scholarly journals Comparison of Electromyographic Activity of Anterior Tibial Muscles and Long Fibular in Athletes With and Without Chronic Ankle Instability

2020 ◽  
Vol 22 (4) ◽  
pp. 260-264
Author(s):  
Giovanna Piai Cezar ◽  
Barbara Pasqualino Fachin ◽  
Christiane de Souza Guerino Macedo
Keyword(s):  
Surface Electromyography ◽  
Ankle Instability ◽  
Functional Limitation ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Electromyographic Activity ◽  
Ankle Sprains ◽  
Muscle Recruitment ◽  
Significant Difference ◽  
Anterior Tibial

AbstractChronic ankle instability (ICT) is common in jumping sports, may alter muscle recruitment, result in functional limitations and recurrence of sprains in this joint. The purpose of the study was to compare the muscle recruitment of the anterior tibial and long fibular muscles of athletes with and without chronic ankle instability by means of surface electromyography. Thirty-four athletes were recruited, divided into instability group (GI: n=14) and control group (GC: n=20), of both sexes and from different sport modalities, aged between 18 and 27 years old, history of ankle sprain in the last 12 months and functional limitation established by the Cumberland Ankle Instability (CAIT) questionnaire, the recruitment of the anterior tibial and long fibular muscles was analyzed by surface electromyography during the lunge exercise. The results for GI and GC were, respectively: age 21.3±2.88 and 22.4±3.25, height 1.77±0.10 and 1.74±0.08, CAIT 17[12.2-19] and 29.5 [27-30] (p<0.001). The anterior tibial and long fibular muscle recruitment in GI was 111.1[62.5-165.4] and 68.2±29, respectively and in GC 106.8[79.8-230.5] and 54.4±26.4, without significant difference. ICT did not interfere in the recruitment of the anterior tibial and long fibular muscles during the lunge exercise in athletes. Keywords: Ankle. Sprains and Strains. Health Evaluation. ResumoA instabilidade crônica do tornozelo (ICT) é comum em esportes de saltos, pode alterar o recrutamento muscular, resultar em limitações funcionais e recidivas de entorses nesta articulação. O objeto do estudo foi comparar o recrutamento muscular dos músculos tibial anterior e fibular longo de atletas com e sem instabilidade crônica de tornozelo por meio da eletromiografia de superfície. Foram recrutados 34 atletas, divididos em grupo instabilidade (GI: n=14) e grupo controle (GC: n=20), de ambos os sexos e de diferentes modalidades esportivas, com idade entre 18 e 27 anos, história de entorse de tornozelo nos últimos 12 meses e limitação funcional estabelecida pelo questionário Cumberland Ankle Instability (CAIT), o recrutamento dos músculos tibial anterior e fibular longo foi analisado pela eletromiografia de superfície durante o exercício de agachamento afundo. Os resultados para GI e GC foram, respectivamente: idade 21,3±2,88 e 22,4±3,25, altura 1,77±0,10 e 1,74±0,08, CAIT 17[12,2–19] e 29,5 [27-30] (p<0,001). O recrutamento muscular do tibial anterior e fibular longo no GI foi 111,1[62,5-165,4] e 68,2±29, respectivamente e no GC 106,8[79,8-230,5] e 54,4±26,4, sem diferença significativa. A ICT não interferiu no recrutamento dos músculos tibial anterior e fibular longo durante a realização do exercício de agachamento afundo em atletas. Palavras-chave: Tornozelo. Entorses e Distensões. Avaliação em Saúde

scholarly journals Lower Extremity Muscle Activation in Patients With or Without Chronic Ankle Instability During Walking

2015 ◽  
Vol 50 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Mark A. Feger ◽  
Luke Donovan ◽  
Joseph M. Hart ◽  
Jay Hertel
Keyword(s):  
Lower Extremity ◽  
Surface Electromyography ◽  
Muscle Activation ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Ankle Sprains ◽  
Activation Time ◽  
Peroneus Longus ◽  
Healthy Control

