȱ ’‘ȱȱ–Š¢ȱ‹Žȱ›Ž•ŠŽȱ˜ȱŠ—ȱŽŠ›•’Ž›ȱŠŒžŽȱ’—“ž›¢ȱ˜›ȱ–Š¢ȱ‹Žȱ‘Žȱ›Žœž•ȱ˜ȱ •˜—ȱ’–Žȱ’œžœŽȱ˜›ȱŠœȱŠȱŒ˜—œŽšžŽ—ŒŽȱ˜ȱ™‘¢œ’ŒŠ•ȱ˜›ȱ™œ¢Œ‘˜•˜’ŒŠ•ȱ˜ŸŽ›•˜Šǯȱ’•Žȱ’œȱ ”—˜ —ǰȱ‘˜ ŽŸŽ›ǰȱŠ‹˜žȱ‘˜ ȱ—˜—œ™ŽŒ’’Œȱ™Š’—ȱ›Ž•ŠŽȱ—Žž›˜–žœŒž•˜œ”Ž•ŽŠ•ȱ’œŠ‹’•’Ȭ ’Žœȱ˜ŒŒž›ȱŠ—ȱ‘˜ ȱ‘ž–Š—œȱ•ŽŠ›—ȱ˜ȱŒ˜—›˜•ȱŠ—ȱ˜™’–’£Žȱ‘Ž’›ȱ–˜ŸŽ–Ž—œǯȱ‘ŽȱŠ—Ȭ œ Ž›ȱ•’Žœȱ’—ȱ‘Žȱ’—Ž›ŠŒŽȱ˜ȱ—Žž›˜œŒ’Ž—ŒŽǰȱ”’—Žœ’˜•˜¢ǰȱ—Žž›˜™‘¢œ’˜•˜¢ǰȱ™œ¢Œ‘˜•˜¢ǰȱ ‹’˜–ŽŒ‘Š—’ŒœȱŠ—ȱŒ•’—’ŒŠ•ȱœŒ’Ž—ŒŽœȱǽŗŝȬŘŖǾǯȱ ȱ ȱ‘Šœȱ‹ŽŽ—ȱœžŽœŽȱ‘Šȱ™›˜ŽŒ’ŸŽȱ™Š’—ȱ‹Ž‘ŠŸ’˜ž›ȱ–Š¢ȱž—Ž›•’Žȱ‘Žȱ–Š•ŠŠ™’ŸŽȱ –˜ŸŽ–Ž—œȱ Š—ȱ ‘Žȱ –˜˜›ȱ Œ˜—›˜•ȱ ’–™Š’›–Ž—œȱ ’—ȱ ™Š’Ž—œȱ  ’‘ȱ Œ‘›˜—’Œȱ •˜ ȱ ‹ŠŒ”ȱ ™Š’—ȱǽŘŗǾǯȱ›˜ŽŒ’ŸŽȱ™Š’—ȱ‹Ž‘ŠŸ’˜ž›ȱ’–™•’ŽœȱŠ—¢ȱŠŒ’˜—ȱ‘Šȱ’œȱ’—Ž—Žȱ˜ȱ›ŽžŒŽȱ‘Žȱ ™›˜‹Š‹’•’¢ȱ ˜ȱ ž›‘Ž›ȱ ’—“ž›¢ǰȱ –’—’–’£Žȱ ‘Žȱ Ž¡™Ž›’Ž—ŒŽȱ ˜ȱ ™Š’—ȱ ˜›ȱ ™›˜–˜Žȱ ›ŽŒ˜ŸŽ›¢ȱ ›˜–ȱ’—“ž›¢ȱǽŘŘǾǯȱŠŒ”ȱ™Š’—ȱ–Š¢ȱ’—•žŽ—ŒŽȱŠ—’Œ’™Š˜›¢ȱ™˜œž›Š•ȱŒ˜–™Ž—œŠ’˜—ȱž›’—ȱ Šȱ –˜ŸŽ–Ž—ȱ ‘Šȱ ’—Ÿ˜•ŸŽœȱ ‘Žȱ œ™’—Žǰȱ ™•žœȱ ‘Žȱ ’—Œ›ŽŠœŽȱ ŠŒ’ŸŠ’˜—ȱ ˜ȱ ŽŽ™ȱ –žœŒ•Žȱ œ›žŒž›Žœȱ–’‘ȱ›Ž•ŽŒȱŠȱ™›˜ŽŒ’ŸŽȱ–ŽŒ‘Š—’œ–ȱŠ’–ŽȱŠȱ–’—’–’£’—ȱ–˜ŸŽ–Ž—ȱŠœȬ œ˜Œ’ŠŽȱ ’‘ȱŠ—ȱ’—Œ›ŽŠœŽȱ’—ȱ™Š’—ȱǽŘřǾǯȱ —’Ÿ’žŠ•œȱŽ—ŠŽȱ’—ȱ‹Ž‘ŠŸ’˜ž›œȱœžŒ‘ȱŠœȱ‘˜•Ȭ ’—ȱ˜›ȱžŠ›’—ȱ‘Žȱ™Š›ȱ˜ȱ‘Žȱ‹˜¢ȱ ‘Ž›Žȱ™Š’—ȱ’œȱ‹Ž’—ȱ™Ž›ŒŽ’ŸŽȱŠ—ȱ‘Ž¢ȱ™Ž›˜›–ȱ ŠŒ’˜—œȱ’—ȱŠȱ›’’ȱ˜›ȱ‘Š•’—ȱ–Š——Ž›ȱ˜ȱ–’—’–’£Žȱ–˜ŸŽ–Ž—œȱ‘ŠȱŒŠžœŽȱ™Š’—ȱǽŘŘȬŘŚǾǯȱ ȱ ‘Ž›ŽȱŠ›Žȱ’—’ŒŠ’˜—œȱ‘ŠȱŽ–˜’˜—Š•ȱŠŒ˜›œȱ›Ž•ŠŽȱ˜ȱŽŠ›ȱ˜ȱ™Š’—ȱ™•Š¢ȱŠȱœ’—’’ŒŠ—ȱ ›˜•Žȱ’—ȱ‘ŽȱŽ›ŽŽȱ˜ȱ™›˜ŽŒ’ŸŽȱ‹Ž‘ŠŸ’˜ž›ȱ’—’Ÿ’žŠ•œȱ ’••ȱ’œ™•Š¢ȱ ‘Ž—ȱŽ¡™Ž›’Ž—Œ’—ȱ ™Š’—ǯȱ ˜—œ’œŽ—ȱ ›ŽœŽŠ›Œ‘ȱ ’—’—œȱ Œ˜››˜‹˜›ŠŽȱ ‘Šȱ ’—’Ÿ’žŠ•œȱ œžŽ›’—ȱ ›˜–ȱ ȱ ŽŸŽ•˜™ȱ ŽŠ›ȬŠŸ˜’Š—ŒŽȱ œ›ŠŽ’Žœǰȱ ™Š’—Ȭ›Ž•ŠŽȱ ’œŠ‹’•’¢ȱ Š—ȱ Ž—Ž›Š••¢ȱ —ŽŠ’ŸŽȱŠŽŒȱǽŘśǾǯȱŽŠ›ȱ˜ȱ™Š’—ȱ‘Šœȱ‹ŽŽ—ȱŽ’—ŽȱŠœȱŠȱ‘’‘•¢ȱœ™ŽŒ’’Œȱ—ŽŠ’ŸŽȱŽ–˜Ȭ ’˜—Š•ȱ ›ŽŠŒ’˜—ȱ ˜ȱ ™Š’—ȱ Ž•’Œ’’—ȱ œ’–ž•’ȱ ’—Ÿ˜•Ÿ’—ȱ Šȱ ‘’‘ȱ Ž›ŽŽȱ ˜ȱ –˜‹’•’£Š’˜—ȱ ˜›ȱ ŠŸ˜’Š—ŒŽȱ‹Ž‘ŠŸ’˜ž›ȱǽŘŜǾǯȱ —’Ÿ’žŠ•œȱ ‘˜ȱœŒ˜›Žȱ‘’‘ȱ˜—ȱ–ŽŠœž›Žœȱ˜ȱŽŠ›ȱ˜ȱ™Š’—ȱŠ›Žȱ. Ř. ȱ.

(13) ȱ. ȱ.  ȱ. •ŽœœȱŠŒ’ŸŽǰȱ‘ŠŸŽȱ›ŽžŒŽȱ›Š—Žȱ˜ȱ–˜’˜—ǰȱŠ›Žȱ™›˜—Žȱ˜ȱ’œŒ˜—’—ž’—ȱŠŒ’Ÿ’’Žœȱ‘Šȱ Š›ŽȱŠœœ˜Œ’ŠŽȱ ’‘ȱ™Š’—ȱŠ—ȱŠŸ˜’ȱŠŒ’Ÿ’’Žœȱ‘Šȱ‘Ž¢ȱŽ¡™ŽŒȱ ’••ȱ‹ŽȱŠœœ˜Œ’ŠŽȱ ’‘ȱ ™Š’—ȱǽŘŚǰȱŘŝǰȱŘŞǾǯȱ ȱ ›˜–ȱ Šȱ œ‘˜›ȱ Ž›–ȱ ™Ž›œ™ŽŒ’ŸŽǰȱœžŒ‘ȱž—Œ˜—œŒ’˜žœ•¢ȱ ›Žœ›’Œ’ŸŽȱ –˜ŸŽ–Ž—ȱ‘Š‹’œȱŒŠ—ȱ ‹Žȱ œŽŽ—ȱ Šœȱ Šȱ ™‘¢œ’˜•˜’ŒŠ••¢ȱ ‹Ž—Ž’Œ’Š•ȱ Œ˜™’—ȱ œ›ŠŽ¢ȱ ‘Šȱ ™›˜ŽŒœȱ ŠŠ’—œȱ ž›‘Ž›ȱ ˜ŸŽ›•˜Šȱ Š—Ȧ˜›ȱ ’—“ž›¢ǯȱ ’—ŠŽœ‘Ž’Œȱ ™Ž›ŒŽ™’˜—ǰȱ ‘˜ ŽŸŽ›ǰȱ ‹ŽŒ˜–Žœȱ •Žœœȱ ’Ž›Ž—’Ȭ ŠŽȱ ‘Ž—ȱŠŒ’˜—ȱ’œȱ›Žœ›’ŒŽȱǽŗŚǰȱŘşǰȱřŖǾǯȱ‘’œȱ’–™•’Žœȱ‘ŠȱŠŽ›ȱœ˜–Žȱ’–Žǰȱ‘Žȱ™ŠȬ ’Ž—ȱ ’‘ȱȱ ’••ȱ—˜ȱ•˜—Ž›ȱ™Ž›ŒŽ’ŸŽȱ‘’œȱ˜›ȱ‘Ž›ȱ–˜ŸŽ–Ž—œȱŠœȱ™›ŽŒ’œŽ•¢ȱŠœȱ‹ŽȬ ˜›Žǯȱ‘’œȱ  ’••ȱ ›ŽžŒŽȱ‘Žȱ Š‹’•’¢ȱ ˜ȱ Œ˜Ȭ˜›’—ŠŽȱ ‘Žȱ ’—ŽȬž—ŽǰȱŒ˜–™•Ž¡ȱ –˜ŸŽ–Ž—œȱ ˜ȱ‘Žȱœ™’—ŽȱŠ—ȱŠȱŸ’Œ’˜žœȱŒ’›Œ•Žȱ’œȱ’—’’ŠŽȱ ’‘ȱ™Š’—ȱ‹Ž’—ȱ‘Žȱ™Š’Ž—Ȃœȱ˜—•¢ȱ—˜’ŒŽȬ Š‹•Žȱœ’—ǯȱ ȱ ‘Ž—ȱ ›ŽŽ››’—ȱ ˜ȱ ‘Žȱ Š‹˜ŸŽǰȱ ȱ œŽŽ–ȱ ˜ȱ ™›ŽœŽ—ȱ˜—Žȱ ˜ȱ ‘Žȱ–˜œȱ Œ‘Š••Ž—’—ȱ Šœ™ŽŒœȱ˜ȱ›Ž‘Š‹’•’Š’˜—ȱœ’—ŒŽȱ—˜ȱž—Ž›•¢’—ȱ’œŽŠœŽȱ˜›ȱŠ—Š˜–’ŒŠ•ȱœ˜ž›ŒŽȱ˜ȱ™Š’—ȱŒŠ—ȱ Ž¡™•Š’—ȱ‘Žȱ™Š’Ž—œȂȱœŽŸŽ›Žȱ™Š’—ȱœ¢–™˜–œǰȱ™‘¢œ’ŒŠ•ȱ’œŠ‹’•’’ŽœȱŠ—Ȧ˜›ȱ™œ¢Œ‘˜•˜’Ȭ ŒŠ•ȱ ’œ›Žœœǯȱ ˜›Ž˜ŸŽ›ǰȱ ’—ȱ ™Š’Ž—œȱ  ’‘ȱ ȱ ‘Ž›Žȱ ’œȱ —˜ȱ Œ˜—Œž››Ž—ȱ ’œŽŠœŽȱ ˜›ȱ ™Š‘˜™‘¢œ’˜•˜’ŒŠ•ȱ ™›˜ŒŽœœǰȱ  ‘’Œ‘ȱŒŠ—ȱ ™›˜›Žœœȱ Š—ȱ ™˜œœ’‹•¢ȱ ‹’Šœȱ ‘Žȱ ˜žŒ˜–Žȱ ˜ȱ Šȱ ™˜Ž—’Š••¢ȱŽ’Œ’Ž—ȱ’—Ž›ŸŽ—’˜—ǯȱȱ ȱ ‘ŽȱŠž‘˜›ȱ˜ȱ‘’œȱ‘Žœ’œȱ‘Šȱ‘Žȱ˜‹“ŽŒ’ŸŽȱ˜ȱŽŸŽ•˜™’—ȱŠȱŒ˜–™›Ž‘Ž—œ’ŸŽȱ’—Ž›ŸŽ—Ȭ ’˜—ȱ Š’–Žȱ Šȱ ‘Žȱ ›Ž‘Š‹’•’Š’˜—ȱ ˜ȱ ™Š’Ž—œȱ  ’‘ȱ ǯȱ ȱ  Šœȱ ’—Ž—Žȱ ‘Šȱ ‘Žȱ ’—Ž›ŸŽ—’˜—ȱ  ˜ž•ȱ Š›Žœœȱ ‘Žȱ  ‘˜•Žȱ ™Ž›œ˜—ȱ Š—ȱ ‘Ž›Ž˜›Žȱ ’ȱ  Šœȱ —Š–Žȱ Ž—œ˜›¢ȱ ˜˜›ȱŽŠ›—’—ȱǻǼǯȱȱ ȱ. ȱ řȱ.

