Posts Tagged treadmill

[Abstract + References] Experimental Human Walking and Virtual Simulation of Rehabilitation on Plane and Inclined Treadmill – Conference paper

Abstract

The paper presents the results of the authors concerning the experimental human walking and numerical simulation of human rehabilitation on a treadmill. Using Biometrics data acquisition system based on electrogoniometers, experimental measurements for ankle, knee and hip joints of right and left legs during walking on plane and inclined treadmill are performed. The human legs motion assistance for rehabilitation is proposed with an attached exoskeleton. The numerical simulation of a virtual mannequin walking with the attached exoskeleton on a plane and inclined treadmill is performed, using ADAMS virtual environment. A comparison between human experimental measurements and numerical simulations of a virtual mannequin with exoskeleton is presented.

 

References

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via Experimental Human Walking and Virtual Simulation of Rehabilitation on Plane and Inclined Treadmill | SpringerLink

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[WEB SITE] Kessler Foundation partners with Motek to develop new rehabilitation treatments

Researchers will investigate virtual reality-based interventions to improve cognitive and motor deficits in individuals with disabilities

KESSLER FOUNDATION

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IMAGE: PARTICIPANT WALKING ON C-MILL WITH RESEARCH SCIENTIST AT KESSLER FOUNDATION.

Kessler Foundation, a major nonprofit organization in the field of disability, has partnered with Motek, a leader in virtual reality (VR) rehabilitation technologies, to develop new treatments to improve cognitive and motor impairments in individuals with disabilities.

Mobility deficits due to disease, trauma, or aging, adversely affect a person’s quality of life. Specifically, the inability to adjust one’s gait to one’s environment – such as to maneuver a doorstep, puddle of water or other obstacles – leads to increased risk of falling. Using a VR-based device called C-Mill, investigators at Kessler Foundation are exploring interventions to improve disabling deficits in individuals with multiple sclerosis, spinal cord injury, and stroke. The C-Mill is a state-of-the-art treadmill that trains the user in obstacle avoidance and influences gait pattern by projecting virtual cues on a safe walking surface.

“The flexibility of the C-Mill allows researchers to program for specific environments, enabling better training and evaluation of gait pattern and gait adaptability,” said Guang Yue, PhD, director of Human Performance and Engineering Research at Kessler Foundation. “New technologies such as C-Mill enable researchers to develop universal standards for measuring and improving mobility. This exciting collaboration advances our mission to improve mobility, independence and quality of life for individuals with disabilities caused by a range of neurological conditions.”

Investigators will use advanced brain imaging technology at the Rocco Ortenzio Neuroimaging Center at Kessler Foundation to examine the neurofunctional changes underlying cognitive and motor improvements in individuals in studies testing the C-Mill. The findings of these studies may help reduce loss of independence and improve daily functioning in people with disabilities by providing critical biomarkers for post-intervention changes in learning and memory, fatigue, gait and balance.

“Motek gives clinicians and researchers the tools they need to provide dynamic, high-quality technology solutions that can be customized to meet the patient’s needs,” said Frans Steenbrink, PhD, Head of Clinical Applications & Research at Motek. “With this strategic partnership, Motek and Kessler Foundation aim to facilitate both the integration of our technology in clinical settings and the accommodation of different patient populations. Together, we will create a strong scientific network that will push evidence-based clinical research into the underlying mechanisms of impaired gait and balance control. Furthermore, we hope to extend this strategic partnership with Kessler Foundation to the entire DIH Group, laying the groundwork for numerous future innovations.”

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For more information, or to enroll in a Kessler Foundation study, contact our Research Recruitment Specialist: researchstudies@kesslerfoundation.org.

About Motek

Motek is the global leader in virtual reality and robotics research and rehabilitation, combining almost 20 years of experience in high-level technologies. We excel in building the most versatile devices, integrating latest VR, motion capture and multiple sensory technologies and ensuring real-time feedback, data quality and synchronization. Our treadmill- and balance platform-based systems, arm movement tools or body weight supports are easily interconnected through our in-house software platform. From global knowledge exchange to unique research set-ups: with our all-round support package, we are the perfect partner for every stage of your research on human movement. Motek is a proud partner of DIH International and Hocoma and is part of the DIH Rehabilitation Division.

