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Paterson KL, Hinman RS, Metcalf BR, Jones SE, Menz HB, Munteanu SE, Kasza J, Bennell KL. Foot orthoses for first metatarsophalangeal joint osteoarthritis: study protocol for the FORT randomised controlled trial. BMC Musculoskelet Disord 2020; 21:830. [PMID: 33302926 PMCID: PMC7726603 DOI: 10.1186/s12891-020-03809-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/19/2020] [Indexed: 01/23/2023] Open
Abstract
Background First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a painful and debilitating condition affecting nearly one in 10 people aged over 50 years. Non-drug, non-surgical treatments are recommended by OA clinical guidelines, yet there have only ever been two randomised controlled trials (RCTs) evaluating such strategies in people with first MTP joint OA. Foot orthoses are a common non-drug, non-surgical strategy used by allied health professionals for people with first MTP joint OA, however, it is unknown whether these devices are effective in improving the symptoms associated with the condition. This clinical trial aimed to determine whether contoured foot orthoses lead to greater reductions in first MTP joint pain on walking compared to sham flat insoles in people with first MTP joint OA. Methods The FORT trial (Foot ORthoses for big Toe joint osteoarthritis) is a two-arm participant- and assessor-blinded, multi-site RCT conducted in Melbourne, Sydney, Brisbane and the Gold Coast, Australia. We are recruiting 88 community-dwelling people with symptomatic radiographic first MTP joint OA. Following baseline assessment, participants are randomized to receive either: i) contoured foot orthoses; or ii) sham flat insoles following baseline assessment. Participants have two visits with a study podiatrist where they are provided with their allocated insoles, to be worn daily for 12 weeks at all times when wearing shoes. The primary outcome is self-reported first MTP joint pain on walking (numerical rating scale), assessed at baseline and 12 weeks. Secondary outcomes include additional measures of first MTP joint and foot pain, physical function, quality of life, participant-perceived global ratings of change (pain and function), and level of physical activity. Discussion This study will provide novel evidence about whether contoured foot orthoses improve pain and other symptoms compared to sham insoles in people with first MTP joint OA. Outcomes will help to inform clinical guidelines and practice about the use of foot orthoses for managing symptoms in this under-researched group of people with OA. Trial registration Prospectively registered with the Australian New Zealand Clinical Trials Registry (reference: ACTRN12619000926134) on 3/07/2019.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Ben R Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Sarah E Jones
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
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Lopes M, Oliveira J, Ribeiro F. Injury prevention in futsal players: is the FIFA 11+ a simple answer to a complex problem? PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1731177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Mário Lopes
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
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van der Heijden SMT, Prins MR, van der Wurff P. Toward more reliable stability measurements in stance: recommendations for number of measurements, foot position and feedback -- a cross-sectional study among servicemen. Mil Med Res 2019; 6:21. [PMID: 31296263 PMCID: PMC6624869 DOI: 10.1186/s40779-019-0212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the military, insufficient postural stability is a risk factor for developing lower extremity injuries. Postural stability training programs are effective in preventing these injuries. However, an objective method for the measurement of postural stability in servicemen is lacking. The primary objective of this study was to assess the influence of the number of repetitions, different foot positions and real-time visual feedback on postural stability, as well as their effects on the intrasession reliability of postural stability measurements in servicemen. The secondary objective was to assess the concurrent validity of the measurements. METHODS Twenty healthy servicemen between 20 and 50 years of age and in active duty were eligible for this quantitative, cross-sectional study. The measurements took place on a force plate, measuring the mean velocity of the center of pressure. The participants were asked to stand as still as possible in three different foot positions (wide stance, small stance, and on one leg), five times each for 45 s each time, and the measurements were performed with and without real-time visual feedback. RESULTS We observed a significant main effect of foot position (P < 0.001), but not of visual feedback (P = 0.119) or repetition number (P = 0.915). Postural stability decreased in the more challenging foot positions. The ICC estimates varied from 0.809 (one repetition in wide stance) to 0.985 (five repetitions on one leg). The common variance (R2) between different foot positions without feedback varied between 0.008 (wide stance) and 0.412. CONCLUSIONS To yield reliable data, wide-stance measurements should be conducted three times, and small-stance measurements and measurements on one leg should be conducted two times. The scores of a measurement in a particular foot position cannot predict the scores of measurements in other foot positions.