(14)  ȱ ȱ. AIMS ȱ ‘Žȱ˜ŸŽ›Š••ȱ™ž›™˜œŽȱ˜ȱ‘’œȱ‘Žœ’œȱ Šœȱ˜ȱŽ—Ž›ŠŽȱ”—˜ •ŽŽȱ‹¢ȱŽŸŠ•žŠ’—ȱ‘ŽȱŽ—Ȭ œ˜›¢ȱ ˜˜›ȱ ŽŠ›—’—ȱ ǻǼȱ ’—Ž›ŸŽ—’˜—ȱ  ‘Ž—ȱ Š™™•’Žȱ ’—ȱ ™Š’Ž—œȱ  ’‘ȱ —˜—œ™ŽŒ’’Œȱ Œ‘›˜—’Œȱ•˜ ȱ‹ŠŒ”ȱ™Š’—ȱǻǼǯȱ˜ȱŠŒ‘’ŽŸŽȱ‘Žȱ™ž›™˜œŽȱ‘ŽȱŒ˜—ŒŽ™žŠ•ȱ›Š–Ž ˜›”ȱ ‹Ž‘’—ȱ ‘Žȱ ȱ ’—Ž›ŸŽ—’˜—ȱ  Šœȱ ˜ž•’—Žȱ Š—ȱ ‘Žȱ ’—ŸŽœ’Š’˜—ȱ ’–™•Ž–Ž—Žȱ ‘›˜ž‘ȱ˜ž›ȱœŽ™Š›ŠŽȱœž’Žœȱ ’‘ȱ‘Žȱ˜••˜ ’—ȱŠ’–œDZȱȱ. ž¢ȱ DZȱȱ ‘Žȱ Š’–ȱ ˜ȱ œž¢ȱ ȱ  Šœȱ ˜ȱ ’—ŸŽœ’ŠŽȱ ’ȱ ‘Žȱ ˜™˜Ž•ŽŒ›˜—’Œȱ ˜œž›˜Ȭ˜Œ˜–˜’˜—Ȭ Š—’™ž•Š’˜—ȱ ǻǼȱ Žœȱ  Šœȱ Šȱ ŸŠ•’ȱ Š—ȱ ›Ž•’Š‹•Žȱ –ŽŠœž›Ž–Ž—ȱ ˜˜•ǰȱ Š‹•Žȱ ˜ȱ ŠœœŽœœȱ ¢—Š–’Œȱ–˜ŸŽ–Ž—ȱŒŠ™ŠŒ’¢ȱ˜‹“ŽŒ’ŸŽ•¢ȱ’—ȱ›ŽŽ•¢ȱ–˜Ÿ’—ȱ™Š’Ž—œȱ ’‘ȱǯȱȱ ȱ. ž¢ȱ DZȱȱ ‘ŽȱŠ’–ȱ˜ȱœž¢ȱ ȱ Šœȱ˜ȱŽŸŠ•žŠŽȱ‘˜ ȱ‘Žȱȱ’—Ž›ŸŽ—’˜—ȱ’—•žŽ—ŒŽȱ–˜ŸŽ–Ž—ȱ ŒŠ™ŠŒ’¢ȱ’—ȱ™Š’Ž—œȱ ’‘ȱǯȱȱ ȱ. ž¢ȱ DZȱȱ ‘ŽȱŠ’–ȱ˜ȱœž¢ȱ ȱ Šœȱ˜ȱŽŸŠ•žŠŽȱ‘˜ ȱ‘Žȱȱ’—Ž›ŸŽ—’˜—ȱ’—•žŽ—ŒŽȱŠȱ›˜ž™ȱ˜ȱ ™Š’Ž—œȱ ’‘ȱȱ ’‘ȱ›ŽŠ›ȱ˜ȱ‘Ž’›ȱœž‹“ŽŒ’ŸŽȱŒ˜—’’ŸŽȱ™Ž›œ™ŽŒ’ŸŽœǯȱȱ ȱ. ž¢ȱ DZȱȱ ‘Žȱ Š’–ȱ ˜ȱ œž¢ȱ ȱ  Šœȱ ˜ȱ Œ˜–™Š›Žȱ ‘˜ ȱ ™Š’Ž—œȱ  ’‘ȱ ȱ Ž¡™›Žœœȱ ‘Ž’›ȱ Ž¡Ȭ ™Ž›’Ž—ŒŽœȱ›˜–ȱ ˜ȱ’—Ž›ŸŽ—’˜—œȱ‘ŠȱŠ›Žȱ‹ŠœŽȱ˜—ȱ’Ž›Ž—ȱŒ˜—ŒŽ™žŠ•ȱ›Š–Ž ˜›”œDzȱ ȱŠ—ȱŽ¡Ž›Œ’œŽȱ‘Ž›Š™¢ȱǻǼȱ’—Ž›ŸŽ—’˜—œǯȱȱ ȱ Design ˜ȱŠŒ‘’ŽŸŽȱ‘ŽȱŸŠ›’˜žœȱŠ’–œȱ˜ȱ‘Žȱ˜ž›ȱœž’Žœǰȱ–ž•’™•Žȱ–Ž‘˜˜•˜’ŒŠ•ȱŠ™™›˜ŠŒ‘Žœȱ  Ž›Žȱ›Žšž’›Žǯȱ —ȱœž¢ȱ ȱŠ—ȱ ȱ‘ŽȱŠŠȱŒ˜••ŽŒ’˜—ȱ ŠœȱŒ˜–™žŽ›Ȭ‹ŠœŽȱŠ—ȱ‘Žȱ’–Žȱ Š”Ž—ȱ˜›ȱ‘ŽȱŽ—’›ŽȱȱŽœȱ–˜ŸŽ–Ž—ȱŠ—ȱ˜›ȱ’œȱ‘›ŽŽȱ™‘ŠœŽœDzȱ™˜œž›Š•ȱǻǼǰȱ•˜Œ˜Ȭ –˜’˜—ȱ ǻǼȱ Š—ȱ Š—’™ž•Š’˜—ȱ ǻǼȱ  Ž›Žȱ ŒŠ•Œž•ŠŽȱ Š—ȱ œŠ’œ’ŒŠ••¢ȱ Š—Š•¢œŽǯȱ ‘Ž›Žȱ  ŠœȱŠ•œ˜ȱŠ—ȱŠŽ–™ȱ˜ȱ–ŽŠœž›Žȱ˜ȱ ‘ŠȱŽ›ŽŽȱ‘Žȱ™˜œž›Š•ȱ–˜˜›ȱ™›˜›Š–ȱ Šœȱ’—Ȭ Ž›ŠŽȱ ’‘ȱŠ’ȱŠ—ȱŠ›–ȱŽ¡Ž›’¢ȱ’—˜ȱŠ—ȱŽ’Œ’Ž—ȱ–˜ŸŽ–Ž—ȱ‹¢ȱ‘ŽȱŒŠ•Œž•Š’˜—ȱ˜ȱ Šȱ œ’–ž•Š—Ž’¢ȱ ’—Ž¡ȱ ǻ Ǽǯȱ —ȱ œž¢ȱ ȱ  ˜ȱ ’—’Ÿ’žŠ•ȱ ’—Ž›Ÿ’Ž œȱ  ’‘ȱ ŽŠŒ‘ȱ ™Š’Ž—ȱ  Ž›ŽȱŠž’˜ȱ›ŽŒ˜›Žǰȱ›Š—œŒ›’‹ŽȱŠ—ȱ‘ŽȱŒ˜—Ž—ȱ ŠœȱŠ—Š•¢œŽȱžœ’—ȱŠȱœ¢œŽ–Š’ŒȱŝȬ œŽ™ȱ’Ž›Š’ŸŽȱ™›˜ŒŽž›Žǯȱž¢ȱ ȱ ŠœȱŽœ’—ŽȱŠœȱŠȱšžŠ•’Š’ŸŽȱ›Š—˜–’£ŽȱŒ•’—’ŒŠ•ȱ. Ś. ȱ.