About Human Performance & Engineering Research at Kessler Foundation

Under the leadership of Guang Yue, PhD, six areas of specialized research are headed by experts in biomechanics, bioengineering, movement analysis, robotics, neurophysiology and neuroimaging. All areas of specialized research contribute to the common goal to improve mobility and motor function so individuals with disabilities can participate fully in school, work, and community activities. Their efforts fuel innovative approaches to address disabling conditions, including brain injury, spinal cord injury, multiple sclerosis, cerebral palsy, arthritis and cancer.

Research is funded by the National Institute on Disability, Independent Living & Rehabilitation Research, National Institutes of Health, Department of Defense, Reeve Foundation, New Jersey Commission on Spinal Cord Injury Research, Craig H. Neilsen Foundation, and Children’s Specialized Hospital.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities.

Learn more by visiting http://www.KesslerFoundation.org.Stay Connected

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via Kessler Foundation partners with Motek to develop new rehabilitation treatments | EurekAlert! Science News

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[WEB SITE] Using Virtual Reality to Make Users Want to Exercise

[VIDEO] High-Tech Treadmill Uses Virtual Reality to Encourage Cardiovascular Fitness

Businesses are finding more uses for Virtual Reality (VR) as the technology develops.

VR is no longer only for gaming or enjoyment. An American company called Blue Goji is using VR to improve one’s health by making exercise more fun.

Blue Goji has offices in Austin, the capital of Texas. The company demonstrated its cardiovascular workout machine, called the Infinity treadmill, at the recent South by Southwest festival. The event is held every year in Austin.

A person using the treadmill wears a virtual reality headset when exercising. Before starting, the user is connected to a belt to prevent falls. Then, the user plays a VR game while running on the machine. The game can transport the user into the virtual world, where he or she can be racing against virtual people.

The cost of the hardware and computer software program is $12,000. That is a lot of money for most people. But Kyra Constam of Blue Goji says the virtual reality treadmill is ideal for places where people go to exercise, like a high-end gymnasium or recreation center. She added that people seeking treatment at physical therapy or rehabilitation centers would find the equipment useful.

Recently, Leonardo Mattiazzi tested the Infinity treadmill. Mattiazzi said he had a strong feeling to actually get running and do something that pushed his limits. He said the experience was more interesting than running inside the gym without actually going anywhere.

Motion sickness less likely

Constam said the active use of virtual reality helps solve a common problem while wearing a VR headset. She noted that a lot of VR experiences cause motion sickness because people are in motion during the game, but not moving in real life. But when the user is moving on the treadmill and in the game, the chances of motion sickness are reduced, she said.

However, users who tested the treadmill while wearing the VR headset each had a different experience. It took Leonardo Mattiazzi 10 seconds to set the controls to running in the virtual world.

VR learning curve

Kyra Constam said there generally is a learning curve for VR. The first time users feel lost, but “the more you do it, the more you get used to it,” she said.

Mark Sackler was a first time user. He said he felt a little sick at one point during the game. But he thought the experience was surprisingly realistic.

After carefully studying the users’ experiences, Blue Goji plans to begin selling the Infinity treadmill to the public in 2019.

