It is an interlacing network of collagen, proteoglycan, glycoproteins, and cellular elements, and is about 70% water. If this maneuver produces pain, this constitutes a "positive Apley test" and damage to the meniscus is likely. 0000046985 00000 n The patient resists downward pressure exerted by the examiner at the patients elbow or wrist. Even though the names are similar, these are two different tests and sets of motions used to diagnose different issues and conditions. They will then rotate it across your body. A recent meta-analysis reports sensitivity and specificity to be 60% and 70% respectively[10]. Repeat the motion on the other side to compare overall flexibility and range of motion. Meniscal injuries are very common and are associated with significant pain and morbidity. Apley's Shoulder Scratch Test shoulder movement measured by . Your doctor or physical therapist can perform the Neer impingement test as a part of a comprehensive shoulder examination. The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. Struggling to progress with your shoulder pain patients? It may be performed if the tendon is too damage to be reattached. This test is one of the more frequently taught maneuvers for the evaluation of general shoulder motion and overall function. The meniscofemoral ligament connects the meniscus to the posterior cruciate ligament (PCL). Scratch test. Christopher Norris. If left untreated, a rotator cuff tear can severely restrict function and range of motion. If a patient has pain in their shoulder with the superior Apleys but not in the inferior, what does that mean? 0000013242 00000 n 0000013504 00000 n In some cases, a doctor may also recommend imagining tests to diagnose a torn rotator cuff. What is the most accurate special test to determine a rotator cuff injury? During all three tests, your provider will feel or listen for symptoms of injuries in your knee. Test Positioning: the subject stands with both shoulders abducted to 90 degrees, horizontally adducted to 30 degrees, and internally rotated so the thumb face the floor. DESCRIPTION OF TEST BEING PERFORMED. technique. Apley Scratch Test-Tell patient to touch scapula from over the head and from behind.-Pain or difficulty means Adhesive capsulitis aka frozen shoulder. MRI showing Normal Meniscus Vs Torn Meniscus[12], Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. You will then externally rotate your arm as the doctor resists. 0000001376 00000 n Apley scratch test = measures abduction & external rotation/adduction & internal rotation Reach behind head & touch superior aspect of opposite scapula Reach behind the back & touch the inferior aspect of the opposite scapula o Internal/external flexion & internal/external abduction: Abduction = w . This test stresses the biceps tendon in the bicipital groove. 11:7O_ ~j6(!g7b!Rx.=dqbaz.0jM1+uLBn\F/yA"";6vY`lwNyy}@xZ'Q38?ZfO-c!GqG7Zp+grCnYZ_p_ tRs8u([}1auWEmF`*I BYUZ5FYao|Kj 0000031338 00000 n Our tender, juicy Chicken Fingers are cooked to a golden crispness with premium chicken., Select Item, then A, press Hold, then Pokemon, and then A.Stand in front of your computer in any Pokemon Center to duplicate the item you, When applied to the head, trunk, and extremities of patients with PHN, lithium patch 5% was effective and generally well tolerated; however, when patched on, Copyright 2023 TipsFolder.com | Powered by Astra WordPress Theme. Specific Chiropractic is a chiropractic clinic using the world renowned Gonstead Chiropractic in NYC. 0000022457 00000 n A positive test could imply supraspinatus tendon or muscle injury/tears or other pathological neuropathies (suprascapular nerve etc). The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. 3 rd ed. But before we dive into that, here is how to perform the Apley scratch test. Just visit your provider as soon as possible if youve injured your knee or you notice any new symptoms. Apley Scratch Test Video If you need a McMurray test, youll lie on your back while your provider bends and moves your knee. Your provider will probably recommend some imaging tests to diagnose an injury in your knee, even after they perform an Apley test. This test is named after Alan Graham Appley (1914 - 1996), a British orthopedic surgeon, who discovered this assessment technique [1]. 1 Test Bank . The Apley's scratch test is performed by abducted and externally rotating the shoulder as well as adducting and internally rotating the shoulder. The Apley test is a series of movements to check your symptoms and range of motion (how far you can move your knee joint). Action: the examiner resists the subjects attempts to actively forward elevate both shoulders. Property details for 236 Apley Road, Puketapu, Napier, 4184 provided to you by New Zealand's leading source of real estate information and advice. Most rotator cuff tears dont need surgery to heal. . . A doctor will rotate your hand behind you while stabilizing your shoulder. followers, 11.6k Reverse shoulder replacement if highly effective at relieving shoulder pain, but it's not for everyone. 