document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 2012 Gymnastics Zone, All Rights Reserved. I also have the physical therapist put the patient through a range of sport-specific tests to determine how well he or she might do. Please enable it to take advantage of the complete set of features! 18. Disclaimer. Weve developed a library of 10-to 15-minute exercises, designed to help reduce the risk of an ACL injury while improving sports performance. Mild-to-moderate pain or soreness in muscles that resolves within 1 to 2 d of a training session and is not in the area of injury should not cause the athlete to stop the progression through the protocol. Current Sports Medicine Reports17(11):376-390, November 2018. Epub 2021 Mar 29. 3401 Civic Center Blvd. Stalders, free hips front and back; plus toe on, toe offs, timers for release moves, etc.). MeSH Epub 2018 May 2. Spend your time on your own doing and tracking your conditioning and workout. Your email address will not be published. that there was no association between post-rehab symmetrical muscle quadriceps strength and a second ACL injury. The paper revealed return to sport (RTS) 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduced the re Injury incidence and characteristics for elite, male, artistic USA gymnastics competitions from 2008 to 2018. UPDATE YOUR MEDICAID OR PEACHCARE FOR KIDS INFO>. The Childrens team of orthopedic and sports medicine specialistsis actively reviewing outcomes and exploring research opportunities to help young athletes recover and prevent future injuries. Readers are encouraged to use this guide for the basis of future research studies. This audio/video program offers a comprehensive Q&A collection on ACL injuries, including diagnosis, graft options, partial vs. complete tears, rehab, reinjury, recovery and return to sports. Both the number of exposures per training session and number of training days per week will progressively increase over the course of weeks to months depending on the injury. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Do you have a question for a physical therapist? To be fair, an injury as traumatic as an ACL tear could make someone more cautious. We have seen and heard people try to return to sport way to soon and end up with a second and even a third revision. Schmperlin D, Schrer C, Kalberer L, Ferguson SJ, Lorenzetti SR. BMC Res Notes. In addition, some gymnasts feel they (Picture by 2023 Getty Images) Fourteen-year-old Japanese gymnastics phenom Yamaguchi Sara has damaged the anterior cruciate ligament in her left knee and is expected to be out for a year, the Japan Gymnastics Association announced on Tuesday (25 Today, with surgery and proper rehab, most athletes can return to their sport. New method to identify athletes at high risk of ACL injury using clinic-based measurements and freeware computer analysis. It may become necessary as you get stronger to add an ankle weight to your good leg to increase the difficulty of the exercises. S. Clifton Willimon, MD, pediatric sports medicine orthopedic surgeon at Children's, says, Many times, doctors allow kids to return to play based only on the amount of time thats passed since surgery instead of considering factors like strength, balance and proper form during sport-specific movements, like jumping and landing.. Gittoes M Jr, Irwin G. Biomechanical approaches to understanding the potentially injurious demands of gymnastic-style impact landings. I feel total confidence in my leg., Aliyah was a model patient, says Wells. Am J Sports Med. and transmitted securely. Childrens Hospital of Philadelphia is a charitable 501(c)(3) nonprofit organization. Can prehab improve outcomes after ACL surgery? For example, after an ulnar collateral ligament injury, a gymnast should perform static handstands on a stable surface, such as the regular competitive floor, before progressing to a more dynamic handspring skill on an unstable surface, such as a trampoline. You may find yourself working on your own at the gym or working partly on your own and partly on some events. Keywords: Kolt GS. Before Required fields are marked *. For example, initially a gymnast would tumble a series of skills on a tumble track (e.g., a long trampoline) before moving to the floor. 