Context Ankle sprains are among the most common musculoskeletal injuries, and many individuals with ankle sprains develop chronic ankle instability (CAI). Individuals with CAI exhibit proprioceptive and postural-control deficits, as well as altered osteokinematics, during gait. Neuromuscular activity is theorized to play a pivotal role in CAI, but deficits during walking are unclear. Objective To compare motor-recruitment patterns as demonstrated by surface electromyography amplitudes between participants with CAI and healthy control participants during walking. Design Descriptive laboratory study. Setting Laboratory. Patients or Other Participants Fifteen adults with CAI (5 men, 10 women; age = 23 ± 4.2 years, height = 173 ± 10.8 cm, mass = 72.4 ± 14 kg) and 15 matched healthy control adults (5 men, 10 women; age = 22.9 ± 3.4 years, height = 173 ± 9.4 cm, mass = 70.8 ± 18 kg). Intervention(s) Participants walked shod on a treadmill while surface electromyography signals were recorded from the anterior tibialis, peroneus longus, lateral gastrocnemius, rectus femoris, biceps femoris, and gluteus medius muscles. Main Outcome Measure(s) Preinitial contact amplitude, postinitial contact amplitude, time of activation relative to initial contact, and percentage of activation time across the stride cycle were calculated for each muscle. Results Time of activation for all muscles tested occurred earlier in the CAI group than in the control group. The peroneus longus was activated for a longer duration across the entire stride cycle in the CAI group (36.0% ± 10.3%) than the control group (23.3% ± 22.2%; P = .05). No differences were noted between groups for measures of electromyographic amplitude at either preinitial or postinitial contact (P &gt; .05). Conclusions We identified differences between the CAI and control groups in the timing of muscle activation relative to heel strike in multiple lower extremity muscles and in the percentage of activation time across the entire stride cycle in the peroneus longus muscle. Individuals with CAI demonstrated neuromuscular-activation strategies throughout the lower extremity that were different from those of healthy control participants. Targeted therapeutic interventions for CAI may need to be focused on restoring normal neuromuscular function during gait.

scholarly journals Stability of Measurement Outcomes for Voluntary Task Performance in Participants With Chronic Ankle Instability and Healthy Participants

2011 ◽  
Vol 46 (4) ◽  
pp. 366-375 ◽  
Author(s):  
Sara Van Deun ◽  
Karel Stappaerts ◽  
Oron Levin ◽  
Luc Janssens ◽  
Filip Staes
Keyword(s):  
Muscle Activity ◽  
Muscle Activation ◽  
Intervention Program ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Muscle Recruitment ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Recruitment Order

Context: Acceptable measurement stability during data collection is critically important to research. To interpret differences in measurement outcomes among participants or changes within participants after an intervention program, we need to know whether the measurement is stable and consistent. Objective: To determine the within-session stability of muscle activation patterns for a voluntary postural-control task in a group of noninjured participants and a group of participants with chronic ankle instability (CAI). Design: Descriptive laboratory study. Setting: Musculoskeletal laboratory. Patients or Other Participants: Twenty control participants (8 men, 12 women; age = 21.8 ± 2.4 years, height = 164.3 ± 13.4 cm, mass = 68.4 ± 17.9 kg) and 20 participants with CAI (12 men, 8 women; age = 21.2 ± 2.1 years, height = 176 ± 10.2 cm, mass = 71.7 ± 11.3 kg). Intervention(s): Participants performed 4 barefoot standing trials, each of which included a 30-second double-legged stance followed by a 30-second single-legged stance in 3 conditions: with vision, without vision, and with vision on a balance pad. Main Outcome Measure(s): The activity of 7 muscles of the lower limb was measured for the stance task in the 3 different conditions for each trial. The onset of muscle activity and muscle recruitment order were determined and compared between the first and the fourth trials for both groups and for each condition. Results: We found no differences in the onset of muscle activity among trials for both groups or for each condition. The measurement error was 0.9 seconds at maximum for the control group and 0.12 seconds for the CAI group. In the control group, 70% to 80% of the participants used the same muscle recruitment order in both trials. In the CAI group, 75% to 90% used the same recruitment order. Conclusions: Within 1 session, measurement stability for this task was acceptable for use in further research. Furthermore, no differences were found in measurement stability across conditions in the control or CAI groups.