(15) ȱ. ȱ.  ȱ. ›’Š•ȱžœ’—ȱ˜Œžœȱ›˜ž™œȱ˜ȱŒ˜–™Š›Žȱ‘˜ ȱ™Š’Ž—œȱ ’‘ȱȱŽ¡™›ŽœœŽȱ‘Ž’›ȱŽ¡Ȭ ™Ž›’Ž—ŒŽœȱ›ŽŠ›’—ȱ‘Žȱ ˜ȱ’Ž›Ž—ȱ’—Ž›ŸŽ—’˜—œǯȱȱ ȱ —ȱ˜ŸŽ›Ÿ’Ž ȱ˜ȱ‘Žȱ›ŽœŽŠ›Œ‘ȱŽœ’—ȱ’œȱ’ŸŽ—ȱ’—ȱŠ‹•Žȱ ǯȱȱ ȱ Š‹•Žȱŗȱ ȱ Study. I. II. Design. Assessment of PLM-test’s validity and reliability. Assessment of movement capacity before, after and 1 year after SML. Setting. Movement laboratory. Neutral conference Movement laboraSML intervention clinic room tory. Data collection. Computer based measurements of time. Computer based measurements of time. Audio recorded, transcribed individual interviews. Audio recorded, transcribed focus group discussions. Patients with NSCLBP and control group. Patients with NSCLBP and control group. Patients with NSCLBP. Patients with NSCLBP. Descriptive and non-parametric statistics. Descriptive and non-parametric statistics. Qualitative content analysis of cognitive individual interviews. Qualitative discursive analysis of focus group discussions. Participants. Analysis. III. IV. Focus groups discusIndividual interviews to sions to compare how assess how patients patients express experceive and interpret periences of SML and SML ET. ȱ ȱ ȱ. ȱ śȱ.

(16)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ȱ. THE CONCEPTUAL FRAMEWORK behind Sensory Motor Learning (SML) intervention ȱ ‘ŽȱŠž‘˜›ȱ˜ȱ‘’œȱ‘Žœ’œȱœŠ›ŽȱŽŸŽ•˜™’—ȱ‘ŽȱŽ—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›Ȭ ŸŽ—’˜—ȱ’—ȱ‘Žȱ–’ȱŗşşŖœȱŠœȱœ‘Žȱ Šœȱ›Žœ™˜—œ’‹•Žȱ˜›ȱŠȱ™›˜“ŽŒȱ—Š–Žȱȃ˜ȱ•ŽŠ›—ȱ ’‘ȱ ‘Žȱ‹˜¢ȱŠ—ȱŽŸ˜•ŸŽȱŠœȱŠȱ‘ž–Š—ȱ‹Ž’—Dzȱ‘Žȱ–˜ŸŽ–Ž—ȱœŒ‘˜˜•ȱȮȱ Š›Ž—Žœœȱ‘›˜ž‘ȱ –˜ŸŽ–Ž—Ȅǯȱ Ž›ȱ ’ŽŠȱ  Šœȱ ˜ȱ œŠ›ȱ ‘Ž›ȱ ŽŸŽ•˜™–Ž—Š•ȱ  ˜›”ȱ ‹¢ȱ ŠœœŽœœ’—ȱ ‘Žȱ ˜žȬ Œ˜–Žœȱ ˜ȱ ‘Žȱ Ž•Ž—”›Š’œȱ –Ž‘˜ȱ ǻǼDzȱ  Š›Ž—Žœœȱ ‘›˜ž‘ȱ ˜ŸŽ–Ž—ȱ ǻǼȱ •ŽœȬ œ˜—œȱ ǽřŗǾǰȱ ˜Ž›Žȱ ˜ȱ ™Š’Ž—œȱ  ’‘ȱ —˜—œ™ŽŒ’’Œȱ Œ‘›˜—’Œȱ ™Š’—Ȭ›Ž•ŠŽȱ ’œŠ‹’•’’Žœǰȱ  ‘˜ȱ ‘Šȱ—˜ȱ‹ŽŽ—ȱ‘Ž•™Žȱ‹¢ȱŒ˜—ŸŽ—’˜—Š•ȱ™‘¢œ’ŒŠ•ȱ‘Ž›Š™¢ǯȱȱ ȱ ™™›˜¡’–ŠŽ•¢ȱ śŖȱ ™Š’Ž—œȱ  ’‘ȱ –Ž’ŒŠ•ȱ ’Š—˜œŽœȱ œžŒ‘ȱ Šœȱ ’‹›˜–¢Š•’Šǰȱ ‘›˜—’Œȱ •˜ ȱ ‹ŠŒ”ȱ ™Š’—ȱ Š—ȱ ‘’™•Šœ‘ȱ ’—“ž›¢ȱ ˜˜”ȱ ™Š›ȱ ’—ȱ ‘Žȱ ™›˜“ŽŒǯȱ ‘Žȱ ŽŸŠ•žŠ’˜—œȱ  Ž›Žȱ ™Ž›˜›–Žȱ‹¢ȱ’—Š•ȱŽ›–ȱ™‘¢œ’ŒŠ•ȱ‘Ž›Š™¢ȱœžŽ—œȱŠ—ȱ›Žœž•Žȱ’—ȱ’ŸŽȱ›ŠžŠŽȱ›ŽȬ œŽŠ›Œ‘ȱ –Ž‘˜˜•˜¢ȱ ™›˜“ŽŒœǯȱ ‘Žȱ ™Š’Ž—œȂȱ œŽ—œŽȱ ˜ȱ Œ˜‘Ž›Ž—ŒŽȱ ǻǼȱ  Šœȱ ŠœœŽœœŽȱ žœ’—ȱ Šȱ šžŽœ’˜——Š’›Žȱ ŽŸŽ•˜™Žȱ ‹¢ȱ —˜—˜Ÿœ”¢ȱ ǽřŘǾǯȱ ‘Žȱ Žœȱ ŠŸŽ—ȱ Š•Žȱ ž•’Ȭ ’–Ž—œ’˜—Š•ȱŠ’—ȱ —ŸŽ—˜›¢ȱǻ Ǽȱ ŠœȱžœŽȱ˜ȱŠœœŽœœȱ–ž•’™•Žȱ™Š’—ȱ’–Ž—œ’˜—œȱǽřřǾǯȱ ˜ȱ’—ŸŽœ’ŠŽȱ‘ŽȱšžŠ•’Š’ŸŽ•¢ȱ’Ž›Ž—ȱ Š¢œȱ’—ȱ ‘’Œ‘ȱ‘Žȱ™Š’Ž—œȱŽ¡™Ž›’Ž—ŒŽȱ‘Žȱ ’—Ž›ŸŽ—’˜—ǰȱ ˜ȱœŽ™Š›ŠŽȱ’—Ž›Ÿ’Ž ȱœž’Žœȱ Ž›Žȱ™Ž›˜›–Žǯȱ˜ȱŠœœŽœœȱ‘Žȱ™Š’Ž—œȂȱ –˜ŸŽ–Ž—ȱŒŠ™ŠŒ’¢ǰȱ‘Žȱ˜¢ȱ Š›Ž—ŽœœȱŒŠ•ŽȱǻȱŽœǼȱǽřŚǾȱŠ—ȱ‘ŽȱŽœ˜ž›ŒŽȱ›’Ȭ Ž—Žȱ ‹˜¢ȱ ’—ŸŽœ’Š’˜—ȱ ǻ Ǽȱ ǽřśǾǰȱ  Ž›Žȱ žœŽǯȱ ‘Žȱ ›Žœž•œȱ ’—’ŒŠŽȱ ‘Šȱ ‘Žȱ ™ŠȬ ’Ž—œȂȱ ȱ ’–™›˜ŸŽȱ ǽřŜǾȱ Š—ȱ ‘Ž’›ȱ ™Š’—ȱ ’—Ž—œ’¢ȱ ŽŒ›ŽŠœŽȱ ǽřŝǾǯȱ ‘Žȱ ™Š’Ž—œȱ Ž¡Ȭ ™Ž›’Ž—ŒŽȱ ™˜œ’’ŸŽȱ ™‘¢œ’ŒŠ•ȱ Š—ȱ ™œ¢Œ‘˜•˜’ŒŠ•ȱ Œ‘Š—Žœǰȱ  ‘’Œ‘ȱ ›Žœž•Žȱ ’—ȱ Šȱ –˜›Žȱ ™˜œ’’ŸŽȱ œŽ•ȱ ’–ŠŽȱ Š—ȱ Œ˜’—Œ’Žȱ  ’‘ȱ –Š›”Žȱ ’–™›˜ŸŽ–Ž—œȱ ’—ȱ  Ž••Ȭ‹Ž’—ȱ Š—ȱ Š’•¢ȱ•’ŽȱŒŠ™Š‹’•’¢ȱǽřŞȬŚŖǾǯȱȱ ȱ ‘Ž›Žȱ  Ž›Žȱ œŽŸŽ›Š•ȱ –Ž‘˜˜•˜’ŒŠ•ȱ •’–’Š’˜—œȱ ˜ȱ ‘ŽœŽȱ ™’•˜ȱ œž’Žœǯȱ Žȱ Œ˜ž•ȱ —˜ȱ ’—ȱŠȱŸŠ•’ȱ˜žŒ˜–Žȱ–ŽŠœž›Žȱ˜ȱŠœœŽœœȱ‘Žȱ™Š’Ž—œȂȱ–˜ŸŽ–Ž—ȱŒŠ™ŠŒ’¢ǯȱŠ“˜›ȱ˜‹“ŽŒȬ ’˜—œȱ Ž›Žȱ’›ŽŒŽȱ˜ Š›œȱ‘Žȱ•ŠŒ”ȱ˜ȱŒ˜—›˜•ȱ›˜ž™œǯȱ‘Žȱž—žœžŠ•ȱ’ŽŠȱ˜ȱ’—Œ•ž’—ȱ ™Š’Ž—œȱ ’‘ȱŸŠ›’˜žœȱ–Ž’ŒŠ•ȱ’Š—˜œŽœȱ’—ȱ‘ŽȱœŠ–Žȱ’—Ž›ŸŽ—’˜—ȱ ŠœȱšžŽœ’˜—Žǯȱȱȱ ȱ Š’—œȱ‘Žȱ‹ŠŒ”›˜ž—ȱ˜ȱ ‘Šȱ‘ŽȱŠž‘˜›ȱ‘Šȱ•ŽŠ›—Žȱ›˜–ȱ‘ŽœŽȱ™’•˜ȱ™›˜“ŽŒœȱŠ—ȱ ‘›˜ž‘ȱŠŸŠ—ŒŽǰȱ‘Ž˜›Ž’ŒŠ•ȱŠ—ȱŠ™™•’ŽȱŒ˜ž›œŽœȱ’—ȱȱǽŚŗȬŚśǾȱŠ—ȱœž’Žœȱ’—ȱœ¢Ȭ Œ‘˜œ¢—‘Žœ’œȱ ǽŚŜȬŚŞǾȱ Š—ȱ ˜’ŸŠ’˜—Š•ȱ —Ž›Ÿ’Ž ’—ȱ ǻ Ǽȱ ǽŚşǰȱ śŖǾǰȱ Šȱ Œ˜—ŒŽ™žŠ•ȱ ›Š–Ž ˜›”ȱ Šœȱ˜ž•’—Žǯȱ‘›ŽŽȱ™‘Ž—˜–Ž—Šȱ Ž›ŽȱŠœœž–Žȱ˜ȱ™•Š¢ȱŠȱŽŒ’œ’ŸŽȱ›˜•Žȱ’—ȱ ‘Žȱ ȱ ’—Ž›ŸŽ—’˜—ȱ Œ˜–™›’œ’—ȱ Š—ȱ Ž’Œ’Ž—ȱ ’—Ž›ŸŽ—’˜—ȱ Š’–Žȱ Šȱ ™Š’Ž—œȱ  ’‘ȱ ǰȱŽŸŽ—ȱ‘˜ž‘ȱ’œȱ–Š“˜›ȱ’—•žŽ—ŒŽȱŒŠ–Žȱ›˜–ȱǯȱ‘ŽȱŒ˜—ŒŽ™žŠ•ȱ›Š–Ž ˜›”ȱ ’œȱ˜ž•’—Žȱ‹Ž•˜ ȱŠ—ȱ‘ŽȱŽ¡ȱ’œȱ’Ÿ’Žȱ’—˜ȱ‘›ŽŽȱ™Š›œǯȱȱ ȱ Š›ȱ ˜—Žȱ ’œŒžœœŽœȱ  ‘Šȱ Œ˜—œ’žŽœȱ Š—ȱ Ž’Œ’Ž—ȱ –˜ŸŽ–Ž—ȱ ™ŠŽ›—ȱ Š—ȱ ‘˜ ȱ ’—Ž’Ȭ Œ’Ž—ȱ–˜ŸŽ–Ž—ȱ™ŠŽ›—œȱŒŠ—ȱ‹Žȱ˜‹œŽ›ŸŽȱŠ—ȱ‘Ž›Š™Žž’ŒŠ••¢ȱŠ›ŽœœŽȱ›˜ž‘ȱ‘Žȱ Ŝ. ȱ.

