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Clinical effects of robot-assisted gait training and treadmill training for Parkinson's disease. A randomized controlled trial / Marianna Capecci in Annals of physical and rehabilitation medicine, Vol. 62, n°5 (Septembre 2019)
[article]
Titre : Clinical effects of robot-assisted gait training and treadmill training for Parkinson's disease. A randomized controlled trial Type de document : texte imprimé Auteurs : Marianna Capecci ; Sanaz Pournajaf ; Daniele Galafate ; Patrizio Sale ; Domenica Le Pera ; Michela Goffredo ; Maria Francesca De Pandis ; Marco Franceschini Année de publication : 2019 Article en page(s) : p. 303-312 Note générale : doi.org/10.1016/j.rehab.2019.06.016 Langues : Anglais (eng) Mots-clés : Gait Robotics Parkinson disease Rehabilitation Freezing Résumé : Background
Although gait disorders strongly contribute to perceived disability in people with Parkinson's disease, clinical trials have failed to identify which task-oriented gait training method can provide the best benefit. Freezing of gait remains one of the least investigated and most troublesome symptoms.
Objective
We aimed to compare the effects of robot-assisted gait training and treadmill training on endurance and gait capacity in people with Parkinson disease; the secondary aim was to compare the effect of the treatments in people with freezing and/or severe gait disability and assess changes in overall disease-related disability and quality of life.
Methods
Outpatients with Parkinson disease (Hoehn and Yahr stage ≥ 2) were randomly assigned to receive 20 sessions of 45-min gait training assisted by an end-effector robotic device (G-EO System) or treadmill training. Outcome assessments were the 6-min walk test, Timed Up and Go test, Freezing of Gait Questionnaire, Unified Parkinson's Disease Rating Scales and Parkinson's Disease Quality of Life Questionnaire-39 administered before (T0) and after treatment (T1).
Results
We included 96 individuals with Parkinson disease: 48 with robot-assisted gait training and 48 treadmill training. Both groups showed significant improvement in all outcomes. As compared with baseline, with robot-assisted gait training and treadmill training, endurance and gait capacity were enhanced by 18% and 12%, respectively, and motor symptoms and quality of life were improved by 17% and 15%. The maximum advantage was observed with the Freezing of Gait Questionnaire score, which decreased by 20% after either treatment. On post-hoc analysis, dependent walkers benefited more than independent walkers from any gait training, whereas freezers gained more from robot-assisted than treadmill training in terms of freezing reduction.
Conclusions
Repetitive intensive gait training is an effective treatment for people with Parkinson disease and can increase endurance and gait velocity, especially for those with severe walking disability. Advantages are greater with robot-assisted gait training than treadmill training for individuals with freezing of gait – related disability.Permalink : ./index.php?lvl=notice_display&id=84139
in Annals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 303-312[article] Clinical effects of robot-assisted gait training and treadmill training for Parkinson's disease. A randomized controlled trial [texte imprimé] / Marianna Capecci ; Sanaz Pournajaf ; Daniele Galafate ; Patrizio Sale ; Domenica Le Pera ; Michela Goffredo ; Maria Francesca De Pandis ; Marco Franceschini . - 2019 . - p. 303-312.
doi.org/10.1016/j.rehab.2019.06.016
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°5 (Septembre 2019) . - p. 303-312
Mots-clés : Gait Robotics Parkinson disease Rehabilitation Freezing Résumé : Background
Although gait disorders strongly contribute to perceived disability in people with Parkinson's disease, clinical trials have failed to identify which task-oriented gait training method can provide the best benefit. Freezing of gait remains one of the least investigated and most troublesome symptoms.
Objective
We aimed to compare the effects of robot-assisted gait training and treadmill training on endurance and gait capacity in people with Parkinson disease; the secondary aim was to compare the effect of the treatments in people with freezing and/or severe gait disability and assess changes in overall disease-related disability and quality of life.
Methods
Outpatients with Parkinson disease (Hoehn and Yahr stage ≥ 2) were randomly assigned to receive 20 sessions of 45-min gait training assisted by an end-effector robotic device (G-EO System) or treadmill training. Outcome assessments were the 6-min walk test, Timed Up and Go test, Freezing of Gait Questionnaire, Unified Parkinson's Disease Rating Scales and Parkinson's Disease Quality of Life Questionnaire-39 administered before (T0) and after treatment (T1).