Eversion Strength and Surface Electromyography Measures With and Without Chronic Ankle Instability Measured in 2 Positions

2017 ◽  
Vol 38 (7) ◽  
pp. 769-778 ◽  
Author(s):  
Lindsy Donnelly ◽  
Luke Donovan ◽  
Joseph M. Hart ◽  
Jay Hertel
Keyword(s):  
Surface Electromyography ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Neutral Position ◽  
Healthy Controls ◽  
Healthy Group ◽  
Peroneus Longus ◽  
And Control

Background: Individuals with chronic ankle instability (CAI) have demonstrated strength deficits compared to healthy controls; however, the influence of ankle position on force measures and surface electromyography (sEMG) activation of the peroneus longus and brevis has not been investigated. The purpose of this study was to compare sEMG amplitudes of the peroneus longus and brevis and eversion force measures in 2 testing positions, neutral and plantarflexion, in groups with and without CAI. Methods: Twenty-eight adults (19 females, 9 males) with CAI and 28 healthy controls (19 females, 9 males) participated. Hand-held dynamometer force measures were assessed during isometric eversion contractions in 2 testing positions (neutral, plantarflexion) while surface sEMG amplitudes of the peroneal muscles were recorded. Force measures were normalized to body mass, and sEMG amplitudes were normalized to a resting period. Results: The group with CAI demonstrated less force when compared to the control group ( P < .001) in both the neutral and plantarflexion positions: neutral position, CAI: 1.64 Nm/kg and control: 2.10 Nm/kg) and plantarflexion position, CAI: 1.40 Nm/kg and control: 1.73 Nm/kg). There were no differences in sEMG amplitudes between the groups or muscles ( P > .05). Force measures correlated with both muscles’ sEMG amplitudes in the healthy group (neutral peroneus longus: r = 0.42, P = .03; plantarflexion peroneus longus: r = 0.56, P = .002; neutral peroneus brevis: r = 0.38, P = .05; plantarflexion peroneus longus: r = 0.40, P = .04), but not in the group with CAI ( P > .05). Conclusions: The group with CAI generated less force when compared to the control group during both testing positions. There was no selective activation of the peroneal muscles with testing in both positions, and force output and sEMG activity was only related in the healthy group. Clinical relevance: Clinicians should assess eversion strength and implement strength training exercises in different sagittal plane positions and evaluate for other pathologies that may contribute to reduced eversion strength in patients with CAI. Level of Evidence: Level III, cross-sectional

scholarly journals Eccentric Plantar-Flexor Torque Deficits in Participants With Functional Ankle Instability

2008 ◽  
Vol 43 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Jason Fox ◽  
Carrie L. Docherty ◽  
John Schrader ◽  
Trent Applegate
Keyword(s):  
Athletic Training ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Control Group ◽  
Prior History ◽  
Ankle Sprains ◽  
Plantar Flexors ◽  
Functional Ankle Instability ◽  
Significant Difference ◽  
History Of