(17)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ǯȱŠ›ȱ ˜ȱ’œŒžœœŽœȱ‘Žȱ™›˜ŒŽœœȱ˜ȱŒ‘Š—ŽȱŠ—ȱŽœŒ›’‹Žœȱ‘˜ ȱ‘Žȱȱœ¢–™Ȭ ˜–œȱŒŠ—ȱ‹ŽȱŽ¡™•Š’—ŽȱŠ—ȱ–ŠŽȱ–ŽŠ—’—ž•ȱŠ—ȱž—Ž›œŠ—Š‹•Žȱœ˜ȱ‘Šȱ‘ŽȱŽ“ŽŒŽȱ ™Š’Ž—ȱ ŒŠ—ȱ ›Ž™•ŠŒŽȱ ‘Žȱ •˜Œžœȱ ˜ȱ Œ˜—›˜•ȱ ˜—˜ȱ ‘’–œŽ•ȱ Š—ȱ ’—ȱ ‘Žȱ –˜’ŸŠ’˜—ȱ ˜ȱ ™Ž›œ’œǯȱŠ›ȱ‘›ŽŽȱŽœŒ›’‹Žœȱ ‘Šȱ’œ’—ž’œ‘Žœȱ‘ŽȱŒ˜–™•Ž¡ȱŠ—ȱ¢—Š–’Œȱ‘Ž›Š™Žž’Œȱ ›Ž•Š’˜—ȱ ‹Ž ŽŽ—ȱ ‘Žȱ ȱ ŽŠŒ‘Ž›ȱ Š—ȱ ‘Žȱ ™Š’Ž—ǰȱ ’—Œ•ž’—ȱ ‘Žȱ ™›ŠŒ’ŒŠ•ȱ ȱ œ”’••œȱ ‘ŽȱȱŽŠŒ‘Ž›ȱ—ŽŽœȱ˜ȱ–ŠœŽ›ȱ’—ȱ˜›Ž›ȱ˜ȱž’Žȱ‘Žȱ™Š’Ž—ȱ˜ȱ’œŒ˜ŸŽ›ȱ Š¢œȱ‘Šȱ –Š¢ȱ•ŽŠȱ‘’–Ȧ‘Ž›ȱ˜žȱ˜ȱ‘ŽȱœŽ•ȱ’–™˜œŽȱ™›˜ŽŒ’ŸŽȱ™Š’—ȱ‹Ž‘ŠŸ’˜ž›ǯȱȱ ȱ Movement patterns ›˜–ȱ‘Žȱ™Ž›œ™ŽŒ’ŸŽȱ˜ȱŠ—ȱ˜‹œŽ›ŸŽ›ǰȱŠ—ȱ’—’Ÿ’žŠ•Ȃœȱ–˜ŸŽ–Ž—ȱ™ŠŽ›—ȱ’œȱŽ’—Žȱ‹¢ȱ ‘Žȱ˜‹œŽ›ŸŽȱ›Ž•Š’˜—œȱ‹Ž ŽŽ—ȱ‘Žȱ‹˜’•¢ȱ™Š›œȱ˜ȱ‘Žȱ’—’Ÿ’žŠ•ȱ ‘’•Žȱ’—ȱ–˜ŸŽ–Ž—ǯȱ ŠŒ‘ȱ Š’•¢ȱ •’Žȱ ŠŒ’Ÿ’¢ȱ Œ˜–™›’œŽœȱ Šȱ Ž’—Žȱ —ž–‹Ž›ȱ ˜ȱ •˜‹Š•ȱ ˜ŸŽ–Ž—ȱ ŠŽ›—œȱ ǻ Ǽȱ ǽśŗǾǯȱ ‘Žȱ Œ˜—ŒŽ™ȱ ȃ •˜‹Š•Ȅȱ ǻ Ǽȱ ’œȱ žœŽȱ ˜ȱ Ž–™‘Šœ’£Ž ‘Šȱ ‘Žȱ  ‘˜•Žȱ ‹˜¢ȱ ’œȱ ’—Ÿ˜•ŸŽǰȱ›˜–ȱ‘Žȱ‘ŽŠȱ˜ȱ‘Žȱ˜Žœǰȱ ‘Ž—ȱŠ—ȱŠŒ’˜—ȱ’œȱ™Ž›˜›–Žȱ’—ȱ‘Žȱ–˜œȱŽ’Œ’Ž—ȱ  Š¢ǯȱ ‘Žȱȃ–˜œȱ Ž’Œ’Ž—ȱ  Š¢Ȅȱ›ŽŽ›œȱ ˜ȱ Šȱ œ’žŠ’˜—ȱ  ‘Ž—ȱ‘Žȱ ›Š—œ–’œœ’˜—ȱ ˜ȱ ˜›ŒŽœȱ ‘›˜ž‘ȱ‘Žȱœ”Ž•Ž˜—ȱ’œȱ–˜—˜ȱŸŽŒ˜›ŽȱŠ—ȱ‘Žȱ’œ›’‹ž’˜—ȱ˜ȱ–˜ŸŽ–Ž—œȱŠ•˜—ȱ’—Ȭ Ÿ˜•ŸŽȱ“˜’—œȱ’œȱŒ˜—›žŽ—ȱ ’‘ȱ‘Žȱœ’£Žȱ˜ȱ‘ŽœŽȱ“˜’—œǯȱȱ ȱ ‘ŽȱšžŠ•’¢ȱ˜ȱŽŠŒ‘ȱ ȱ’œȱŒ›ŽŠŽȱ‹¢ȱ‘Žȱ’—’Ÿ’žŠ•Ȃœȱ—Ž›Ÿ˜žœȱœ¢œŽ–ȱž›’—ȱ‘ŽȱŠŒȱ ˜ȱ–˜Ÿ’—ǯȱŸŽ›¢ȱ ȱŒ˜–™›’œŽœȱœŽŸŽ›Š•ȱ–˜ŸŽ–Ž—œȱŠ—ȱŽŠŒ‘ȱ–˜ŸŽ–Ž—ȱŠ›ŽœœŽœȱ œ™ŽŒ’’Œȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ›Ž•Š’˜—œ‘’™œǯȱœȱ‘ŽȱŽ›ŽŽȱ˜ȱ›ŽŽ˜–ȱ’—ȱ‘Žȱ‘ž–Š—ȱ‹˜¢ȱ ’œȱŸŽ›¢ȱ•Š›Žȱ‘Ž›ŽȱŠ›Žȱ–Š—¢ȱ™˜œœ’‹’•’’Žœȱ›ŽŠ›’—ȱ‘˜ ȱŽŠŒ‘ȱ–˜ŸŽ–Ž—ȱŠȱ‘Žȱ•ŽŸŽ•ȱ ˜ȱ ‘Žȱ œ™ŽŒ’’Œȱ –žœŒž•˜œ”Ž•ŽŠ•ȱ ›Ž•Š’˜—œ‘’™œȱ ’—‘Ž›Ž—ȱ ’—ȱ Šȱ ȱ ’œȱ Œ›ŽŠŽǯȱ œȱ ‘Žȱ ‘ž–Š—ȱ –žœŒž•˜œ”Ž•ŽŠ•ȱ œ›žŒž›Žȱ ’œȱ ’Ž—’ŒŠ•ȱ ’—ȱ ŽŸŽ›¢ȱ —˜—ȱ ’–™Š’›Žȱ ’—’Ÿ’žŠ•ǰȱ ’—ȱ ‘Ž˜›¢ȱ ‘Žȱ ’——ŠŽȱ –˜ŸŽ–Ž—ȱ ™˜œœ’‹’•’’Žœȱ Š›Žȱ ”—˜ —ǯȱ ˜›Ž˜ŸŽ›ǰȱ ‘Žȱ ’ŽŠ•ȱ Ž—œž’—ȱ ˜ŸŽ–Ž—ȱ ŽœŠ•ȱǻ Ǽȱ˜ȱ™Ž›ŽŒ•¢ȱ™Ž›˜›–Žȱ ȱŒŠ—ȱ‹ŽȱŠ—’Œ’™ŠŽȱŠ—ȱ‘Žȱ’—ŽȬ ’Œ’Ž—ȱ ȱ˜‹œŽ›ŸŽȱ Š—ȱ›ŽŒ˜—’£Žǯȱ‘Žȱ ȱ›ŽŽ›œȱ˜ȱ‘Žȱ ‘˜•Žȱ‹˜¢ȱŒ˜—’ž›ŠȬ ’˜—ȱ ‘ŠȱŒ˜—œ’žŽœȱ ‘Žȱ ›Žœž•’—ȱ˜‹œŽ›ŸŽȱ ȃ’–ŠŽȄȱ ˜ȱ Š—ȱ ’—’Ÿ’žŠ•Ȃœȱ‹˜¢ȱ ’—ȱ –˜Ȭ ’˜—ǯȱ ‘Ž—ȱ ˜‹œŽ›Ÿ’—ȱ ‘Žȱ  ȱ ˜ȱ Š—ȱ ’—’Ÿ’žŠ•ȱ  ‘˜œŽȱ ŠŒ’˜—ȱ ’œȱ Œ˜–™›’œŽȱ ‹¢ȱ ’ŽŠ•ȱ ǰȱ˜—ŽȱŽœȱŠ—ȱŽ–‹˜’Žȱ’–™›Žœœ’˜—ȱ˜ȱ‹ŽŠž¢ȱŠ—ȱ•’‘—Žœœǯȱ‘Žȱ ȱ‘Šȱ’ŸŽœȱ ›’œŽȱ˜ȱ‘Žȱȃ’ŽŠ•Ȅȱ ȱŽ—Œ˜–™ŠœœŽœȱ‘Žȱ–˜œȱŽ’Œ’Ž—ȱ™Ž›˜›–Š—ŒŽǯȱ ȱ ‘’œȱ ’–™•’Žœȱ ‘Šȱ ŽŠŒ‘ȱ ŠŒ’˜—ȱ ŒŠ—ȱ ‹Žȱ ™Ž›˜›–Žȱ ’—ȱ –Š—¢ǰȱ –˜›Žȱ ˜›ȱ •Žœœȱ ’—Ž’Œ’Ž—ǰȱ  Š¢œǯȱ‘ŽȱŽ’—’—ȱŠŒ˜›œȱŠ›ŽȱŽŒ’Žȱ‹˜‘ȱ‹¢ȱ‘Žȱœ’žŠ’˜—Š•ȱ•˜ŒŠ•ȱœŽ—œ˜›¢ȱȬȱ–˜˜›ȱȬȱ œ”Ž•ŽŠ•ȱ œŠžœȱ Š—ȱ ‹¢ȱ œ’žŠ’˜—Š•ȱŽ—Ÿ’›˜—–Ž—Š•ȱ Œ˜—œ›Š’—œǯȱ —ȱ ‘Žȱ Š‹œŽ—ŒŽȱ ˜ȱŽ—Ÿ’Ȭ ›˜—–Ž—Š•ȱ Œ˜—œ›Š’—œȱ‘Žȱ Ž’Œ’Ž—Œ¢ȱ ˜ȱ Š—ȱ ŠŒ’˜—ȱ ’œȱ ˜—•¢ȱ ŽŽ›–’—Žȱ‹¢ȱ ‘Žȱ ’—’Ÿ’Ȭ žŠ•Ȃœȱ žœŽȱ ˜ȱ œŽ•ǰȱ  ‘’Œ‘ȱ ’—ȱ ’œȱ ž›—ȱ ’œȱ Ž™Ž—Ž—ȱ ˜—ȱ ‘Žȱ ”’—ŠŽœ‘Ž’Œȱ ›Š—œ™Š›Ž—Œ¢ȱ ˜ȱ ‘Žȱ’—’Ÿ’žŠ•Ȃœȱ‹˜’•¢ȱœŽ•ȱ’–ŠŽǯȱȱȱȱ ȱ ’ž›Žȱŗȱ’••žœ›ŠŽœȱ‘˜ ȱ‘ŽȱœŠ–ŽȱŠŒ’˜—ȱŒŠ—ȱ‹Žȱ™Ž›˜›–Žȱ’—ȱŸŠ›’˜žœȱ Š¢œǯȱ ȱ ȱ. ȱ ŝȱ.