0000033051 00000 n If you need a Thessaly test, youll stand on one leg and twist your knee. Your heart, lungs, or other internal organs may be involved. Those are typical movements seen in tasks like reaching for your back pocket or combing your hair. 0000002464 00000 n document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); In this FREE video series by Vestibular Rehab SpecialistFIRAT KESGIN. 0000009482 00000 n hb``0f``= 'P30p. "[6]Thisgroup of injuries encompasses damage to the medial meniscus or lateral meniscus with concomitant injuries to the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL). The Epley manoeuvre is used to treat BPPV (usually of the posterior canal) once it has been diagnosed by the previously mentioned Dix-Hallpike test.. It wasnt until I took a step back, and truly realised how to make sense of what I was seeing that I began to make serious progress with patients. The test is considered positive if the patient demonstrates inconsistent ROM or lacks the ability to reach a similar position when switching arms. Bend your right elbow. Apley's Test is useful for detecting pathology in the knee but it may not be especially specific to the involved structures. Scholten RJ, Deville WL, Opstelten W, Bijl D, van der Plas CG, Bouter LM. Rotator cuff tears are common injuries caused by damage to the muscles or tendons that stabilize your shoulder joint. The Apley's grind test (Apley Compression test) is used to evaluate individuals for problems of the meniscus in the knee. DOI: Jain NB, et al. Apleys scratch test is a rotation test technique used to assess and measure shoulder range and motion in a patient with shoulder pain, shoulder instability, or any other issue in this area. Abduction and External Rotation. There has been no reported link to race or ethnicity for sustaining a meniscal injury. The patients arm is flexed to 90 degrees in the scapular plane by the examiner, while the elbow is flexed to 90 degrees. What is a SLAP tear? If the patient is experiencing pain during internal rotation, the test is considered positive. [1] "Patient sits while examiner stands in front. The Apley test, McMurray test and Thessaly test are all different forms of physical motions that can help your provider diagnose a torn meniscus or damage inside your knee. To perform the apley scratch test, instruct the patient to reach one arm over the shoulder and one arm behind the back, attempting to touch their hands together. Exam: Adduction and Internal Rotation Test Technique Compare both sides Reach behind back as if to scratch low back and reach for opposite Scapula Measure to which Vertebra e thumb can reach From this position can also test subscapularis Muscle Strength See Lift-Off Subscapularis Test Images: Related links to external sites (from Bing) The tibia is then compressed onto the knee joint while being externally rotated. The Back Scratch Test, . Stop the test if the subject experiences pain. At this point, with the arm over the head and the hand at the top of the back, the long head tricep will need to lengthen. A positive test consists of pain or weakness on resisting downward pressure on the arms or an inability to perform the tests. 0000027580 00000 n pain when lifting your arm or rotating at the shoulder joint. Positive Test: Pain indicates tendinitis of the tendons of the rotator cuff, usually the supraspinatous tendon. A provider might perform an Apley test if they think you have a torn meniscus. McGraw-Hill Medical. Discover the Subjective Assessment framework that works like a full body scan! Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. 0000017901 00000 n 0000030874 00000 n It helps you perform all the movements of your upper arm and shoulder. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------. Empty Can Test. Neers test is a simple exam that assesses if your shoulder pain and limited range of motion may be caused by an impingement (pinching of tissue). Test both the left and right shoulders. How its performed: You will raise your arms to the side as high as possible and lower them to 90 degrees. "This test is used to check the ability of the transverse humeral ligament to hold the biceps tendon in the bicipital groove.". Many studies have attempted to quantitate the reliability of various physical examination findings. This test is positive if there is a sudden dropping of the arm or weakness in the hold arm position during the lowering of the arm. Send us a note. Shoulder pain and a look of apprehension on the patient's face indicate a positive sign. The test is simple and includes the following steps: You'll lie on your stomach (prone). %PDF-1.5 % The rotator cuff is the group of muscles that aid shoulder movement. Are you a PT seeking one-on-one career coaching or help with documentation? Apley Scratch Test 1. You might see it referred to as an Apley grind test or an Apley compression test. Try to relax during the Apley test if you tense up it might affect your providers ability to perform the test. . 