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Affiliation(s)
- Saskia Maria Theresia van der Heijden
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands.,Research and Development, Military Rehabilitation Center Aardenburg, Korte Molenweg 3, 3941PW, Doorn, The Netherlands
| | - Maarten Reinders Prins
- Research and Development, Military Rehabilitation Center Aardenburg, Korte Molenweg 3, 3941PW, Doorn, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam and Amsterdam Movement Sciences, 1081BT, Amsterdam, The Netherlands.,Institute for Human Movement Studies, HU University of Applied Sciences Utrecht, 3584CS, Utrecht, The Netherlands
| | - Peter van der Wurff
- Research and Development, Military Rehabilitation Center Aardenburg, Korte Molenweg 3, 3941PW, Doorn, The Netherlands. .,Institute for Human Movement Studies, HU University of Applied Sciences Utrecht, 3584CS, Utrecht, The Netherlands.
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Bonanno DR, Ledchumanasarma K, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effects of a contoured foot orthosis and flat insole on plantar pressure and tibial acceleration while walking in defence boots. Sci Rep 2019; 9:1688. [PMID: 30737450 PMCID: PMC6368555 DOI: 10.1038/s41598-018-35830-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022] Open
Abstract
This study investigated the effects of a contoured, prefabricated foot orthosis and a flat insole on plantar pressure and tibial acceleration while walking in defence boots. Twenty-eight adults walked along an 8-metre walkway in a: (i) defence boot (control condition), (ii) defence boot with a flat insole, and (iii) defence boot with a contoured foot orthosis. Plantar pressure data were collected using the pedar-X in-shoe system and tibial accelerations were measured with an accelerometer. In relation to plantar pressure under the rearfoot, the contoured foot orthosis, compared to the defence boot, decreased peak pressure and maximum force, and increased contact area. Under the medial midfoot, the contoured foot orthosis and flat insole increased peak pressure, maximum force and contact area. Under the medial forefoot, the contoured foot orthosis and flat insole increased maximum force. Under the lateral forefoot, the contoured foot orthosis and flat insole increased contact area, with the flat insole also increasing maximum force. In relation to tibial acceleration, the contoured foot orthosis, compared to the defence boot, decreased tibial peak positive acceleration. These findings provide novel biomechanical evidence for the effects of contoured foot orthoses in defence boots.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia. .,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Ketharasarma Ledchumanasarma
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, 3086, Australia
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Li L, Yang L, Yu F, Shi J, Zhu L, Yang X, Teng H, Wang X, Jiang Q. 3D printing individualized heel cup for improving the self-reported pain of plantar fasciitis. J Transl Med 2018; 16:167. [PMID: 29914501 PMCID: PMC6007068 DOI: 10.1186/s12967-018-1547-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/12/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To explore the therapeutic effect and the biomechanical mechanism of 3D printing individualized heel cup in treating of plantar heel pain. METHODS The clinical effect was evaluated by plantar pressure analysis and pain assessment in participants. Its biomechanical mechanism of protecting the plantar heel was explored using finite element simulation. RESULTS The individualized heel cup could support and protect the osseous structure and soft tissue of plantar heel while walking and jogging, as well as significantly reduce the self-reported pain after being worn for 4 weeks. The nylon heel cup could alter the load concentration of the heel as well as decrease the load affected on plantar fascia and calcaneus bone. It also provided an obvious support for heel pad. CONCLUSION To summarize, the 3D printed individualized heel cup can be used as an effective method for the treatment of plantar heel pain.