(18)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ȱ ŽŠ—’—ž•ȱŠŒ’˜— •˜‹Š• ˜ŒŠ• –žœŒž•˜Ȭ œ”Ž•ŽŠ• ›Ž•Š’˜—œ‘’™œ –˜ŸŽ–Ž—ȱ™ŠŽ›— ǻ Ǽ —Ž—’˜—. ‘ŽȱŠŒ’˜—ȱ’œȱ‘ŽȱœŠ–Žȱ˜›ȱŠ••ȱ‘›ŽŽȱ ’—’Ÿ’žŠ•œȱ’—ȱ‘Žȱ™‘˜˜ǯȱ‘Ž¢ȱŠ›Žȱœ’’—ȱ ˜—ȱ‘Žȱ•˜˜›ǰȱž›—’—ȱ•ŽǯȱŠŒ‘ȱ’—’Ÿ’žŠ•œȂ ȱ’œȱ–’››˜›Žȱ‹¢ȱ‘Žȱ–˜ŸŽ–Ž—ȱŽœŠ•ȱ ǻ ǼǰȱŒ›ŽŠŽȱ‹¢ȱ‘Žȱ•˜ŒŠ•ȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ ›Ž•Š’˜—œ‘’™œȱŠȱŽŸŽ›¢ȱ“˜’—ǯȱ‹œŽ›Ÿ’—ȱ‘Žȱ  Ȃœȱ˜ȱ‘Žȱ‘›ŽŽȱ™Ž›œ˜—œȱ˜—Žȱ’œŒ˜ŸŽ›œȱ ’Ž›Ž—ŒŽœȱŠȱŠ•–˜œȱŽŸŽ›¢ȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ Œ˜——ŽŒ’˜—Dzȱ˜ŽœǰȱŽŽǰȱ”—ŽŽœǰȱ‘’™œǰȱ™Ž•Ÿ’œǰȱ •ž–‹Š›ȱœ™’—Žǰȱ‘˜›ŠŒ’Œȱœ™’—Žǰȱ—ŽŒ”ȱǰȱ œ‘˜ž•Ž›ȱ’›•ŽǰȱŽ•‹˜ œȱŠ—ȱ‘Š—œǯȱ. ’ž›Žȱŗǯȱ‘Žȱ™‘˜˜ȱŽ–˜—œ›ŠŽœȱ‘˜ ȱŽŠŒ‘ȱ™Ž›œ˜—ȱŽ—œȱ˜ȱŠŒȱ’—ȱŠŒŒ˜›Š—ŒŽȱ ’‘ȱ ‘’œȦ‘Ž›ȱ‘Š‹’žŠŽȱ‹˜’•¢ȱœŽ•Ȭ’–ŠŽǯȱ ȱ ȱŒŠ—ȱ‹Žȱšž’ŽȱŽŠœ¢ȱ˜ȱŽŽŒȱ’œ’—Œ’ŸŽȱ’Ž›Ž—ŒŽœȱœž‹“ŽŒ’ŸŽ•¢ȱ’—ȱ‘Žȱ Š¢ȱ ˜ȱ’—’Ȭ Ÿ’žŠ•œȱ ™Ž›˜›–ȱ ‘Žȱ œŠ–Žȱ ŠŒ’˜—ǯȱ ˜ȱ –ŽŠœž›Žȱ ‘Žȱ šžŠ•’¢ȱ ˜ȱ Š—ȱ ŠŒ’˜—ǰȱ ’—ȱ ˜›Ž›ȱ ˜ȱ Œ˜–™Š›Žȱ ‘Žȱ –˜ŸŽ–Ž—ȱ ™ŠŽ›—œȱ ˜ȱ ’Ž›Ž—ȱ ’—’Ÿ’žŠ•œǰȱ ˜›ȱ ‘Žȱ œŠ–Žȱ ’—’Ÿ’žŠ•ȱ Šȱ ’Ž›Ž—ȱ˜ŒŒŠœ’˜—œǰȱŠȱ›Ž•’Š‹•Žȱ˜‹œŽ›ŸŠ’˜—ȱœ¢œŽ–ȱ’œȱ—ŽŽŽǯȱȱŸŠ•’ȱ˜žŒ˜–Žȱ–ŽŠœȬ ž›Žȱ –žœȱ ‹Žȱ Š‹•Žȱ ˜ȱ ŒŠ™ž›Žȱ ‘Žȱ ŽœœŽ—’Š•ȱ ’œ’—ž’œ‘’—ȱ ȱ ˜ȱ Šȱ œ™ŽŒ’’Žȱ ŠŒ’˜—ȱ Š—ȱ–˜—’˜›ȱ’œȱ’—‘Ž›Ž—ȱ–˜ŸŽ–Ž—œȱŠœȱŠ—ȱ’—Ž›ŠŽȱ ‘˜•Žǰȱ’ǯŽǯȱŠ—ȱŽ—’¢ȱŒ˜–™›’œŽȱ ˜ȱ’—Ž›Ž™Ž—Ž—ȱ™Š›œȱ ˜›”’—ȱ˜Ž‘Ž›ǯȱȱ ȱ ‘Žȱȱ’œȱ‹ŠœŽȱ˜—ȱ‘Žȱ’——ŠŽȱ‘ž–Š—ȱŒŠ™ŠŒ’¢ȱ˜›ȱ•’Ž•˜—ȱŽŸŽ•˜™–Ž—ȱŠ—ȱ›˜ ‘ǯȱ ‘ŽȱŒ•’Ž—ȱ’œȱŽ—Œ˜ž›ŠŽȱ˜ȱž™ŠŽȱ‘’œȦ‘Ž›ȱ–˜ŸŽ–Ž—ȱ›Ž™Ž›˜’›Žȱ‹¢ȱŒ‘˜˜œ’—ȱ˜ȱ–Š—’Ȭ Žœȱ  ‘Šȱ ’œȱ ”’—ŠŽœ‘Ž’ŒŠ••¢ȱ ™Ž›ŒŽ’ŸŽȱ Šœȱ ‘Žȱ ŽŠœ’Žœȱ  Š¢ȱ ’—œŽŠȱ ˜ȱ ž—Œ˜—œŒ’˜žœ•¢ȱ ™Ž›˜›–’—ȱ Š—¢ȱ ’—Ž—’˜—ȱ ’—ȱ ‘Žȱ ‘Š‹’žŠ•ȱ  Š¢ǯȱ ‘’œȱ ’–™•’Žœȱ ˜ȱ Œ˜—œ’Ž›ȱ Š—ȱ ’—’Ÿ’Ȭ žŠ•Ȃœȱ’—Ž’Œ’Ž—•¢ȱ™Ž›˜›–ŽȱǻŽŸŽ—žŠ••¢ȱ™Š’—ž•ǼȱŠŒ’˜—œȱ›˜–ȱ‘Žȱ™Ž›œ™ŽŒ’ŸŽȱ˜ȱ‘Žȱ ȱ Š—ȱ ŠŸ˜’ȱ ‘Žȱ ž’•Žȱ ™›˜‹•Ž–ȱ ™Ž›œ™ŽŒ’ŸŽǯȱ ›ŽŽ’—ȱ œŽ•ȱ ’–™˜œŽȱ ‹Ž‘ŠŸ’˜ž›Š•ȱ •’–’Š’˜—œǰȱ  ‘Ž‘Ž›ȱ ™›˜žŒŽȱ ‹ŽŒŠžœŽȱ ˜ȱ ™Š’—ȱ ˜›ȱ —˜ǰȱ ’œȱ —˜ȱ ˜—•¢ȱ œž™™˜œŽȱ ˜ȱ ™›˜Ȭ. Ş. ȱ.