VOA’s Elizabeth Lee reported on this story from Texas. Xiaotong Zhou adapted her report for Learning English. George Grow was the editor.

via Using Virtual Reality to Make Users Want to Exercise

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[ARTICLE] Intensity- and Duration-Adaptive Functional Electrical Stimulation Using Fuzzy Logic Control and a Linear Model for Dropfoot Correction – Full Text

Functional electrical stimulation (FES) is important in gait rehabilitation for patients with dropfoot. Since there are time-varying velocities during FES-assisted walking, it is difficult to achieve a good movement performance during walking. To account for the time-varying walking velocities, seven poststroke subjects were recruited and fuzzy logic control and a linear model were applied in FES-assisted walking to enable intensity- and duration-adaptive stimulation (IDAS) for poststroke subjects with dropfoot. In this study, the performance of IDAS was evaluated using kinematic data, and was compared with the performance under no stimulation (NS), FES-assisted walking triggered by heel-off stimulation (HOS), and speed-adaptive stimulation. A larger maximum ankle dorsiflexion angle in the IDAS condition than those in other conditions was observed. The ankle plantar flexion angle in the IDAS condition was similar to that of normal walking. Improvement in the maximum ankle dorsiflexion and plantar flexion angles in the IDAS condition could be attributed to having the appropriate stimulation intensity and duration. In summary, the intensity- and duration-adaptive controller can attain better movement performance and may have great potential in future clinical applications.

Introduction

Stroke is a leading cause of disability in the lower limb, such as dropfoot (1). A typical cause of dropfoot is muscle weakness, which results in a limited ability to lift the foot voluntarily and an increased risk of falls (24). Great effort is made toward the recovery of walking ability for poststroke patients with dropfoot, such as ankle–foot orthoses (5), physical therapy (6), and rehabilitation robot (7).

Functional electrical stimulation (FES) is a representative intervention to correct dropfoot and to generate foot lift during walking (89). The electrical pulses were implemented via a pair of electrodes to activate the tibialis anterior (TA) muscle and to increase the ankle dorsiflexion angle. The footswitch or manual switch was used to time the FES-assisted hemiplegic walking in previous studies, while they were only based on open-loop architectures. The output parameters of the FES required repeated manual re-setting and could not achieve an adaptive adjustment during walking (1011). Some researchers have found that the maximum ankle dorsiflexion angle by using FES with a certain stimulation intensity had individual differences due to the varying muscle tone and residual voluntary muscle activity and varied during gait cycles (1213). If the stimulation intensity was set to a constant value during the whole gait cycle, the result could be that the muscle fatigues rapidly (14). Another important problem was that the FES using fixed stimulation duration from the heel-off event to the heel-strike event would affect the ankle plantar flexion angle (1516).

Closed-loop control was an effective way to adjust the stimulation parameters automatically, and several control techniques have been proposed (1718). Negård et al. applied a PI controller to regulate the stimulation intensity and obtain the optimal ankle dorsiflexion angle during the swing phase (19). A similar controller was also used in Benedict et al.’s study, and the controller was tested in simulation experiments (20). Cho et al. used a brain–computer interface to detect a patient’s motion imagery in real time and used this information to control the output of the FES (21). Laursen et al. used the electromechanical gait trainer Lokomat combined with FES to correct the foot drop problems for patients, and there were significant improvements in the maximum ankle dorsiflexion angles compared to the pre-training evaluations (22). There were also several studies that used trajectory tracking control to regulate the output and regulate the pulse width and pulse amplitude of the stimulation (23). The module was based on an adaptive fuzzy terminal sliding mode control and fuzzy logic control (FLC) to determine the stimulation output and force the ankle joint to track the reference trajectories. In their study, FES applied to TA was triggered before the heel-off event. Because the TA activation has been proven to occur after the heel-off event and the duration of the TA activation changed with the walking speed (2425), a time interval should be implemented after the heel-off event (26). In Thomas et al.’s study, the ankle angle trajectory of the paretic foot was modulated by an iterative learning control method to achieve the desired foot pitch angles (27). The non-linear relationship between the FES settings and the ankle angle influenced the responses of the ankle motion (28). FLC represents a promising technology to handle the non-linearity and uncertainty without the need for a mathematical model of the plant, which has been widely used in robotic control (29). Ibrahim et al. used FLC to regulate the stimulation intensity of the FES (30), and the same control was used on the regulation of the stimulation duration to obtain a maximum knee extension angle in Watanabe et al.’s study (31). However, most closed-loop controls adjust only one stimulation parameter, and few FES controls considered both varying the stimulation intensity and duration while accounting for the changing walking velocities.