Results
We included 96 individuals with Parkinson disease: 48 with robot-assisted gait training and 48 treadmill training. Both groups showed significant improvement in all outcomes. As compared with baseline, with robot-assisted gait training and treadmill training, endurance and gait capacity were enhanced by 18% and 12%, respectively, and motor symptoms and quality of life were improved by 17% and 15%. The maximum advantage was observed with the Freezing of Gait Questionnaire score, which decreased by 20% after either treatment. On post-hoc analysis, dependent walkers benefited more than independent walkers from any gait training, whereas freezers gained more from robot-assisted than treadmill training in terms of freezing reduction.
Conclusions
Repetitive intensive gait training is an effective treatment for people with Parkinson disease and can increase endurance and gait velocity, especially for those with severe walking disability. Advantages are greater with robot-assisted gait training than treadmill training for individuals with freezing of gait – related disability.Permalink : ./index.php?lvl=notice_display&id=84139 Exemplaires (1)
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Exclu du prêtClinical non-superiority of technology-assisted gait training with body weight support in patients with subacute stroke : A meta-analysis / Chih-Yang Hsu in Annals of physical and rehabilitation medicine, Vol. 63, n°6 (November 20)
[article]
Titre : Clinical non-superiority of technology-assisted gait training with body weight support in patients with subacute stroke : A meta-analysis Type de document : texte imprimé Auteurs : Chih-Yang Hsu ; Yu-Hsuan Cheng ; Chien-Hung Lai ; Yen-Nung Lin Année de publication : 2020 Article en page(s) : p. 535-542 Note générale : doi.org/10.1016/j.rehab.2019.09.009 Langues : Anglais (eng) Mots-clés : Stroke rehabilitation Robotics Body-weight-support Treadmill Gait Résumé : Background
Technology-assisted gait training (TAGT) with body weight support (BWS) has been designed to provide high numbers of repetitions during stepping practice, but its benefits have been inconclusive.
Objective
We evaluated the superiority of TAGT over conventional overground training (COT) to judge the clinical benefits.
Methods
We searched PubMed, Embase and Web of Science databases from their earliest record to July 1, 2019 and included randomized controlled trials of TAGT with BWS, such as robot-assisted gait training and body weight-supported treadmill training, for treating walking disability in patients within 6 months after stroke. We conducted a meta-analysis of the outcomes motor impairment, mobility capacity, walking speed, endurance and fitness, balance, and activities of daily living as well as subgroup analyses of initial ambulatory ability and stroke duration.
Results
Among 14 robotics and 10 body weight-supported treadmill studies included for review, 23 studies involving 1452 participants contributed to the meta-analysis. We found no significant standardized mean differences between TAGT and COT (P > 0.05) across all outcome categories in the robotics subgroup, the body weight-supported treadmill subgroup, or both subgroups combined, for both the short and long term. Further subgroup analyses also revealed non-significant standardized mean differences (P > 0.05) across all outcomes in the subgroups initially ambulatory, non-ambulatory, or stroke duration less than 3 months.
Conclusions
TAGT with BWS was not superior to COT in improving post-stroke recovery in patients with subacute stroke. Strategies other than simply increasing the repetitions by external assistance may be considered to augment the treatment effects of TAGT.Permalink : ./index.php?lvl=notice_display&id=91466
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 535-542[article] Clinical non-superiority of technology-assisted gait training with body weight support in patients with subacute stroke : A meta-analysis [texte imprimé] / Chih-Yang Hsu ; Yu-Hsuan Cheng ; Chien-Hung Lai ; Yen-Nung Lin . - 2020 . - p. 535-542.
doi.org/10.1016/j.rehab.2019.09.009
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 535-542
Mots-clés : Stroke rehabilitation Robotics Body-weight-support Treadmill Gait Résumé : Background
Technology-assisted gait training (TAGT) with body weight support (BWS) has been designed to provide high numbers of repetitions during stepping practice, but its benefits have been inconclusive.
Objective
We evaluated the superiority of TAGT over conventional overground training (COT) to judge the clinical benefits.
Methods
We searched PubMed, Embase and Web of Science databases from their earliest record to July 1, 2019 and included randomized controlled trials of TAGT with BWS, such as robot-assisted gait training and body weight-supported treadmill training, for treating walking disability in patients within 6 months after stroke. We conducted a meta-analysis of the outcomes motor impairment, mobility capacity, walking speed, endurance and fitness, balance, and activities of daily living as well as subgroup analyses of initial ambulatory ability and stroke duration.
Results
Among 14 robotics and 10 body weight-supported treadmill studies included for review, 23 studies involving 1452 participants contributed to the meta-analysis. We found no significant standardized mean differences between TAGT and COT (P > 0.05) across all outcome categories in the robotics subgroup, the body weight-supported treadmill subgroup, or both subgroups combined, for both the short and long term. Further subgroup analyses also revealed non-significant standardized mean differences (P > 0.05) across all outcomes in the subgroups initially ambulatory, non-ambulatory, or stroke duration less than 3 months.