(19)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ žŒŽȱ–˜›ŽȱŽ’Œ’Ž—ȱ–˜ŸŽ–Ž—œȱ‹žȱŠ•œ˜ȱœ’—’’ŒŠ—ȱ›Ž•’Žȱ˜ȱ–žœŒž•Š›ȱœ›Š’—ȱŠ—ȱ›ŽȬ žŒŽȱŽŸŽ—žŠ•ȱ™Š’—ǯȱȱ ȱ ‘Žȱȱ•Žœœ˜—œȱŠ’–œȱŠȱž’’—ȱ‘Žȱ™Š’Ž—ȱ˜ȱ˜›Š—’£Žȱ‘’–œŽ•ȱž—Œ’˜—Š••¢ȱ˜ȱ–˜ŸŽȱ  ’‘ȱ –’—’–ž–ȱ Ž˜›ȱ Š—ȱ –Š¡’–ž–ȱ Ž’Œ’Ž—Œ¢ǰȱ —˜ȱ ‘›˜ž‘ȱ –žœŒž•Š›ȱ œ›Ž—‘ǰȱ ‹žȱ ‘›˜ž‘ȱ’—Œ›ŽŠœŽȱ”’—ŠŽœ‘Ž’ŒȱŠ Š›Ž—Žœœȱ˜ȱœŽ•ǰȱ›Žœž•’—ȱ’—ȱ‹ŽŽ›ȱ‹˜¢ȱŠ•’—–Ž—ȱ Š—ȱ–˜›ŽȱŽ’Œ’Ž—ȱŠŒ’˜—œǯȱ‘Ž›Žȱ’œȱŠȱœŽ—œ˜›¢ȱŒ˜››Ž•Š’˜—ȱœ˜ȱ‘Šȱ˜™’–Š•ȱŠŒ’˜—œȱŽŽ•ȱ Ž˜›•Žœœǰȱ  ‘Ž›ŽŠœȱ ’—Ž’Œ’Ž—ȱ ŠŒ’˜—œȱ ŽŽ•ȱ Ž˜›ž•ȱ ǽśŘǾǯȱ ‘Žȱ ȱ žœŽœȱ  ˜ȱ –˜ŽœDzȱ ž—Œ’˜—Š•ȱ —Ž›Š’˜—ȱǻ Ǽȱ•Žœœ˜—œȱŠ—ȱ Š›Ž—Žœœȱ‘›˜ž‘ȱ˜ŸŽ–Ž—ȱǻǼȱ•Žœœ˜—œȱ ǽśřǾȱ ȱ —ȱ  ȱ •Žœœ˜—ȱ Œ˜–™›’œŽœȱ Šȱ ‘Š—œȬ˜—ǰȱ —˜—Ȭ’—ŸŠœ’ŸŽȱ Š—ȱ ’—Ž›ŠŒ’ŸŽȱ Š™™›˜ŠŒ‘ǯȱ ‘Šȱ ˜ŒŒž›œȱ ’œȱ ‘Žȱ ’›ŽŒȱ ›Žœž•ȱ ˜ȱ ‘Žȱ ’—Ž›ŠŒ’˜—ȱ ‹Ž ŽŽ—ȱ ‘Žȱ ŽŠŒ‘Ž›ȱ Š—ȱ ‘Žȱ Œ•’Ž—ǯȱ ‘Žȱ ŽŠŒ‘Ž›ȱžœŽœȱ ‘Šȱ‘ŽȦœ‘ŽȱŽŽ•œȱŠ—ȱœŽŽœȱ˜ȱž’Žȱ‘ŽȱŒ•’Ž—ȱ˜ȱŠȱ–˜›Žȱ’ŸŽ›œŽǰȱ ‘˜•Žǰȱ Š—ȱ Ž••Ȭ˜›Š—’£ŽȱžœŽȱ˜ȱœŽ•ǯȱ‘ŽȱŽŠŒ‘Ž›ȱŠ›ŽœœŽœȱ‘ŽȱŒ•’Ž—ȂœȱœŽ•ȱ’–ŠŽȱ‘›˜ž‘ȱ ‘Žȱ•˜ŒŠ•ȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ›Ž•Š’˜—œ‘’™œȱ˜ȱŠȱœ™ŽŒ’’Œȱ Dzȱ’›œȱŒŠ›Žž••¢ȱŽ¡™•˜›’—ȱ‘Žȱ œ›žŒž›Š•ȱŒ‘Š›ŠŒŽ›’œ’Œœȱ˜ȱ‘ŽȱŒ•’Ž—ȱŠ—ȱ‘Ž—ȱǻ—˜—ŸŽ›‹Š••¢ǰȱ‘Š—œȬ˜—Ǽȱ™˜œ’—ȱšžŽœȬ ’˜—œȱ’—ȱ›Ž•Š’˜—ȱ˜ȱ™Ž›ŒŽ’ŸŽȱ›ŽŽȱ–˜ŸŽ–Ž—ȱ’›ŽŒ’˜—œǯȱŽ™Ž—’—ȱ˜—ȱ‘ŽȱŽŠŒ‘Ž›Ȃœȱ Ž•ȱœŽ—œŽȱ˜ȱ‘ŽȱŒ•’Ž—Ȃœȱœ›žŒž›Š•ȱ•Ž¡’‹’•’¢ȱ‘ŽȦœ‘ŽȱŠ•œ˜ȱ–Š¢ȱǻ—˜—ŸŽ›‹Š••¢ǰȱ‘Š—œȬ˜—Ǽȱ ™›˜™˜œŽȱŠ•Ž›—Š’ŸŽȱ–˜ŸŽ–Ž—ȱ’›ŽŒ’˜—œǰȱ ’‘˜žȱŽŸŽ›ȱ’–™˜œ’—ȱŒ‘Š—Žǯȱȱ ȱ ȱ •Žœœ˜—œȱ Œ˜–™›’œŽȱ Šȱ œŽ›’Žœȱ ˜ȱ ž’Žȱ –˜ŸŽ–Ž—ȱ œŽšžŽ—ŒŽœǰȱ ‘›˜ž‘ȱ  ‘’Œ‘ȱ Œ•’Ȭ Ž—œȱ Š›Žȱ •Žȱ ŸŽ›‹Š••¢ǰȱ Ž’‘Ž›ȱ ’—ȱ ›˜ž™œȱ ˜›ȱ ’—’Ÿ’žŠ••¢ǯȱ •’Ž—œȱ Š›Žȱ Ž—Œ˜ž›ŠŽȱ ˜ȱ –˜ŸŽȱœ•˜ •¢ȱŠ—ȱŽ—•¢ǰȱžœžŠ••¢ȱ•¢’—ȱ˜ —ȱ˜›ȱœ’’—ȱǻœ˜–ŽȱœŠ—’—Ǽǰȱ ’‘ȱŠ—ȱŽ–Ȭ ™‘Šœ’œȱ˜—ȱ›ŽžŒ’—ȱŽ˜›ȱŠ—ȱŽŸŽ•˜™’—ȱŠ Š›Ž—Žœœǯȱ‘ŽȱŽŠŒ‘Ž›ȱŠ›ŽœœŽœȱ‘ŽȱœŽ•ȱ ’–ŠŽȱ ˜ȱ ‘Žȱ Œ•’Ž—œȱ ‹¢ȱ œžŽœ’—ȱ ‘Šȱ ‘Ž¢ȱ Ž¡™•˜›Žȱ œ™ŽŒ’’Žȱ •˜ŒŠ•ȱ –žœŒž•˜œ”Ž•ŽŠ•ȱ ›Ž•Š’˜—œ‘’™œȱ ’—‘Ž›Ž—ȱ ’—ȱ Šȱ œŽ•ŽŒŽȱ ȱ Š—ȱ ‹Ž•˜—’—ȱ ˜ȱ Šȱ œ™ŽŒ’’Žȱ –ŽŠ—’—ž•ȱ ŠŒ’˜—ȱǻ’ž›ŽȱŗǼǯȱ‘’œȱ’–™•’Žœȱ‘Šȱ‘ŽȱŒ•’Ž—œȂȱŠŽ—’˜—ȱ’œȱ’›ŽŒŽȱ˜ȱŠ›ŽŠœȱ˜ȱœŽ•ȱ‘Šȱ –Š¢ȱ—˜ȱ‹Žȱ‘Žȱ˜—Žœȱ˜ȱ ‘’Œ‘ȱ‘ŽȦœ‘ŽȱžœžŠ••¢ȱ™Š¢œȱŠŽ—’˜—ǯȱ‘ŽȱŠ’–ȱ’œȱ˜ȱ‹›’—ȱŠ‹˜žȱ Šȱ–˜›ŽȱŒ˜–™•ŽŽȱœŽ—œŽȱ˜ȱ ‘Šȱ‘ŽȱŒ•’Ž—ȱ’œȱ˜’—ȱŠ—ȱ‘˜ ȱ‘ŽȦœ‘Žȱ’œȱ˜’—ȱ’ǯȱ ŠŸ’—ȱ ’Ž—’’Žȱ‘ŽœŽȱŒ‘Š›ŠŒŽ›’œ’Œœȱ–ŽŠ—œȱ‘ŠŸ’—ȱ˜ž—ȱŠȱ Š¢ȱ˜ȱœž¢ȱ‘Žȱ˜ —ȱ‘Š‹’žȬ ŠŽȱ–˜ŸŽ–Ž—ȱ™ŠŽ›—œȱŠ—ȱ‘Ž›Ž‹¢ȱ‘Žȱ–Ž‘˜ȱ˜ȱŒ‘Š—Žȱ‘Ž–ǯȱȱ ȱ The process of change ‘Šȱ Š›Žȱ Œ•ŽŠ›•¢ȱ Š—ȱ Œ˜–™›Ž‘Ž—œ’‹•¢ȱ ˜ž•’—Žȱ ’—ȱ ‘Žȱ –Ž‘˜ȱ —Š–Žȱ ˜’ŸŠ’˜—Š•ȱ —Ž›Ÿ’Ž ’—ȱ ǻ Ǽȱ ǽŚşǰȱ śŖǾȱ Š›Žȱ ’—‘Ž›Ž—ǰȱ ‹žȱ ‘’Ž—ȱ Š—ȱ ž—œ™˜”Ž—ǰȱ ™›’—Œ’™•Žœȱ˜ȱ ‘Žȱ ǯȱ‘’œȱ ’–™•’Žœȱ‘˜—˜ž›’—ȱ‘Žȱ ™Š’Ž—œȂȱ Šž˜—˜–¢ǰȱ •’œŽ—’—ȱ  ’‘ȱ Ž–™Š‘¢ǰȱ ›Žœ’œȬ ’—ȱ ‘Žȱ›’‘’—ȱ ›Ž•Ž¡ǰȱ ž—Ž›œŠ—’—ȱ Š—ȱ Ž¡™•˜›’—ȱ ‘Žȱ™Š’Ž—Ȃœȱ˜ —ȱ –˜’ŸŠ’˜—œǰȱ ŽŸŽ•˜™’—ȱ ’œŒ›Ž™Š—Œ¢ǰȱ ŠŸ˜’’—ȱ Š›ž–Ž—Š’˜—ǰȱ ›˜••’—ȱ  ’‘ȱ ›Žœ’œŠ—ŒŽȱ Š—ȱ Ž–Ȭ ™˜ Ž›’—ȱ ‘Žȱ ™Š’Ž—ȱ ‹¢ȱ Ž—Œ˜ž›Š’—ȱ ‘˜™Žȱ Š—ȱ ˜™’–’œ–ǯȱ ‘Žȱ  ȱ –Ž‘˜ȱ ’œȱ ™›ŽȬ œŽ—ŽȱŠ—ȱžœŽȱŠœȱŠȱŸŽ›‹Š•ȱ–Ž‘˜ȱ‹žȱ’—ȱȱ‘Žȱ ȱ™›’—Œ’™•ŽœȱŠ›Žȱ˜••˜ Žȱ‹˜‘ȱ ’—ȱ‘ŽȱŸŽ›‹Š•ȱȱ–˜ŽȱŠ—ȱ’—ȱ‘Žȱ—˜—ŸŽ›‹Š•ȱ ǰȱȱ–˜Žǯȱȱ. ȱ şȱ.