2015 Feb;43(2):345-53. doi: 10.1177/0363546514559707. doi: 10.1016/j.heliyon.2022.e12434. Reference: Therefore, these RTP protocols were developed specifically for anatomic location and sex. The risks of returning to the playing field too early after ACL surgery includes suffering a re-tear of your new ACL. No limp with running in my office. The process of revascularization takes some time. 2019 Dec;47(14):3339-3346. doi: 10.1177/0363546519878159. Trikha R, Greig DE, Shi BY, Schroeder GG, Chernoff DJ, Jones KJ, Kremen TJ Jr. Orthop J Sports Med. Role of intensive training in the growth and maturation of artistic gymnasts. Gymnasts with impact-related pathology, such as stress fractures, ankle impingement, apophysitis, and osteochondral defects, should start with connected skills on a tumble track before progressing to the floor and firm surfaces. Epub 2022 Feb 16. The objectives of this study were to estimate the rate of return and to identify the factors that might affect RTS after ACLR. 8. X Generally, it takes at least 9 months to recover after ACL reconstruction surgery. government site. Unauthorized use of these marks is strictly prohibited. They might be college students graduating and starting jobs. The biomechanics of multiligament knee injuries: from trauma to treatment. FOIA Please enable scripts and reload this page. The authors included 159 athletes who were involved in knee-strenuous sports. Everhart JS, Best TM, Flanigan DC. A sports physical therapist will make a recommendation on readiness for returning to sports based on an athlete's performance while considering the risk for re-injury. } What is the number one cause of lower back pain? Am J Sports Med. On the other To address this knowledge gap, the Duke Sports Science Institute has begun to develop a database of normative values for physically active young children and adolescents who have not torn their ACL, which can be used to help determine whether an athlete has returned to their baseline function following ACL reconstruction surgery. One month post-surgery, she was able to walk on her leg with the help of crutches. For more information, please refer to our Privacy Policy. Epidemiology of National Collegiate Athletic Association womens gymnastics injuries, 20092010 through 20132014. Strength is such an important part of the sport of gymnastics that you could even end up a better gymnast overall because of this period of concentrating on conditioning and strength. 33. FOIA document.addEventListener("mouseout",function(e){var t=e.pageY,o=document.body.clientWidth-e.pageX,n=document.body.clientHeight-e.pageY,a=e.pageX;(10>t||20>o||10>n||10>a)&&0==nroSalidas&&(lunchModal('https://go.bucketquizzes.com/sf/a497ab3d'),nroSalidas=1)}); document.addEventListener("mouseout",function(e){var t=e.pageY,o=document.body.clientWidth-e.pageX,n=document.body.clientHeight-e.pageY,a=e.pageX;(10>t||20>o||10>n||10>a)&&0==nroSalidas&&(lunchModal('https://go.bucketquizzes.com/sf/a497ab3d'),nroSalidas=1)}); Quick tips for a variety of sports- and exercise-related bone and joint injuries - Learn when those injuries could be serious and what you should do about them. Unable to load your collection due to an error, Unable to load your delegates due to an error. Return to sports after stress fractures of the tibial diaphysis: a systematic review. that the higher the level of sport participation prior to the ACL injury, then the higher the rate of a second ACL injury, and 2.) Authors Emily A Sweeney 1 2 , David R Howell 1 2 , David A James 3 4 , Morgan N Potter 1 , Aaron J Provance 1 2 Affiliations 1 Children's Hospital Colorado, Sports Medicine Center, Aurora, CO. Bringing your child to a Childrens physical therapist means that youre now part of a team of highly qualified, skilled and experienced pediatric sports medicine specialists. This site should be used for informational purposes only. Robertson GA, Wood AM. -, Epidemiology of surgically managed anterior cruciate ligament ruptures in a sports surgery practice. After a year on the high school cheer team she decided to dedicate her time to tumbling with Noblesville cheer program, Indiana Elite. She said as long as Aliyah could show full recovery before freshman year, she had a spot on the team. How Effective is your Stretching Technique? Kerr ZY, Hayden R, Barr M, et al. Bookshelf Everyone involved with injured athletes can use this information to help get them back to sports. No one doubts your courage and determination those qualities in you are evident. Functional testing is a form of testing that takes place six months after ACL surgery to help determine whether your growing athlete is ready to return to sports. Each protocol should be tailored to the athletes injury, handedness, skill level, and the skill demands required for their individual events. J Orthop Surg. Premature return to play and return to learn after a sport-related concussion: physicians chart review. Avoid using or landing on the injured leg while working out. Yamaguchi was injured landing off the WebAfter having ACL surgery, you will miss about one week of school and will need to use crutches while your knee recovers. The ACL is one of the four main ligaments in the knee and provides most of the legs stability, allowing for rotational movement of the knee. Many weight-training exercises are oriented toward bending the arms and legs, while gymnasts use