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Affiliation(s)
- Lan Li
- School of Mechanical Engineering, Southeast University, No. 2 Southeast University Road, Nanjing, China
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
- Institute of Medical 3D Printing, Nanjing University, Nanjing, China
| | - Longfei Yang
- School of Mechanical Engineering, Southeast University, No. 2 Southeast University Road, Nanjing, China
| | - Fei Yu
- Drum Tower of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Jianping Shi
- School of Mechanical Engineering, Southeast University, No. 2 Southeast University Road, Nanjing, China
| | - Liya Zhu
- School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
| | - Xianfeng Yang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Huajian Teng
- School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Model Animal Research Center, Nanjing University, Nanjing, China
| | - Xingsong Wang
- School of Mechanical Engineering, Southeast University, No. 2 Southeast University Road, Nanjing, China
| | - Qing Jiang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
- Model Animal Research Center, Nanjing University, Nanjing, China
- Institute of Medical 3D Printing, Nanjing University, Nanjing, China
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Bonanno DR, Munteanu SE, Murley GS, Landorf KB, Menz HB. Risk factors for lower limb injuries during initial naval training: a prospective study. J ROY ARMY MED CORPS 2018; 164:347-351. [DOI: 10.1136/jramc-2018-000919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/14/2018] [Accepted: 03/14/2018] [Indexed: 11/04/2022]
Abstract
IntroductionThis study aimed to identify risk factors associated with the development of common lower limb injuries during initial defence training in naval recruits who were enrolled in a randomised trial.MethodsThree-hundred and six naval recruits were randomly allocated flat insoles (n=153) or foot orthoses (n=153) while undertaking 11 weeks of initial training. Participant characteristics (including anthropometrics, general health, physical activity, fitness and foot characteristics) were collected at the baseline assessment and injuries were documented prospectively. Injury was defined as the combined incidence of participants with medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain throughout the 11 weeks of training. A discriminant function analysis was used to explore the ability of baseline measures to predict injury.ResultsOverall, 67 (21.9%) participants developed an injury. Discriminant function analysis revealed that participants who sustained an injury were slightly younger (mean 21.4±SD 4.1 vs 22.5±5.0 years) and were less likely to be allocated to the foot orthosis group (40% vs 53%) compared with those who remained uninjured. The accuracy of these baseline variables to predict injury was moderate (78.1%).ConclusionsLower limb injury was not accurately predicted from health questionnaires, fitness results and clinical assessments in naval recruits undertaking initial defence training. However, although not reaching statistical significance, the use of foot orthoses may be protective against common lower limb injuries.Trial registration numberACTRN12615000024549; Post-results.
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Whittaker GA, Munteanu SE, Menz HB, Elzarka A, Landorf KB. Corticosteroid injections compared to foot orthoses for plantar heel pain: protocol for the SOOTHE heel pain randomised trial. Contemp Clin Trials Commun 2017; 5:1-11. [PMID: 29740617 PMCID: PMC5936710 DOI: 10.1016/j.conctc.2016.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Corticosteroid injections and foot orthoses are common interventions for plantar heel pain. Previous clinical trials have found that the effectiveness of these interventions differs over time, with corticosteroid injections being more effective in the short-term (i.e. 0-4 weeks) and foot orthoses more effective in the longer-term (i.e. 5-12 weeks). However, some of these trials have methodological weaknesses that could have caused confounding and bias, which may have led to over- or under-estimation of the effectiveness of these interventions. As a result, there is a need to compare the effectiveness of corticosteroid injections and foot orthoses in a robust clinical trial with an appropriate follow-up time. METHODS This article describes the protocol for a pragmatic, parallel-group assessor-blinded randomised trial (Steroid injection versus foot orthoses (SOOTHE) heel pain trial). One hundred participants with plantar heel pain will be randomly allocated (i.e. two groups of approximately 50) to receive either an ultrasound-guided corticosteroid injection or prefabricated foot orthoses. Outcome measures will be obtained at baseline, 4, 8 and 12 weeks, with two primary endpoints at 4 and 12 weeks to reflect the hypothesised temporal effects of each intervention. The primary outcome measure will be the foot pain domain of the Foot Health Status Questionnaire. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry number ACTRN12615001266550.
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Affiliation(s)
- Glen A. Whittaker
- Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - Shannon E. Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - Hylton B. Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - Ayman Elzarka
- Southern Cross Medical Imaging, La Trobe Private Hospital, Bundoora, Victoria, 3083, Australia
| | - Karl B. Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
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Bonanno DR, Landorf KB, Munteanu SE, Murley GS, Menz HB. Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis. Br J Sports Med 2016; 51:86-96. [PMID: 27919918 DOI: 10.1136/bjsports-2016-096671] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the evidence relating to the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury. DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Clinical trials evaluating the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury. DATA SOURCES Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016. RESULTS 11 trials that had evaluated foot orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated foot orthoses and shock-absorbing insoles was 5 (range 3-8/10) and 3 (range 1-7/10), respectively. Meta-analysis found that foot orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15). CONCLUSIONS Foot orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
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Affiliation(s)
- Daniel R Bonanno
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Allied Health, Melbourne Health, Parkville, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - George S Murley
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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