(20)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ȱ ••ȱ Ž–˜’˜—œȱ Š›Žǰȱ ’—ȱŽœœŽ—ŒŽǰȱ ’–™ž•œŽœȱ ˜ȱ ŠŒȱ Š—ȱ –ž—ȱ

(21) ŠŒ˜‹œŽ—ȱ  Šœȱ ‘Žȱ ’›œȱ ˜ȱ ŽŸŽ•˜™ȱ Š—ȱ ŽŸ’Ž—ŒŽȬ‹ŠœŽȱ œŽ•Ȭ˜‹œŽ›ŸŠ’˜—Š•ȱ ŽŒ‘—’šžŽȱ Š’–Žȱ Šȱ ”’—ŠŽœ‘Ž’Œȱ Š Š›Ž—Žœœȱ ˜ȱ ‘ŽȱŽ—œ’˜—ȱ •ŽŸŽ•ȱ ˜ȱ ‹˜’•¢ȱ –žœŒž•Šž›Žǯȱ Žȱ Ž–˜—œ›ŠŽȱ ‘Šȱ ‘Žȱ ŠŒȬ ’˜—ȱ ™˜Ž—’Š•œȱ ’—ȱ –žœŒ•Žœȱ ŸŠ›¢ȱ ’—ȱ Šȱ ™›Ž’ŒŠ‹•Žȱ  Š¢ȱ  ’‘ȱ–Ž—Š•ȱ ŠŒ’Ÿ’¢ȱ Š—ȱ Žœ™ŽȬ Œ’Š••¢ȱ  ’‘ȱ ŽŽ•’—œȱ ˜ȱ Ž—œ’˜—ȱ ǽśŚǾǯȱ ‘Žȱ ’—’–ŠŽȱ ‹˜—ȱ ‹Ž ŽŽ—ȱ Ž–˜’˜—œǰȱ ‘˜ž‘œȱ Š—ȱ –˜ŸŽ–Ž—œȱ ˜Ž—ȱ œŽŽ–ȱ ˜‹Ÿ’˜žœȱ ˜ȱ ™Š’Ž—œDzȱ  ’‘ȱ ŽŠ›ȱ ‘Žȱ ‹˜¢ȱ Ž—œȱ ˜ȱ ›ŽŽ£Žȱ Š—ȱ œŠ—Žœœȱ ‹›’—œȱ œ’—’’ŒŠ—ȱ •˜œœȱ ˜ȱ –žœŒž•Š›ȱ œ›Ž—‘ǯȱ ˜›Ž˜ŸŽ›ǰȱ ‘Šȱ ‹˜’•¢ȱ –˜ŸŽ–Ž—œȱ›ŽŸŽŠ•ȱ‘Žȱ‘˜ž‘œȱŠ—ȱ’—Ž—’˜—œȱ˜ȱ™Ž˜™•Žȱ–˜›Žȱ›ž•¢ȱ‘Š—ȱ˜ȱ ˜›œǰȱ  ‘’Œ‘ȱ–Š¢ȱ‹Žȱž—›žŽǰȱ’œȱ—˜ȱŒ˜—›˜ŸŽ›œ’Š•ȱǽśśǾǯȱ —ȱŠ’’˜—ȱ˜ȱŽ¡™Ž›’Ž—ŒŽȬ‹ŠœŽȱ’œȬ Œžœœ’˜—œȱ ˜—ȱ ‘Žȱ ›Ž•Š’˜—œ‘’™ȱ ‹Ž ŽŽ—ȱ Ž–˜’˜—œȱ Š—ȱ ‹˜’•¢ȱ –˜ŸŽ–Ž—ȱ™ŠŽ›—œǰȱ ’Ȭ ž›ŽȱŘȱ–Š¢ȱ‹ŽȱžœŽȱ˜ȱŽœŒ›’‹Žȱ‘ŽœŽȱŒ˜–™•Ž¡ȱ›Ž•Š’˜—œ‘’™œȱ˜ȱ‘Žȱ™Š’Ž—ȱŠ—ȱŽ¡™•Š’—ȱ ‘˜ ȱ™Š’—ǰȱœ›Š’—ȱŠ—ȱ‹Ž’—ȱ˜žȱ˜ȱ‹Š•Š—ŒŽȱŒŠ—ȱ‹ŽȱŒ›ŽŠŽȱŠœȱŠȱ›Žœž•ȱ˜ȱœŽ•ȱ’—žŒŽȱ ™›˜ŽŒ’ŸŽȱ™Š’—ȱ‹Ž‘ŠŸ’˜ž›ǯȱȱ MIND. Images catch the reality for which one has no words and awaken memories that aěect the feelings.. The feelings (fear, sorrow, insecurity etc) aěect the musculoskeletal system through the autonomic nerve system.. FEELING. The symptoms created by the unbalanced musculoskeletal system are experienced in the body as pain, strain and being out of balance etc.. BODY. ȱ ’ž›ŽȱŘǯȱ ••žœ›Š’˜—ȱ˜ȱŠȱ‘¢™˜‘Žœ’œȱœŠ’—ȱ‘˜ ȱ™›˜ŽŒ’ŸŽȱ™Š’—ȱ‹Ž‘ŠŸ’˜ž›ȱ’œȱ‹Ž’—ȱ Œ›ŽŠŽȱ‘›˜ž‘ȱ‘ŽȱŒ’›Œž•Š›ȱ›Ž•Š’˜—œ‘’™ȱ‹Ž ŽŽ—ȱ–’—ǰȱ‹˜¢ȱŠ—ȱŽŽ•’—œȱ•ŽŠ’—ȱ˜ȱ Šȱ•Žœœȱ›Š—œ™Š›Ž—ȱœŽ•ȱ’–ŠŽǯȱ ȱ ȱ —˜›–Š’˜—ǰȱ ‘˜ ŽŸŽ›ǰȱ ›Š›Ž•¢ȱ •ŽŠœȱ ˜ȱ ™›˜˜ž—ȱ Œ‘Š—Žǯȱ ȱ  Šœȱ •‹Ž›ȱ ’—œŽ’—ȱ  ‘˜ȱ œŠ’ȱ‘Šȱ’–Š’—Š’˜—ȱ’œȱ–˜›Žȱ’–™˜›Š—ȱ‘Š—ȱ”—˜ •ŽŽȱ’ȱ˜—Žȱ—ŽŽœȱ˜ȱ•˜˜”ȱŠȱ˜•ȱ ™›˜‹•Ž–œȱ›˜–ȱŠȱ—Ž ȱŠ—•Žǯȱ‘’œȱ’–™•’Žœȱ‘Šȱ’—ȱ˜›Ž›ȱ˜›ȱŒ‘Š—Žȱ˜ȱ‘Š™™Ž—ȱ‘ŽȱŽ–˜Ȭ ’˜—Š•ȱŠ—ȱœŽ—œ˜›¢ȱ–˜’ŸŽœȱŠ›Žȱ–˜›Žȱ’–™˜›Š—ȱ‘Š—ȱ‘ŽȱŒ˜—’’ŸŽȱ˜—Žœǯȱ —ȱ‘Žȱȱ ’—Ž›ŸŽ—’˜—ȱœŽ•ŽŒŽȱ–ŽŠ™‘˜›œȱŠ›ŽȱžœŽȱ˜ȱ–˜‹’•’£Žȱ™Š’Ž—œȂȱŒ›ŽŠ’ŸŽȱ™˜Ž—’Š•ȱŠ—ȱȱ ŗŖ ȱ.

(22)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ’–Š’—Š’ŸŽȱ ›Ž™›ŽœŽ—Š’˜—œȱ Š—ȱ ˜ȱ ’••žœ›ŠŽȱ ‘˜ ȱ ’—›Š’—Žȱ ‘Š‹’œȱ Š—ȱ Ž–˜’˜—Š•ȱ ›ŽŠŒ’˜—œȱŽ—ȱ˜ȱ•’–’ȱŽ’Œ’Ž—ȱŠŒ’˜—ǯȱȱ ȱ ‘’œȱ ™Š›ȱ ˜ȱ ȱ ‘Šœȱ ‹ŽŽ—ȱ ’—•žŽ—ŒŽȱ ‹¢ȱ œ¢Œ‘˜œ¢—‘Žœ’œǰȱ Šȱ ‘Ž›Š™Žž’Œȱ Š™™›˜ŠŒ‘ǰȱ  ‘’Œ‘ȱžœŽœȱ’–ŠŽ›¢ȱŠ—ȱ –ŽŠ™‘˜›’ŒŠ•ȱ •Š—žŠŽȱ ˜ȱ Ž¡™•˜›Žȱ ‘Žȱž—Œ˜—œŒ’˜žœȱ Š—ȱ Ž¡Ȭ ™Š—ȱœŽ•ȱŠ Š›Ž—ŽœœȱǽŚŜȬŚŞǾǯȱ ȱœŽŽ–œȱŠœȱ’ȱ‘’œȱ”’—ȱ˜ȱ’–ŠŽ›¢ȱŒ˜—œ’žŽœȱŠ—ȱ’–™˜›Ȭ Š—ȱ ™Š›ȱ ˜ȱ ‘Žȱ ȱ ’—Ž›ŸŽ—’˜—ȱ Šœȱ Šȱ –Š“˜›’¢ȱ ˜ȱ ™Š’Ž—œȱ œŠ¢ȱ ‘Šȱ ‘Žȱ ’–ŠŽ›¢ȱ ‘Ž•™Žȱ‘Ž–ȱ–Š”ŽȱœŽ—œŽȱ˜ȱŠ—ȱœŽŽȱ‘Žȱ–ŽŠ—’—ȱ’—ȱŽŠ›•’Ž›ȱž—Ž¡™•Š’—ŽȱŽ¡™Ž›’Ž—ŒŽœȱ Š—ȱ™Š’—ž•ȱŽŸŽ—œǯȱ‘ŽȱŽ–‹˜’ŽǰȱŽ–˜’˜—Š•ȱœŽ•ȱ–Š¢ȱ‘Ž•™ȱŠȱ™Ž›œ˜—ȱ˜ȱœŽŽȱ‘Žȱ–ŽŠ—Ȭ ’—ȱ˜›ȱœ’—’’ŒŠ—ŒŽȱ˜ȱœ˜–Ž‘’—ȱŠ—ȱŠ™™›Ž‘Ž—ȱ’œȱ’–™•’ŒŠ’˜—œȱǽśŜǾǯȱ ȱ ‘Žȱ–ŽŠ™‘˜›œȱ—›ȱŗȱȬȱśȱ˜—ȱ‘Žȱ—Ž¡ȱ™ŠŽœȱŠ›ŽȱŠȱŽ ȱŽ¡Š–™•Žœȱ˜ȱ‘Žȱ–Š—¢ȱ‘Šȱ Ž›Žȱ Œ›ŽŠŽǰȱ ’—ȱ Œ˜˜™Ž›Š’˜—ȱ  ’‘ȱ ™Š’Ž—œǰȱ ž›’—ȱ ȱ •Žœœ˜—œȱ ’—ȱ ›Žœ™˜—œŽȱ ˜ȱ ‘Ž’›ȱ —˜—Ȭ œ™ŽŒ’’Œȱ™Š’—ȱ›Ž•ŠŽȱ’œŠ‹’•’’ŽœǯȱŽŠ™‘˜›ȱ—›ȱŗȱ‘Šœȱ‹ŽŽ—ȱ˜ž—ȱ˜ȱ‹ŽȱŠȱžœŽž•ȱ’••žœ›ŠȬ ’˜—ȱ˜ȱ‘Žȱ›Ž•Š’˜—œ‘’™ȱ‹Ž ŽŽ—ȱœŽ•ǰȱ–’—ȱŠ—ȱ™‘¢œ’ŒŠ•ȱ‹˜¢ǰȱ ‘’Œ‘ȱ‘Ž•™Žȱ‘Žȱ™ŠȬ ’Ž—œȱ›ŽŒ˜—’£Žȱ‘Žȱ‘˜›œŽǰȱŒŠ››’ŠŽǰȱŒ˜ŠŒ‘–Š—ȱŠ—ȱ›ŠŸŽ••Ž›ȱ ’‘’—ȱ‘Ž–œŽ•ŸŽœǯȱȱ ȱ ȱ ȱ ȱ. ȱ ȱ. ŗǯȱ‘Žȱ‘˜›œŽǰȱŒŠ››’ŠŽȱŠ—ȱŒ˜ŠŒ‘–Š— ‘Žȱ›ŠŸŽ••Ž› ‘ŽȱŽ•ȱȬȱȱ ’‘Ž›ȱŒ˜—œŒ’˜žœ—Žœœȱ ‘’Œ‘ȱ ’ŸŽœȱ’›ŽŒ’˜—ǰȱ™ž›™˜œŽȱŠ—ȱ–ŽŠ—’—ȱŠ—ȱ ’›ŽŒœȱ‘Žȱ’••ȱŽ—Ž›¢ȱ’—ȱ‘Žȱ™œ¢Œ‘Žǯ. ‘ŽȱŒŠ››’ŠŽȱ. ‘ŽȱŒ˜ŠŒ‘–Š—ȱ. ‘Žȱ‘˜›œŽ. ‘Žȱ–žœŒž•˜œ”Ž•ŽŠ•ȱ œ¢œŽ–ȂœȱŒ˜—œ›žŒ’˜—ȱŠ—ȱ ’œȱ›Ž•Š’˜—ȱ˜ȱ›ŠŸ’¢ǯȱ ŽŠ™‘˜›DZȱ‘Žȱ‹’”ŽȱǻŘǼ. ‘Žȱ–’—Dzȱ‘˜ž‘œǰȱ ŽŽ•’—œǰȱŽœ’›Žœdz ŽŠ™‘˜›DZȱ–˜‘Ž›ȱ’—˜›’—ȱ ‘Ž›ȱŒ›¢’—ȱŒ‘’•ȱǻřǼ. ‘Žȱ™›ŽœŽ—ȱ–˜ŸŽ–Ž—ȱ ™ŠĴȱŽ›—Dzȱ‘Žȱ‹˜¢ȱ•Š—žŠŽ ŽŠ™‘˜›œDZȱŠȱŒŠ›˜˜—ȱ Š–’•¢ǻŚǼǰȱŠȱ˜˜›–Š—ȱǻśǼ. ȱ ŗŗȱ.