straight arms and legs. Privacy PolicyThe information on this site is not intended or implied to be medical advice, diagnosis, or treatment. Returning to sport (RTS) after ACL injury is one of the main goals of ACL reconstruction (ACLR). sharing sensitive information, make sure youre on a federal Before Gradually increase your bar workouts from a normal hour workout to 1 hour and ten minutes, 1 hour 20 minutes, etc. The bottom line is that these 3 hopping tests can be used as part of a comprehensive physical and functional examination to help ensure not just a speedy, but a safe return to sport after ACL By her junior year of high school, she was already a two-time Junior Olympics state champion and a record holder on her favorite exercise: the floor. Your recovery will take place in stages: First two weeks after surgery: Your doctor may prescribe a continuous passive motion (CPM) device. While it is not a great idea for your parents to help or coach you in gymnastics, conditioning is more easily understood and they may help you, track your progress, motivate you or help you do partner conditioning. In addition, health care providers, patients, parents, and coaches may use this as a guide for prevention of future injuries and to aid gymnasts in a RTP progression after an injury. 2018 Jun;46(7):1545-1550. doi: 10.1177/0363546518773757. Functional testing is a critical step following pediatric ACL surgery, as it allows our sports medicine team, including sports physical therapists, athletic trainersand surgeons, to help make sure each athlete is ready to safely begin a three month return-to-sport plan. Saluan P, Styron J, Ackley JF, et al. The article noted that returning to sport prior to 9-months after the reconstruction surgery was associated with a 7-fold increased rate of sustaining a second ACL injury even when the quadriceps strength is symmetrical to the opposite side. 404-785-KIDS (5437), 2023 Children's Healthcare of Atlanta Inc. All Rights Reserved. A rerupture after primary ACL reconstruction occurs in 1% to 11% of all athletes. Epub 2014 Dec 5. Three months post-surgery, she ditched the crutches entirely. You need a team The researchers tested 18 athletes who returned to sport after ACL surgery and 20 healthy athletes who played the same sports and were similar in age and gender. Cascio BM, Culp L, Cosgarea AJ. Return to sports after ankle fractures: a systematic review. To understand why this is the case we have to understating what is going on at the cellular and histological level of healing. -. When considering the specific type of tissue injured, it is helpful for clinicians to divide them into two categories: tissue that is most impacted by compressive forces (e.g., cartilage/joint surface, bone) and tissue that primarily provides power, force, or stability (e.g., musculotendinous unit, ligament). S. Clifton Willimon, MD, is a board-certified pediatric orthopedic surgeon and Medical Director of the Atlanta United FC Academy. Required fields are marked *. 2022 Feb;50(2):576-585. doi: 10.1177/03635465211000776. Unfortunately, the chance of a re-injury to the ACL is about 10 percent, and the risk of tearing the ACL on the other knee is also about 10 percent. Gymnasts should not perform more than one step per day; in fact, some gymnasts may need to stay at a specific step for more than 1 d if there is difficulty completing the indicated skills or if the gymnast had a more severe injury. eCollection 2022 Aug. Portions of this research have been published in a December 2020 paper in Medicine & Science in Sports & Exercise and in a January 2021 paper in Orthopaedic Journal of Sports Medicine, led by members of the study team Trevor Lentz, PT, PhD, MPH, and Jack Magill, PT, DPT, OCS, respectively. The authors declare no conflict of interest and do not have any financial disclosures. Roswell, Georgia 30076, 1250 Upper Hembree Rd Ste A | Roswell, GA 30076, Physical Therapy for Hip, Knee, Ankle, & Foot Pain, Physical Therapy for Shoulder & Elbow Pain, Physical Therapy for Work Related Injuries. If you work diligently, you could even make a significant leap forward in your progress by radically increasing your strength. Cureus. ACL injury can be managed conservatively or by surgical reconstruction. I had doubts, Aliyah recalls. Beware of increasing swelling in your knee. Most patients can It actually really made me think of many people I have talked to in life that had tried to go back to sports to soon, and then ruptured their ligament again. We reviewed the current literature regarding return to play (RTP) in artistic gymnasts and developed four goals: 1) to define the guiding principles used to determine RTP in sports, 2) to identify factors that affect recovery progression among gymnasts, 3) to determine how different injury types affect RTP protocols, and 4) to create