Abstract Context: Inversion ankle sprains can lead to a chronic condition called functional ankle instability (FAI). Limited research has been reported regarding isokinetic measures for the plantar flexors and dorsiflexors of the ankle. Objective: To examine the isokinetic eccentric torque measures of the ankle musculature in participants with stable ankles and participants with functionally unstable ankles during inversion, eversion, plantar flexion, and dorsiflexion. Design: Case-control study. Setting: Athletic training research laboratory. Patients or Other Participants: Twenty participants with a history of “giving way” were included in the FAI group. Inclusion criteria for the FAI group included a history of at least 1 ankle sprain and repeated episodes of giving way. Twenty participants with no prior history of ankle injury were included in the control group. Intervention(s): Isokinetic eccentric torque was assessed in each participant. Main Outcome Measure(s): Isokinetic eccentric testing was conducted for inversion-eversion and plantar-flexion–dorsiflexion movements. Peak torque values were standardized to each participant's body weight. The average of the 3 trials for each direction was used for statistical analysis. Results: A significant side-by-group interaction was noted for eccentric plantar flexion torque (P &lt; .01). Follow-up t tests revealed a significant difference between the FAI limb in the FAI group and the matched limb in the control group. Additionally, a significant difference was seen between the sides of the control group (P = .03). No significant interactions were identified for eccentric inversion, eversion, or dorsiflexion torques (P &gt; .05). Conclusions: A deficit in plantar flexion torque was identified in the functionally unstable ankles. No deficits were identified for inversion, eversion, or dorsiflexion torque. Therefore, eccentric plantar flexion strength may be an important contributing factor to functional ankle instability.

scholarly journals EFFECTS OF ATHLETIC TAPING ON PERFORMANCE OF BASKETBALL ATHLETES WITH CHRONIC ANKLE INSTABILITY

2018 ◽  
Vol 24 (6) ◽  
pp. 477-482 ◽  
Author(s):  
Luiza Cammerer Gehrke ◽  
Leonardo Ximenes Londero ◽  
Renata Fanfa Loureiro-Chaves ◽  
Henrique Hahn Souza ◽  
Gabriel Pizetta de Freitas ◽  
...  
Keyword(s):  
Functional Performance ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Joint Stability ◽  
Balance Test ◽  
Joint Stress ◽  
Athletic Tape ◽  
Significant Difference

ABSTRACT Introduction: Ankle sprains are recurrent injuries in basketball, hence more and more athletes are taping their ankles to promote joint stability, aiming at improving dynamic balance and, consequently, functional performance. Objective: To verify the effects of elastic and rigid athletic taping on the functional performance and level of comfort of basketball players with chronic ankle instability. Methods: Twenty-one athletes aged between 18 and 30 years (mean age 23.7 ± 3.2) with chronic ankle instability (CAI), verified using the Cumberland Ankle Instability Tool, were selected to take part in this study. The Star Excursion Balance Test (SEBT) and the Figure-of-8 hop test (F8) were applied unilaterally to assess functional performance, considering the ankle of greater instability in three situations: without athletic taping, with rigid athletic taping and with elastic athletic taping. A draw was held to determine the order in which the tests (held over a number of days) would be applied. A questionnaire was conducted to assess comfort on the same day the athletic tapes were applied. Results: There was no significant difference between the tests in any direction of the SEBT, but there was a significant difference in F8 between the rigid athletic taping x control and elastic athletic taping x control situations. In addition, the elastic athletic tape was considered significantly more comfortable than the rigid athletic tape. Conclusion: Athletic taping appears to effectively improve the dynamic balance and functional performance of athletes with CAI only in activities that cause considerable joint stress, as is the case in F8. Elastic athletic tape appears to be just as effective as rigid athletic tape in these situations, in addition to being a significantly more comfortable alternative. Levef of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

scholarly journals Isokinetic Testing of Evertor and Invertor Muscles in Patients With Chronic Ankle Instability

2013 ◽  
Vol 29 (6) ◽  
pp. 696-704 ◽  
Author(s):  
Pascal David ◽  
Mohamad Halimi ◽  
Isabelle Mora ◽  
Pierre-Louis Doutrellot ◽  
Michel Petitjean
Keyword(s):  
Ankle Instability ◽  
Dynamic Strength ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Myoelectric Activity ◽  
Ankle Sprains ◽  
Isokinetic Testing ◽  
Rehabilitation Programs ◽  
Recurrent Injury ◽  
Angular Velocities