In the present study, an intensity- and duration-adaptive FES was established, the FLC and a linear model were used to regulate the stimulation intensity and duration, respectively. The performance of the intensity- and duration-adaptive stimulation (IDAS) was compared with those of stimulation triggered by no stimulation (NS), heel-off stimulation (HOS), and speed-adaptive stimulation (SAS) for poststroke patients walking on a treadmill. The objective of this study is to find an appropriate FES control strategy to realize a more adaptive ankle joint motion for poststroke subjects.[…]

 

Continue —> Frontiers | Intensity- and Duration-Adaptive Functional Electrical Stimulation Using Fuzzy Logic Control and a Linear Model for Dropfoot Correction | Neurology

Figure 4(A) Ankle angles during the gait cycle for one poststroke subject at free speed; (B) knee angles during the gait cycle for the same poststroke subject at free speed.

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[ARTICLE] The Efficacy of State of the Art Overground Gait Rehabilitation Robotics: A Bird’s Eye View – Full Text

Abstract

To date, rehabilitation robotics has come a long way effectively aiding the rehabilitation process of the patients suffering from paraplegia or hemiplegia due to spinal cord injury (SCI) or stroke respectively, through partial or even full functional recovery of the affected limb. The increased therapeutic outcome primarily results from a combination of increased patient independence and as well as reduced physical burden on the therapist. Especially for the case of gait rehabilitation following SCI or stroke, the rehab robots have the potential to significantly increase the independence of the patient during the rehabilitation process without the patient’s safety being compromised. An intensive gait-oriented rehabilitation therapy is often effective irrespective of the type of rehabilitation paradigm. However, eventually overground gait training, in comparison with body-weight supported treadmill training (BWSTT), has the potential of higher therapeutic outcome due its associated biomechanics being very close to that of the natural gait. Recognizing the apparent superiority of the overground gait training paradigms, a through literature survey on all the major overground robotic gait rehabilitation approaches was carried out and is presented in this paper. The survey includes an in-depth comparative study amongst these robotic approaches in terms of gait rehabilitation efficacy.

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Source: The Efficacy of State of the Art Overground Gait Rehabilitation Robotics: A Bird’s Eye View

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[WEB SITE] Gait Trainer™ 3 – Biodex

More than just a treadmill…It is the most important improvement to gait training since the parallel bars.

The Gait Trainer 3 provides audio and visual biofeedback of step length and step speed

The Biodex Gait Trainer™ 3 is more than a treadmill. It is designed with an instrumented deck that issues both audio and visual real-time biofeedback to prompt patients into their correct gait pattern. Step length, step speed and right-to-left time distribution (step symmetry) are directly addressed; patient footfall is compared to desired footfall step after step, both on the display in real time and documented in an easy to read histogram.

The Biodex Gait Trainer is quiet, non-intimidating and allows the therapist to get in there and treat their patients. Real goals are monitored and progress reported. Objective documentation, with comparison to age- and gender-based normative data, helps prove need and document outcomes to family, referring physicians and insurance providers.

The Biodex Gait Trainer 3, with or without the Unweighing System or FreeStep for BWSTT, is suitable for all rehabilitation pathologies. Biodex has recently published Body Weight Support Treadmill Training (BWSTT) with Transition to Over Ground Ambulation: A Clinical Guideline for the Treatment of Patients with Neurological Conditions using Biodex Unweighing System and Gait Trainer. The document classifies the neurologically involved patient, then steps the user through the various phases of recovery for profound,moderate and minimal neurological impairments.

Treadmill Plus… The Gait Trainer 3 also serves as a traditional treadmill, with all the features and benefits of the Biodex RTM600 Rehabilitation Treadmill.