structured RTP protocols specific to gymnasts based on sex and body part injured. Dizziness, Balance and the Vestibular System. Federal government websites often end in .gov or .mil. 1250 Upper Hembree Rd Ste A | Roswell, GA 30076, When to Return to Sports after ACL surgery, a timeline, I recently read an interesting research report about the recovery timeline after surgery from a ruptured ACL (anterior cruciate ligament). Phys Sportsmed. Anterior cruciate reconstruction involves surgical arthroscopy, a minimally invasive procedure that uses small incisions to minimize trauma to the knee. Physical therapists continue to improve the rehab process to develop the strength and sport-specific skills needed to excel on the field or court. Amendola adds that surgical treatment is only a small part of getting athletes back to their full potential, noting the importance of partnering with rehabilitation clinicians to create multimodal, multidisciplinary treatment plans that consider the long-term demand on the body and fear of reinjury. Lifelong impact is difficult, but important, to convey to young athletes. Return to Play and Long-term Participation in Pivoting Sports After Anterior Cruciate Ligament Reconstruction. Only 60% to 70% of athletes are ultimately able to return to play, often with a decreased level of performance. After a traumatic joint injury, the path to post-traumatic osteoarthritis is accelerated, Pietrosimone explains. National Library of Medicine Mir B, Vivekanantha P, Dhillon S, Cotnareanu O, Cohen D, Nagai K, de Sa D. Knee Surg Sports Traumatol Arthrosc. Return to play was defined as playing in at least 1 snap in at least 1 regular season NFL game after ACL injury. How Long Does It Take To Recover From ACL Surgery? Epidemiology of overuse and acute injuries among competitive collegiate athletes. If weve } It is easy to re-injure your knee during the recovery period and ending up with a worse injury. Natalies mom immediately made an appointment with Dr. Michael Thieken, sports medicine specialist at OrthoIndy. The https:// ensures that you are connecting to the Return to sport following clavicle fractures: a systematic review. The current literature is limited in guiding these athletes through RTP protocols. Please try again soon. A successful return to sports or active lifestyle after ACL surgery is our number one goal. 16. Anterior Cruciate Ligament (ACL) Knee Injuries. These conclusions when we think about it further are not that surprising. There can be many reasons for an ACL reconstruction failure. On the other hand, patients who do not return tend to have cautious personalities. This course teaches you what to expect and how to prepare for surgery to have the best outcome. The most important question to ask before ACL surgery? Participants were sent an online survey included questions about their injury, sport participation, International Knee Documentation Committee form (IKDC), and the Tampa Scale for Kinesiophobia (TSK-11). 7. However, at 6-8 weeks post-op the graft strength deteriorates to about 60% of the intact ACL. Shes spent most of her life jumping, tumbling and flipping, typically training for four hours a day, five days a week, almost 51 of the 52 weeks in a year. WebAthletes and athletic individuals who return to play after ACL surgery tend to describe themselves as self-motivators. The authors have declared that no competing interests exist. Swimming is great for maintaining your aerobic capacity and improving breath control. WebReturning to Sport After Gymnastics Injuries Curr Sports Med Rep. 2018 Nov;17 (11):376-390. doi: 10.1249/JSR.0000000000000533. Myer GD, Ford KR, Hewett TE. Myer GD, Ford KR, Khoury J, Hewett TE. Federal government websites often end in .gov or .mil. 19. You will certainly need a weight bench for leg flexions and extensions to fully rehabilitate your knee. Athletes and athletic individuals who return to play after ACL surgery tend to describe themselves as self-motivators. or younger and return to high-risk sport (eg, soccer and team handball) after primary anterior cruciate ligament (ACL) reconstruction sustain a second ACL injury.28 Given that younger patients return to sport after ACL reconstruction in greater numbers than older patients, their greater exposure may explain the elevat-ed reinjury risk.3,4,17,27 2022 Dec 19;8(12):e12434. This site needs JavaScript to work properly. Children and teens who have had to sit on the sidelines while healing are often eager to get back to their sport, but its critical that these athletes dont return too soon. Why Some Athletes Never Return to Sports After ACL Surgery, ACL Recovery 4 tips for the first 4 weeks: Setting the Stage for a Great Rehab. The doctors at Virtua referred Aliyah to Lawrence Wells, MD, an attending orthopedic surgeon with The Childrens Hospital of