Conclusions
TAGT with BWS was not superior to COT in improving post-stroke recovery in patients with subacute stroke. Strategies other than simply increasing the repetitions by external assistance may be considered to augment the treatment effects of TAGT.Permalink : ./index.php?lvl=notice_display&id=91466 Exemplaires (1)
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Exclu du prêtEffects of robotic gait training after stroke : A meta-analysis / Geoffroy Moucheboeuf in Annals of physical and rehabilitation medicine, Vol. 63, n°6 (November 20)
[article]
Titre : Effects of robotic gait training after stroke : A meta-analysis Type de document : texte imprimé Auteurs : Geoffroy Moucheboeuf ; Romain Griffier ; David Gasq ; Bertrand Glize ; Laurent Bouyer ; Patrick Dehail ; Hélène Cassoudesalle Année de publication : 2020 Article en page(s) : p. 518-534 Note générale : doi.org/10.1016/j.rehab.2020.02.008 Langues : Anglais (eng) Mots-clés : Stroke Robot-assisted gait training Exoskeleton End-effector Gait Walking Rehabilitation Résumé : Background
Robotic devices are often used in rehabilitation and might be efficient to improve walking capacity after stroke.
Objective
First to investigate the effects of robot-assisted gait training after stroke and second to explain the observed heterogeneity of results in previous meta-analyses.
Methods
All randomized controlled trials investigating exoskeletons or end-effector devices in adult patients with stroke were searched in databases (MEDLINE, EMBASE, CENTRAL, CINAHL, OPENGREY, OPENSIGLE, PEDRO, WEB OF SCIENCE, CLINICAL TRIALS, conference proceedings) from inception to November 2019, as were bibliographies of previous meta-analyses, independently by 2 reviewers. The following variables collected before and after the rehabilitation program were gait speed, gait endurance, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC) and Timed Up and Go scores. We also extracted data on randomization method, blinding of outcome assessors, drop-outs, intention (or not) to treat, country, number of participants, disease duration, mean age, features of interventions, and date of outcomes assessment.
Results
We included 33 studies involving 1466 participants. On analysis by subgroups of intervention, as compared with physiotherapy alone, physiotherapy combined with body-weight support training and robot-assisted gait training conferred greater improvement in gait speed (+0.09 m/s, 95% confidence interval [CI] 0.03 to 0.15; p = 0.002), FAC scores (+0.51, 95% CI 0.07 to 0.95; p = 0.022) and BBS scores (+4.16, 95% CI 2.60 to 5.71; p = 0.000). A meta-regression analysis suggested that these results were underestimated by the attrition bias of studies.
Conclusions
Robot-assisted gait training combined with physiotherapy and body-weight support training seems an efficient intervention for gait recovery after stroke.Permalink : ./index.php?lvl=notice_display&id=91465
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 518-534[article] Effects of robotic gait training after stroke : A meta-analysis [texte imprimé] / Geoffroy Moucheboeuf ; Romain Griffier ; David Gasq ; Bertrand Glize ; Laurent Bouyer ; Patrick Dehail ; Hélène Cassoudesalle . - 2020 . - p. 518-534.
doi.org/10.1016/j.rehab.2020.02.008
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 518-534
Mots-clés : Stroke Robot-assisted gait training Exoskeleton End-effector Gait Walking Rehabilitation Résumé : Background
Robotic devices are often used in rehabilitation and might be efficient to improve walking capacity after stroke.
Objective
First to investigate the effects of robot-assisted gait training after stroke and second to explain the observed heterogeneity of results in previous meta-analyses.
Methods
All randomized controlled trials investigating exoskeletons or end-effector devices in adult patients with stroke were searched in databases (MEDLINE, EMBASE, CENTRAL, CINAHL, OPENGREY, OPENSIGLE, PEDRO, WEB OF SCIENCE, CLINICAL TRIALS, conference proceedings) from inception to November 2019, as were bibliographies of previous meta-analyses, independently by 2 reviewers. The following variables collected before and after the rehabilitation program were gait speed, gait endurance, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC) and Timed Up and Go scores. We also extracted data on randomization method, blinding of outcome assessors, drop-outs, intention (or not) to treat, country, number of participants, disease duration, mean age, features of interventions, and date of outcomes assessment.
Results
We included 33 studies involving 1466 participants. On analysis by subgroups of intervention, as compared with physiotherapy alone, physiotherapy combined with body-weight support training and robot-assisted gait training conferred greater improvement in gait speed (+0.09 m/s, 95% confidence interval [CI] 0.03 to 0.15; p = 0.002), FAC scores (+0.51, 95% CI 0.07 to 0.95; p = 0.022) and BBS scores (+4.16, 95% CI 2.60 to 5.71; p = 0.000). A meta-regression analysis suggested that these results were underestimated by the attrition bias of studies.