Gait Training SystemGAIT TRAINER 3 + UNWEIGHING
The Biodex Gait Training System

The Gait Trainer provides audio and visual biofeedback of step length and step speed. The Unweighing Support System provides assistance, helping patients regain their confidence, their strength and their stride. The Unweighing System, combined with the Gait Trainer 3 allows every patient the opportunity to get an early start on rehabilitation.

Source: Gait Trainer™ 3 – Treadmills – Physical Medicine | Biodex

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[Abstract] Constraining movement reveals motor capability in chronic stroke: An initial study

Abstract

Objective: To determine if persons with chronic stroke and decreased hip and knee flexion during swing can walk with improved swing-phase kinematics when the task demands constrained gait to the sagittal plane.

Design: A one-day, within-subject design comparing gait kinematics under two conditions: Unconstrained treadmill walking and a constrained condition in which the treadmill walking space is reduced to limit limb advancement to occur in the sagittal plane.

Setting: Outpatient physical therapy clinic.

Subjects: Eight individuals (mean age, 64.1 ±9.3, 2 F) with mild-moderate paresis were enrolled.

Main measures: Spatiotemporal gait characteristics and swing-phase hip and knee range of motion during unconstrained and constrained treadmill walking were compared using paired t-test and Cohen’s d (d) to determine effect size.

Results: There was a significant, moderate-to-large effect of the constraint on hip flexion (p < 0.001, d = –1.1) during initial swing, and hip (p < 0.05, d = –0.8) and knee (p < 0.001, d = –1.1) flexion during midswing. There was a moderate effect of constraint on terminal swing knee flexion (p = 0.238, d = –0.6). Immediate and significant changes in step width (p < 0.05, d = 0.9) and paretic step length (p < 0.05, d = –0.5) were noted in the constrained condition compared with unconstrained.

Conclusion: Constraining the treadmill walking path altered the gait patterns among the study’s participants. The immediate change during constrained walking suggests that patients with chronic stroke may have underlying movement capability that they do not preferentially utilize.

Source: Constraining movement reveals motor capability in chronic stroke: An initial study

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[REVIEW] Mobility and the Lower Extremity | EBRSR – Evidence-Based Review of Stroke Rehabilitation – Full Text PDF

Chapter 9

Mobility and the Lower Extremity

Rehabilitation techniques of sensorimotor complications post stroke fall loosely into one of two categories; the compensatory approach or the restorative approach. While some overlap exists, the underlying philosophies of care are what set them apart. The goal of the compensatory approach towards treatment is not necessarily on improving motor recovery or reducing impairments but rather on teaching patients a new skill, even if it only involves pragmatically using the non-involved side (Gresham et al. 1995). The restorative approach focuses on traditional physical therapy exercises and neuromuscular facilitation, which involves sensorimotor stimulation, exercises and resistance training, designed to enhance motor recovery and maximize brain recovery of the neurological impairment (Gresham et al. 1995).In this review, rehabilitation of mobility and lower extremity complications is assessed. An overview of literature pertaining to the compensatory approach and the restorative approach is provided. Treatment targets discussed include balance retraining, gait retraining, strength training, cardiovascular conditioning and treatment of contractures in the lower extremities. Technologies used to aid rehabilitation include assistive devices, electrical stimulation, and splints.

For evidence tables, please click here.

Source: Mobility and the Lower Extremity | EBRSR – Evidence-Based Review of Stroke Rehabilitation

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[Abstract] Constraining movement reveals motor capability in chronic stroke: An initial study

Abstract

Objective: To determine if persons with chronic stroke and decreased hip and knee flexion during swing can walk with improved swing-phase kinematics when the task demands constrained gait to the sagittal plane.

Design: A one-day, within-subject design comparing gait kinematics under two conditions: Unconstrained treadmill walking and a constrained condition in which the treadmill walking space is reduced to limit limb advancement to occur in the sagittal plane.

Setting: Outpatient physical therapy clinic.

Subjects: Eight individuals (mean age, 64.1 ±9.3, 2 F) with mild-moderate paresis were enrolled.