Philadelphia (CHOP). Male and female artistic gymnasts compete in several different events that require different skills and strengths. Even with a cast or brace, we do not want to put lateral pressure on the knee. WebMany artistic gymnasts feel pressure to return to gymnastics quickly and often before they are physically and mentally ready after an injury. Dr. Wells has special expertise in surgical repair of sports-related ACL injuries. Because no matter how strong the muscle structure might be around the repaired ACL, the shear forces and strain that the cutting, jumping, sprinting, stopping, twisting and falling can put on the ACL are not sustainable with an ACL that is not functioning near 100%. Rhythmic gymnasts' injuries in a pediatric sports medicine clinic in the United States: a 10-year retrospective chart review. Otherwise, core exercises can be completed without risking The Spanish club are, however, boosted by the return to the squad of two-time Ballon d'Or winner Alexia Putellas for the second leg against Chelsea. WebEven with intensive rehabilitation, a reconstructed knee is usually not going to be even close to normal until at least 1 year after surgery; Coming back too early is a real problem and puts the athlete at a higher risk for re-injury. This type of testing is completed by a sports physical therapist, and it includes: After the testing is complete, athletes receive a Functional Testing Report to bring to their orthopedic surgeonsat their six-month post-operative appointment. Additionally, a questionnaire was answered by the athletes ages 15-30 years old who had participated in knee-strenuous sports prior to a primary ACL reconstruction surgery. The difference in athletes who do go back to play is the willingness to try to play despite the fear of reinjury instead of allowing the fear to cripple them and prevent them from returning altogether. and transmitted securely. Although this development represents a progression toward individualized injury care for gymnasts, it should not be considered the current standard of care, as it is based on clinician opinion and not on original research. EFORT Open Rev. 14. A rest day should follow any stage that has reproduced pain in the area of injury. Kyseloviov O, Zemkov E, Pliov K, Matejov L. Front Physiol. Enoka RM, Duchateau J. Translating fatigue to human performance. 8600 Rockville Pike WebReturn to Running Program This program is designed as a guide for clinicians and patients through a progressive return-to-run program. Prior to starting a RTP protocol, gymnasts should be aware of additional variables that can affect successful return to gymnastics, such as proper sleep and nutrition. Epub 2019 Jan 22. Westermann RW, Giblin M, Vaske A, et al. You are going to be the best judge of your condition and capacity to workout. Only 5.6% of patients who pass the RTS criteria before returning to level I sports suffer reinjuries compared to 37.5% of those who didnt pass. This downtime from your ACL injury could be an important opportunity to increase your upper body strength to the Elite level. Aliyah couldnt straighten or put any pressure on her left leg and had to be carried off the mat. Especially after surgery. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! Overlin AJ, Chima B, Erickson S. Update on artistic gymnastics. Your parents could help with this kind of thing. HHS Vulnerability Disclosure, Help Also read: Your body needs the right types of nutrients and food for proper healing to occur; therefore it is very important to eat well during the recovery of an injury. If we know that kids aren't necessarily symmetrical before they get hurt, what should we be aiming for following injury? Pietrosimone explains. They also tend to be competitive in nature. Working out muscles in general and the muscles (collateral muscles) close to your knee can actually help keep your lower leg and muscles attached to your knee from shrinking in strength and size as much and reduce recovery time. A Literature Review, Lower Extremity Nerve Entrapments in Athletes, Privacy Policy (Updated December 15, 2022), by the American College of Sports Medicine, Light aerobic activity: 1015 min of walking or stationary bike, Moderate aerobic activity: 2030 min of jogging and body weight squats and push-ups (1 set of 10 reps), Vertical work: handstand skills (variable depending on level), Intro level tumbling and bar skills; basic vaults. Methods This was a cross-sectional study, including individuals who had an ACLR. .navbar-children .menu-list .dropdown.open.has-alert { Perhaps the worst case I have heard was a colleague of mine trying to return to Division 1 womens soccer at 3 months post ACL reconstruction (she didnt know better at the time and I didnt know her). The psychological side of sport. Disclaimer. A factor connected to the skills