Ankle sprains are among the most common sport-related injuries and can lead to chronic ankle instability. Impaired sensorimotor function of the ankle musculature is often suggested as a cause. The current study sought to assess and compare the isokinetic performance and electromyographic patterns of evertor and invertor muscles in patients with chronic ankle instability and in a control group. Twelve patients with chronic ankle instability and twelve healthy subjects were included. Isokinetic eccentric and concentric testing at various angular velocities was performed for eversion and inversion movements. The corresponding myoelectric activities of the fibularis longus and tibialis anterior muscles were quantified from surface electromyographic recordings by computing average root mean square values. Patients had lower myoelectric activity of the evertor and invertor muscles than controls did; this difference could account for the eccentric weakness associated with ankle instability. Functional strength ratios revealed a dynamic strength imbalance in unstable ankle patients and that may contribute to recurrent injury. Our findings suggest that rehabilitation programs for unstable ankle patients must be focused on the motor control of eccentric contractions of the ankle evertors and invertors, to boost these muscles’ contribution to ankle stabilization.

scholarly journals Arthroscopic modified Broström operation versus open reconstruction with local periosteal flap in chronic ankle instability

2021 ◽  
Author(s):  
Moritz Mederake ◽  
Ulf Krister Hofmann ◽  
Ingmar Ipach
Keyword(s):  
Surgical Procedures ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Anterior Talofibular Ligament ◽  
Ankle Sprains ◽  
Periosteal Flap ◽  
Significant Difference ◽  
Open Reconstruction ◽  
One Year

Abstract Introduction The modified Broström operation (MBO) has found widespread use in the therapy of lateral chronic ankle instability (CAI). However, alternative surgical techniques like the open reconstruction using a periosteal flap (RPF) are still an important part of the surgical treatment of lateral CAI. Both procedures differ in terms of the reconstruction material used and the surgical procedure. Comparative studies on the surgical therapy of CAI are limited and generally refer to similar surgical procedures. Aim of this study was to compare the arthroscopic MBO and the RPF. Materials and methods We retrospectively analysed 25 patients with lateral CAI after a tear of the anterior talofibular ligament (ATFL). 14 patients received arthroscopic MBO and 11 patients received RPF. We compared the postoperative outcome between both groups with respect to subjective instability, the number of ankle sprains, pain, complications and follow-up operations as well as the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results Both surgical procedures resulted in a significant improvement in pain, in subjective instability, in the reduction in the frequency of ankle sprains and improvement in the AOFAS ankle-hindfoot score one year postoperatively. Three months postoperatively, the values for pain and instability of the MBO group were significantly better compared to the RPF. One year after the operation, these differences were evened out. Also in terms of complications and follow-up operations, no significant difference was found between the two procedures. Conclusions Both surgical procedures give very good results one year postoperatively in terms of pain, instability, function and complication rate. With significantly better results regarding pain and instability three months postoperatively, the MBO allows a faster recovery in patients operated with this technique.

scholarly journals Comparison of the Effect of 6 Weeks of Balancing and Hopping Strengthening Training on the Kinematics of the Lower Extremities of Athletes with Functional Ankle Instability while Running: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Mohammad Hasan Kordi Ashkezari ◽  
Mansur Sahebozamani ◽  
Abdolhamid Daneshjoo ◽  
Hamid Abbasi Bafghi
Keyword(s):  
Knee Flexion ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Balance Training ◽  
Lower Extremities ◽  
Control Group ◽  
Initial Contact ◽  
Ankle Sprains ◽  
Functional Ankle Instability ◽  
Significant Difference