Conclusions
Robot-assisted gait training combined with physiotherapy and body-weight support training seems an efficient intervention for gait recovery after stroke.Permalink : ./index.php?lvl=notice_display&id=91465 Exemplaires (1)
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Exclu du prêtEffect of a strong desire to void on walking speed in individuals with multiple sclerosis and urinary disorders / Claire Hentzen in Annals of physical and rehabilitation medicine, Vol. 63, n°2 (Mars 2020)
[article]
Titre : Effect of a strong desire to void on walking speed in individuals with multiple sclerosis and urinary disorders Type de document : texte imprimé Auteurs : Claire Hentzen ; Nicolas Trumel ; Camille Chesnel ; Audrey Charlanes ; Frédérique Le Breton ; Samer Sheikh Ismaël ; Gérard Amarenco Année de publication : 2020 Article en page(s) : p. 106-110 Note générale : doi.org/10.1016/j.rehab.2019.11.007 Langues : Anglais (eng) Mots-clés : Multiple sclerosis Walking speed Gait Urination Lower urinary tract symptoms Résumé : Background
Lower urinary tract symptoms, especially overactive bladder, are frequent and disabling in individuals with multiple sclerosis (IwMS). An association with gait disorders is common, which could aggravate continence difficulties and affect quality of life. The association between the need to void and walking has never been studied in this population.
Objective
The primary aim of this study was to assess the effect of a strong desire to void (SDV) on walking speed in IwMS and lower urinary tract symptoms. The secondary aim was to identify clinical or urodynamic factors associated with walking speed impairment at SDV in this population.
Methods
We included IwMS with urinary disorders and Expanded Disability Status Scale score < 7 in this observational study. Individuals underwent 3 10-m walk tests (10MWT) and one Timed Up and Go (TUG) test at SDV and at post-void (PV).
Results
Among the 72 IwMS included (mean [SD] age 50.6 [11.6] years; 46 [64%] females), the mean (SD) speed for 10MWT was 1.00 (0.31) m.s−1 at SDV and 1.07 (0.30) m.s−1 at PV (P < 0.0001). Time for TUG was also increased when individuals felt SDV: mean 11.53 (4.6) sec at SDV versus 10.77 (3.8) sec at PV (P = 0.004). No predictors of greater impairment of walking speed at SDV were identified.
Conclusion
This study suggests a clinical impact of bladder sensation on walking speed in IwMS and urinary disorders. None of the individual characteristics could predict greater decrease in gait velocity at SDV.Permalink : ./index.php?lvl=notice_display&id=90779
in Annals of physical and rehabilitation medicine > Vol. 63, n°2 (Mars 2020) . - p. 106-110[article] Effect of a strong desire to void on walking speed in individuals with multiple sclerosis and urinary disorders [texte imprimé] / Claire Hentzen ; Nicolas Trumel ; Camille Chesnel ; Audrey Charlanes ; Frédérique Le Breton ; Samer Sheikh Ismaël ; Gérard Amarenco . - 2020 . - p. 106-110.
doi.org/10.1016/j.rehab.2019.11.007
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°2 (Mars 2020) . - p. 106-110
Mots-clés : Multiple sclerosis Walking speed Gait Urination Lower urinary tract symptoms Résumé : Background
Lower urinary tract symptoms, especially overactive bladder, are frequent and disabling in individuals with multiple sclerosis (IwMS). An association with gait disorders is common, which could aggravate continence difficulties and affect quality of life. The association between the need to void and walking has never been studied in this population.
Objective
The primary aim of this study was to assess the effect of a strong desire to void (SDV) on walking speed in IwMS and lower urinary tract symptoms. The secondary aim was to identify clinical or urodynamic factors associated with walking speed impairment at SDV in this population.
Methods
We included IwMS with urinary disorders and Expanded Disability Status Scale score < 7 in this observational study. Individuals underwent 3 10-m walk tests (10MWT) and one Timed Up and Go (TUG) test at SDV and at post-void (PV).
Results
Among the 72 IwMS included (mean [SD] age 50.6 [11.6] years; 46 [64%] females), the mean (SD) speed for 10MWT was 1.00 (0.31) m.s−1 at SDV and 1.07 (0.30) m.s−1 at PV (P < 0.0001). Time for TUG was also increased when individuals felt SDV: mean 11.53 (4.6) sec at SDV versus 10.77 (3.8) sec at PV (P = 0.004). No predictors of greater impairment of walking speed at SDV were identified.