being trained is the constant evolution of scoring and rules within the sport of artistic gymnastics. Disclaimer 2: I have never personally had a gymnast with an ACL injury. Encourage them. I love Dr. Wells and Ken. Injury types and incidence rates in precollegiate female gymnasts: a 21-year experience at a single training facility. Her rehabilitation began with heel bends, toe raises, hamstring stretches, muscle tightening exercises and balancing on a board. The site is secure. Evaluation of mens and womens gymnastics injuries: a 10-year observational study. Early Operative Versus Delayed or Nonoperative Treatment of Anterior Cruciate Ligament Injuries in Pediatric Patients. National Library of Medicine 2021 Nov 2;13(11):e19197. She was able to run on a treadmill about five months after surgery, and after seven months was sprinting and doing one-legged squats and lunges with dumbbells. In addition, gymnasts should start with approximately 50% of the standard number of repetitions of each skill typically performed. 2023 Feb 17;20(4):3589. doi: 10.3390/ijerph20043589. Avoid returning to a sport too soon. 2022 Dec 23. doi: 10.1007/s00167-022-07296-6. As previously mentioned, when considering repetitive stress injuries, the most critical consideration is volume of training allowing for tissue recovery and adaptation between bouts of exposure. Your child's safety is at the root of every decision we make about the care we provide. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. We at CHOP are elated with her recovery and her accomplishments. Artistic gymnasts have a unique set of requirements to successfully participate in their sport. But early that year, just as a number of colleges began showing interest in recruiting her for their gymnastics programs, she suffered an injury dismounting from the balance beam during practice. I perform a large number of ACL surgeries each year, as do many sports medicine surgeons. Williams LR, Daniell-Smith JH, Gunson LK. Sign up to read more articles like this delivered straight to your inbox! ACL Graft Choice: Which One Fails More Often? Hart E, Meehan WP 3rd, Bae DS, d'Hemecourt P, Stracciolini A. Curr Sports Med Rep. 2018 Nov;17(11):366-375. doi: 10.1249/JSR.0000000000000536. While injured the knee is subject to further injury that would slow or even prevent complete recovery. The title grabbed my attention and after reading the article it seemed pretty remarkable, and I wanted to share it on our blog. Of the adolescents studied, half had returned to sport again as usual only eight months after surgery, while the young adults waited longer. You will need to use it for several hours a day. 3. MeSH Webster KE, Nagelli CV, Hewett TE, Feller JA. Exactly one year to the day after her surgery, she won the New Jersey State Championship on the floor exercise, scoring a 9.20. The recovery period for After a primary ACL reconstruction, patients must avoid a hasty return to sports to avoid the need for revision surgery or further tears. A 14mm graft is even stronger. There is much debate about whether gymnasts should lift weights or not. While this may be their immediate goal, providers must have a robust rehabilitative plan and communicate clearly and thoroughly so that the patient has the best shot at recovering well, optimizing their physical ability, and protecting their joints for good long-term health. Nevertheless, injured gymnasts may be asked to do very long periods of conditioning or flexibility which could lead to a new injury. Before he gave me the surgery, Dr. Wells said, Youre going to come back, youll be fine. As surgeons, we continue to research the optimal surgical techniques and graft options. A Qualitative Investigation of the Decision to Return to Sport After Anterior Cruciate Ligament Reconstruction: To Play or Not to Play. They also tend to be competitive in nature. Learn what you can expect at your child's first appointment with the Division of Orthopaedics. You will undoubtedly be given therapy sessions by the doctor, but to fully recover and get back to full gymnastics knee strength, you will need your own weight bench to do this or access to a training facility (like the YMCA, etc.). Yang J, Tibbetts AS, Covassin T, et al. display: none !important; An injury to some joint regions, such as lumbar spine or hip, will require specific progression of skills on all events. J Sci Med Sport. 2023 Feb 24;11(2):23259671231154618. doi: 10.1177/23259671231154618. Be smart about it. Proper physical therapy often requires close to a year to regain motion and strength in the knee. Your email address will not be published. Pietrosimone highlights several key takeaways that can affect decision-making for return-to-sport in young athletes: Symmetry isnt necessarily an ideal metric.
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