Introduction: Ankle sprains are one of the most common sports injuries. This injury can affect the kinematics of the athlete's lower extremities. Therefore, the aim of this study was to compare the effect of 6 weeks of balancing and hopping strengthening training on the kinematics of the lower extremities of athletes with functional ankle instability while running. Methods: The present study  was a randomized clinical trial on 36 athletes with functional ankle instability who were randomly divided into three groups: hopping training, balance strengthening and control. The training lasted for six weeks and 3 sessions per week. Kinematic data were recorded by 3D OptiTrack camera while running at 10 km/h before and after training. SPSS software version 20 and ANCOVA test were used to compare the effect of exercises. Results: The results showed that there was a significant difference among the 3 groups in dorsiflexion (P = 0.009), inversion (P = 0.001) and knee flexion (P = 0.001). The results of Benferoni test also showed that hopping training in dorsiflexion, ankle inversion and knee flexion were significantly different from the control group (P = 0.009, P = 0.001, P = 0.001). The results also showed that balance strengthening training in the above movements were significantly different from the control group (P = 0.005, P = 0.002, P = 0.006) and in knee flexion, hoping training showed a significant difference compared to balance strengthening training (P =0.012). The results showed that both hopping and balance strengthening training improved the dorsiflexion, inversion and knee flexion angles in the initial contact in running. However, hopping exercises is better than balance strengthening in improving knee flexion angles. Conclusion: Therefore, according to the presented results, it can be concluded that the rehabilitation course of ankle sprains in athletes, coaches and sports rescue specialists should use a combination of balance strengthening training and hopping as a comprehensive program. In addition, hopping training can be used as a good alternative to balance training in places where there is not enough equipment.

scholarly journals The Effect of Fibular Reposition Taping on Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 28 (2) ◽  
pp. 205-210
Author(s):  
Bradley C. Jackson ◽  
Robert T. Medina ◽  
Stephanie H. Clines ◽  
Julie M. Cavallario ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Significant Difference ◽  
History Of

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no significant difference in postural control in patients receiving FRT compared with sham or no tape. Clinical Bottom Line: There is moderate evidence refuting the use of FRT to improve postural control in patients with CAI. Strength of Recommendation: There is grade B evidence to support that FRT does not improve postural control in people with CAI.

scholarly journals Current Perception Threshold Testing in Chronic Ankle Instability

2020 ◽  
Author(s):  
Ran Zhang ◽  
Xi Zhang ◽  
Yaping Chen ◽  
Weiqun Song
Keyword(s):  
Ankle Instability ◽  
Sensory Nerve ◽  
Chronic Ankle Instability ◽  
Nerve Fibers ◽  
Sensory Function ◽  
Control Group ◽  
Perception Threshold ◽  
Current Perception Threshold ◽  
Significant Difference ◽  
Healthy Control

Abstract Background: Damage to sensory input is one of the pathologies underlying chronic ankle instability (CAI). Therefore, it is necessary to evaluate the sensory function of patients with CAI. This study aims to quantitatively evaluate sensory nerve function in patients with CAI and healthy controls using current perception threshold (CPT) measurements.Methods: Fifty-nine subjects with CAI and 30 healthy control individuals participated in this study. CPT values at the anterior talofibular ligament region were tested on the injured and uninjured sides in CAI patients and on a random side in the healthy control group.Results: There were no significant differences in age, gender, height, weight or BMI between the CAI and healthy control groups. The CPT values did not show significant gender differences. The CPT values were not significantly correlated with age or BMI. Compared to the control group (250 Hz: 24.32±9.28, 5 Hz: 6.87±1.56), the CAI group had significantly higher CPT values on the injured (250 Hz: 42.83±28.49, 5 Hz: 23.43±18.53) and uninjured sides (250 Hz: 38.62±19.98, 5 Hz: 18.84±14.21) under 250 Hz and 5 Hz electrical stimuli (p<0.01). No significant difference was observed under 2000 Hz stimuli. There were correlations among CPT values at different frequencies (p<0.01).Conclusion: This study revealed increased sensory thresholds in injured and uninjured ankles of 250 Hz- and 5 Hz-related sensory nerve fibers among patients with CAI. The bilateral change in sensory threshold may indicate a central sensory modulation process.Level of Evidence: Level III, case-control study.

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