Conclusion
This study suggests a clinical impact of bladder sensation on walking speed in IwMS and urinary disorders. None of the individual characteristics could predict greater decrease in gait velocity at SDV.Permalink : ./index.php?lvl=notice_display&id=90779 Exemplaires (1)
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Exclu du prêtRehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial / Amir Ali Jafarnezhadgero in Annals of physical and rehabilitation medicine, Vol. 61, n°3 (Mai 2018)
[article]
Titre : Rehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial Type de document : texte imprimé Auteurs : Amir Ali Jafarnezhadgero ; Mahdi Majlesi ; Hojat Etemadi ; D.G.E. Robertson Année de publication : 2018 Article en page(s) : p. 125-134 Note générale : Doi : 10.1016/j.rehab.2018.01.007 Langues : Anglais (eng) Mots-clés : Genu varus Gait Lower limb Joint angle Résumé : Background
Previous studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority.
Objectives
We aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking.
Methods
Overall, 28 male children with genu varus (age range 9–14 years) volunteered to participate in this study. They were randomly divided into 2 equal groups (experimental and control). The participants of the experimental group received CEC for 16 weeks. 3-D gait analysis involved using a Vicon Motion System. Paired and independent sample t-tests were used for within- and between-group comparisons, respectively.
Results
For the experimental group, comparison of pre- and post-test joint kinematics of the dominant lower limb revealed that CEC decreased the peak ankle dorsiflexion angle by 26% (P=0.020), peak foot internal rotation angle by 53% (P=0.001), peak knee internal rotation angle by 40% (P=0.011), peak hip abduction by 47% (P=0.010), and peak hip external rotation angle by 60% (P=0.001). In contrast, peak knee external rotation angle of the dominant limb was increased after the training program by 46% (P=0.044). For the non-dominant lower limb, CEC decreased the peak ankle inversion by 63% (P<0.01), peak ankle eversion by 91% (P<0.01), peak foot internal rotation by 50% (P<0.01), peak knee internal rotation by 29%; P=0.042), peak hip abduction angle by 38% (P<0.01), and peak hip external rotation angle by 60% (P<0.01).
Conclusions
CEC therapy reduced excessive foot and knee internal rotations as well as excessive hip external rotation during walking in children with genu varus.Permalink : ./index.php?lvl=notice_display&id=80459
in Annals of physical and rehabilitation medicine > Vol. 61, n°3 (Mai 2018) . - p. 125-134[article] Rehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial [texte imprimé] / Amir Ali Jafarnezhadgero ; Mahdi Majlesi ; Hojat Etemadi ; D.G.E. Robertson . - 2018 . - p. 125-134.
Doi : 10.1016/j.rehab.2018.01.007
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 61, n°3 (Mai 2018) . - p. 125-134
Mots-clés : Genu varus Gait Lower limb Joint angle Résumé : Background
Previous studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority.
Objectives
We aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking.
Methods
Overall, 28 male children with genu varus (age range 9–14 years) volunteered to participate in this study. They were randomly divided into 2 equal groups (experimental and control). The participants of the experimental group received CEC for 16 weeks. 3-D gait analysis involved using a Vicon Motion System. Paired and independent sample t-tests were used for within- and between-group comparisons, respectively.
Results
For the experimental group, comparison of pre- and post-test joint kinematics of the dominant lower limb revealed that CEC decreased the peak ankle dorsiflexion angle by 26% (P=0.020), peak foot internal rotation angle by 53% (P=0.001), peak knee internal rotation angle by 40% (P=0.011), peak hip abduction by 47% (P=0.010), and peak hip external rotation angle by 60% (P=0.001). In contrast, peak knee external rotation angle of the dominant limb was increased after the training program by 46% (P=0.044). For the non-dominant lower limb, CEC decreased the peak ankle inversion by 63% (P<0.01), peak ankle eversion by 91% (P<0.01), peak foot internal rotation by 50% (P<0.01), peak knee internal rotation by 29%; P=0.042), peak hip abduction angle by 38% (P<0.01), and peak hip external rotation angle by 60% (P<0.01).
Conclusions
CEC therapy reduced excessive foot and knee internal rotations as well as excessive hip external rotation during walking in children with genu varus.Permalink : ./index.php?lvl=notice_display&id=80459 Exemplaires (1)
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Exclu du prêtHand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy : A Randomized Trial / Yannick Bleyenheuft
PermalinkTest-retest reliability of the 50-foot timed walk and 30-second chair stand test in patients with total hip arthroplasty / Bayram UNVER in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)
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