Main measures: Spatiotemporal gait characteristics and swing-phase hip and knee range of motion during unconstrained and constrained treadmill walking were compared using paired t-test and Cohen’s d (d) to determine effect size.

Results: There was a significant, moderate-to-large effect of the constraint on hip flexion (p < 0.001, d = –1.1) during initial swing, and hip (p < 0.05, d = –0.8) and knee (p < 0.001, d = –1.1) flexion during midswing. There was a moderate effect of constraint on terminal swing knee flexion (p = 0.238, d = –0.6). Immediate and significant changes in step width (p < 0.05, d = 0.9) and paretic step length (p < 0.05, d = –0.5) were noted in the constrained condition compared with unconstrained.

Conclusion: Constraining the treadmill walking path altered the gait patterns among the study’s participants. The immediate change during constrained walking suggests that patients with chronic stroke may have underlying movement capability that they do not preferentially utilize.

 

Source: Constraining movement reveals motor capability in chronic stroke: An initial study

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[Abstract] High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial.  – Europe PMC

Stroke is a major cause of death and long-term disability across the globe. Previous studies have demonstrated the trainability of stroke survivors and documented beneficial effects of aerobic exercises on cardiovascular fitness and gait ability.
The main aim of this study was to compare the effects of a high-intensity treadmill training (HITT) against low-intensity treadmill training (LITT) on gait ability, quality of life, cardiorespiratory fitness and cost of walking in chronic stroke subjects.
Randomized, controlled pilot study.Patients were recruited among Neurorehabilitation Unit outpatient.The sample was composed of 16 subjects suffering from chronic stroke. Subjects were enrolled and randomly allocated either in the HITT (n=8) or in the LITT (n=8). Both groups performed 3-month training, 3 times per week. Subjects were evaluated before starting the training and after the end of the training by mean of clinical scales (Six Minute Walk Test, Ten Meter Walk Test, Health Survey Questionnaire SF-36, Stroke Impact Scale) and instrumental tests (Gait analysis, V02peak and Walking Energy Cost).Fifteen subjects completed the study and no dropouts were observed. One patient in the LITT refused to initiate the training. The HITT group produced greater improvements than LITT group on the Six Minute Walk Test (HITT: 644 meters, LITT: 6 meters; p=0.005) and Ten Meter Walk Test performances (HITT: -1,7 seconds, LITT: 0,6 seconds; p=0.007), stride length (HITT: 3,3 centimetres, LITT: 0,4 centimetres, p=0.003), step length non-paretic side (HITT: 0,5 centimetres, LITT: 2,4 centimetres, p=0.008), step length paretic side (HITT: 1,8 centimetres, LITT: 0,7 centimetres, p=0.004), cadence (HITT: 1,6 step/minute, LITT: 0,6 step/minute, p=0.021) and symmetry ratio (HITT: 0,04, LITT: 0,01, p=0.004), V02peak (HITT: 4,6 ml/kg/min, LITT: 0,87 ml/kg/min; p=0.015) and Walking Energy Cost at 100% of self-selected speed (HITT: -30,8 ml/kg*km, LITT: -20,5 ml/kg*km; p=0.021). Significant changes were found on Six Minute Walk Test (p=0.012) and Ten Meter Walk Test (p=0.042) performances, spatio-temporal gait parameters (stride length p=0.011, step length paretic side p=0.012, cadence p=0.037 and symmetry ratio p=0.012), VO2peak (p=0.025) and cost of walking at 100% of self-selected speed (p=0.018) in the HITT group. In the LITT no significant results were observed.
HITT could be considered a feasible training and led to improvement in gait ability and enhanced VO2peak and reduction in cost of walking compared to LITT. Chronic stroke survivors should be encouraged to engage regular aerobic treadmill training at medium/high intensity. HITT is safe and feasible and has positive effects on gait ability, cardiovascular fitness and cost of walking in subjects with stroke in chronic phase.
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Source: High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke… – Abstract – Europe PMC

 

 

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