(23)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ȱ. Řǯȱ‘Žȱ‹’”ŽDzȱ Šȱ –ŽŠ™‘˜›ȱ ˜›ȱ ‘Žȱ ŽĜ ȱȱȬ Œ’Ž—ȱ Œ˜—œ›žŒ’˜—ȱ ˜ȱ ‘Žȱ ‘ž–Š—ȱ –žœŒž•Š›ȱ œ”Ž•ŽŠ•ȱ œ¢œȬ Ž–Dzȱ Š‹•Žȱ ˜ȱ ™Ž›˜›–ȱ –Š—¢ȱ ŠŒȬ ’Ÿ’’Žœȱ˜›ȱŽ¡Š–™•Žȱ‘ŽȱŒ˜–™•Ž¡ȱ ŠŒ’Ÿ’¢ȱŒŠ••Žȱ Š•”’—ǯȱ‘Žȱ¢›Žœȱ ˜ȱ‘Žȱ‹’”Žȱ–’››˜›ȱ‘ŽȱŽŽǰȱ‹˜‘ȱ ˜ȱ  ‘’Œ‘ȱ ž—Œ’˜—ȱ ‹Žœȱ  ‘Ž—ȱ ‘Ž¢ȱŠ›Žȱž••ȱ˜ȱ‹˜ž—ŒŽǯȱ‘ŽȱŒ˜—Ȭ œ›žŒ’˜—ȱ ˜ȱ ‘Žȱ ‹’Œ¢Œ•Žȱ Œ‘Š’—ȱ Š—ȱ ‘Žȱ  ‘ŽŽ•ȱ ‘ž‹ȱ –’››˜›ȱ ‘Žȱ ž—Œ’˜—Š•ȱŠ—Š˜–¢ȱ˜ȱ‘Žȱœ™’—Š•ȱ ™Ž•Ÿ’Œȱ –žœŒž•Š›ȱ œ¢œŽ–ǯȱ ‘Ž¢ȱ ‹˜‘ȱž—Œ’˜—ȱŠȱ‘Ž’›ȱ‹Žœȱ ‘Ž—ȱ ‘Ž›Žȱ’œȱ›ŽŽȱ›Š—œ–’œœ’˜—ȱ˜ȱ˜›ŒŽȱ ‘›˜ž‘ȱ‘Žȱœ¢œŽ–ǯȱ‘’œȱŒŠ—ȱ‹Žȱ ŠŒŒ˜–™•’œ‘Žȱ˜—•¢ȱ’ȱ‘Ž›Žȱ’œȱ—˜ȱ –ŽŒ‘Š—’ŒŠ•ȱ˜‹œŠŒ•Žȱ˜›ȱ–žœŒž•Š›ȱ Œ˜—œ›Š’—œǯȱ ‘Žȱ ‹’Œ¢Œ•Žȱ ‘Š—•ŽȬ ‹Š›œȱ –’››˜›ȱ ‘Žȱ œ‘˜ž•Ž›ȱ ’›•Žǰȱ ‹˜‘ȱ ‹Ž’—ȱ Œ˜—œ›žŒŽȱ ˜ȱ –˜ŸŽȱ ŽŠœ’•¢ȱ  ’‘ȱ ŸŽ›¢ȱ •’Ĵȱ•Žȱ œ›Š’—ǯȱ. řǯȱȱ–˜‘Ž›ȱ’—˜›’—ȱ‘Ž›ȱ Œ›¢’—ȱŒ‘’•Dzȱ Šȱ–ŽŠ™‘˜›ȱ˜›ȱŠȱ•˜ŒŠ•’£Žȱ™Š’—ǰȱ  ‘’Œ‘ȱ ›’œ”œȱ ‹ŽŒ˜–’—ȱ Œ‘›˜—’Œǯȱ ‘Žȱ ’–ŠŽǰȱ ’—ȱ  ‘’Œ‘ȱ Šȱ Œ›¢’—ȱ Œ‘’•ȱœŽŽ”œȱŠĴȱŽ—’˜—ȱ›˜–ȱŠȱ‹žœ¢ȱ –˜‘Ž›ǰȱ ’••žœ›ŠŽœȱ ‘˜ ȱ Šȱ •˜ŒŠ•ȱ ™Š’—ȱ ˜›ȱ ’œŒ˜–˜›ȱ œŽŽ”œȱ ŠĴȱŽ—Ȭ ’˜—ȱ ›˜–ȱ Š—ȱ ˜ŒŒž™’Žȱ –’—ǯȱ ȱ ‘Žȱ –˜‘Ž›ȱ ’—˜›Žœȱ ‘Žȱ Œ›¢’—ȱ Œ‘’•ȱ ˜›ȱ •˜—ȱ Ž—˜ž‘ȱ ‘Žȱ Œ‘’•ȱ –Š¢ȱ ęȱ—Š••¢ȱ œ˜™ȱ Œ›¢’—ȱ ‹žǰȱ ’—Ȭ œŽŠǰȱ ‹ŽŒ˜–Žȱ Ž™›ŽœœŽǯȱ ȱ ‘Žȱ –˜‘Ž›ȱ •ŽŠ›—œȱ ‘˜ ȱ ˜ȱ ’—Œ›ŽŠœŽȱ ‘Ž›ȱ œŽ•ȬŠ Š›Ž—Žœœǰȱ ‘˜ ŽŸŽ›ǰȱ ‘Ž—ȱ‘Ž›ȱœŽ•Ȭž—Ž›œŠ—’—ǰȱ‘Ž›ȱ œŽ•ȬȱŠŒŒŽ™Š—ŒŽȱŠ—ȱ‘Ž›ȱœŽ•Ȭ–ŠœȬ Ž›¢ȱ ’••ȱ’—Œ›ŽŠœŽȱŠ—ȱ’—ȱ‘’œȱ Š¢ȱ  ’••ȱ Ž—Š‹•Žȱ ‘Ž›ȱ ˜ȱ Œ˜—œ˜•Žȱ ‘Ž›ȱ Œ‘’•ȱ ǻ‘Ž›ȱ ’œ›ŽœœŽȱ ’——Ž›ȱ œŽ•Ǽǯ. ŗŘ ȱ.

(24)  ȱȱ ȱ‹Ž‘’—ȱȱ Ž—œ˜›¢ȱ˜˜›ȱŽŠ›—’—ȱǻǼȱ’—Ž›ŸŽ—’˜—ȱ ȱ ȱ. ŚǯȱȱŒŠ›˜˜—ȱŠ–’•¢Dzȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱȱ Šȱ –ŽŠ™‘˜›ȱ ˜›ȱ Šȱ œ™’—Š•ȱ œ¢œŽ–ȱ ’‘ȱ›ŽžŒŽȱž—Œ’˜—ȱ žŽȱ ˜ȱ ’—ŽĜ ȱȱŒ’Ž—ȱ ›Š—œ–’œȬ œ’˜—ȱ ˜ȱ ˜›ŒŽœȱ ŒŠžœŽȱ ‹¢ȱ Š—ȱ ž—ŽŸŽ—ȱ’œ›’‹ž’˜—ȱ˜ȱ–˜ŸŽȬ –Ž—œȱŠ•˜—ȱ‘Žȱœ™’—Žǯȱ ȱ‘Žȱ ’œ›’‹ž’˜—ȱ ˜ȱ –˜ŸŽ–Ž—œȱ ‘Šȱ ‹ŽŽ—ȱ ’ŽŠ•ȱ ’—ȱ ›Ž•Š’˜—ȱ ˜ȱ ‘Žȱ ž—Œ’˜—Š•ȱ Š—Š˜–¢ȱ ˜ȱ ‘Žȱ‘ž–Š—ȱœ™’—Žȱ‘Ž›Žȱ ˜ž•ȱ ‘ŠŸŽȱ ‹ŽŽ—ȱ –˜›Žȱ –˜’˜—ǰȱ ŽœȬ ™ŽŒ’Š••¢ȱ’—ȱ‘Žȱ‘˜›ŠŒ’Œȱ™Š›ȱ˜ȱ ‘Žȱœ™’—Žȱǻ‘Žȱ‘žœ‹Š—ȱ ˜ž•ȱ ‹Žȱ –˜›Žȱ –˜ŸŽŠ‹•ŽǼȱ Š—ȱ •Žœœȱ –˜’˜—ȱ’—ȱ‘Žȱ•ž–‹Š›ȱ™Š›ȱǻ‘Žȱ  ˜–Š—ȱ  ˜ž•ȱ ›Ž•Š¡ȱ Šȱ •’Ĵȱ•Žȱ ˜ȱ ŽŠœŽȱ ‘Žȱ –žœŒž•Š›ȱ œ›Š’—Ǽǯȱȱ. śǯȱ —ȱ Š—¡’˜žœȱ ˜˜›–Š—ȱ ‘˜•’—ȱ˜—ȱ˜ȱ˜˜›œDzȱ Šȱ–ŽŠ™‘˜›ȱ˜›ȱœ’žŠ’˜—œȱ’—ȱ  ‘’Œ‘ȱœ˜–Žȱ–žœŒ•Žœȱ‘Š‹’žȬ Š••¢ȱ ‘˜•ȱ Š—ȱ ‘žœȱ ‘’—Ž›ȱ –˜ŸŽ–Ž—œȱ ’—ȱ œ˜–Žȱ ŸŽ›Ȭ Ž‹›Š•ȱ “˜’—œǰȱ ˜›Œ’—ȱ ˜‘Ž›ȱ –žœŒ•Žœȱ ˜ȱ  ˜›”ȱ ˜˜ȱ ‘Š›ȱ Š—ȱ ˜˜ȱ –žŒ‘ǯȱ ȱ ‘Žȱ ™Š’—ȱ ›Ž•ŠŽȱŽŠ›ȱŒŠ—ȱ‹Žȱ›ŽžŒŽDzȱ ‘˜ ŽŸŽ›ǰȱ ‘Žȱ ˜˜›–Š—ȱ  ’••ȱ ‹ŽȱŠ‹•Žȱ˜ȱ˜™Ž—ȱŠ—ȱŒ•˜œŽȱ‘Žȱ ˜˜›œȱ’—ȱŠȱ–˜›Žȱ›Ž•’Š‹•Žȱ Š¢ǯ. ȱ ŗřȱ.

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