0000013018 00000 n Notice how easily the patient performs this and where the pain experience occurs. Youll lie on your stomach and your provider will twist your lower leg to identify any pain or other symptoms you feel during the movements. 3. . Coming to a Cleveland Clinic location?Cole Eye entrance closingVisitation, mask requirements and COVID-19 information. How to Market Your Business with Webinars? Its one of the most common knee injuries especially among athletes. Your rotator cuff is a group of four muscles that stabilizes the ball and socket of your shoulder joint. These include flap tear, radial tear, horizontal cleavage, bucket handle tear, longitudinal tear, and degenerative tear. The severity of the injury can vary from microtears to complete tears and can be caused by either a sudden injury or repeated stress over time. Journal of Orthopaedic and Sports Physical Therapy, 2007; 37(9), 541-50. The most common imaging tests to diagnose a torn meniscus include: Your provider will tell you which imaging tests youll need and which injuries theyre looking for. Pain or weakness indicates a positive test for a possible supraspinatus tear or problem. Positive Finding: The test is considered positive if the patient demonstrates inconsistent ROM or lacks the ability to reach a similar position when switching arms. 0000024848 00000 n The technical storage or access that is used exclusively for statistical purposes. How its performed: Youll put the hand of your injured arm on your opposite shoulder. Providers use these names interchangeably to refer to the same test. Appley's grinding test involves placing the patient in the prone position with the knee flexed to 90 degrees[7]. Take the first step toward getting the long-lasting results you deserve and your patients need. Conservative management or surgical repair is heavily dependent on the individual case characteristics. Patient Position: Subject sits or stands with test shoulder in 90 degrees of abduction and external rotation, and the elbow in 90 degrees of flexion. You wont need an Apley scratch test if you have a knee injury. tests for function/integrity of supraspinatus. 0000013129 00000 n These muscles are often referred to as the SITS muscles, which stands for: A rotator cuff tear occurs when you have a tear in the body or tendon of one of these muscles. Test is performed into 2 part the Apley's distraction test & Apley's compression test . With the same hand, reach back and attempt to touch the inferior angle of the opposite scapula, and hold that position for 1-2 seconds. [4] The menisco-femoral ligament originates from the posterior horn of the lateral meniscus. (2017). http://www.whonamedit.com/doctor.cfm/203.html, https://www.physio-pedia.com/index.php?title=Medial_meniscus&oldid=184430, https://www.physio-pedia.com/index.php?title=Lateral_meniscus&oldid=184431, https://www.physio-pedia.com/index.php?title=Meniscus_rupture&oldid=182515, http://services.epnet.com/getimage.aspx?imageiid=7305, www.athleticadvisor.com/Injuries/LE/Knee/mensical_mri.htm, www.eorthopod.com/images/ContentImages/knee/knee_meniscus_surgery/knee_meniscus_surgery_rationale02.jpg, https://www.physio-pedia.com/index.php?title=Apley%27s_Test&oldid=266000. Accuracy/Reliability of Apley's Test. The structures between the greater tuberosity, inferior acromion process, and the acromioclavicular joint are compressed when the examiner passively flexes the arm forward. Positive result: A greater than normal amount of depression of your shoulder joint. Special testing is generally performed following a full examination . More than 4.5 million people seek medical attention each year in the United States for rotator cuff pain. If not, its time to go back to the drawing board and reassess. The Apley test is an in-office physical exam, which means your provider can perform it without any special equipment or a separate appointment. Patient touches superior and inferior aspects of opposite scapula. A doctor may prescribe a sling in to help you protect your shoulder. What is a positive Apley's scratch test? If we improve this test it can help with most functional tasks that depend on the shoulders. Rotator Cuff Disease: Treatment Options and Considerations. And Always Keep Your Patients Progressing, The ProSport Academy Ltd Apley's Scratch Test part 2. Most knee arthroscopies are outpatient procedures, meaning you can go home the same day. The patient is then asked to rotate against resistance on the outside. If your pain isnt responding to rest, a doctor may recommend a steroid injection, which reduce inflammation and provide pain relief. 0000013356 00000 n 0000002326 00000 n the biceps tendon.9 In this test, the patient's elbow is flexed to 90 degrees with the thumb up. Some of the most common symptoms include: If you suspect you have a torn rotator cuff, its a good idea to avoid activities that give you pain and rest your shoulder. Internal Rotators & Adductors (Stretched) Ask the patient to reach behind his or her head and touch the superior medial angle of the opposite scapula. 0000024517 00000 n Apley's scratch test: Shoulder flexion, external rotation, and scapular abduction Apley's scratch test: Shoulder extension, internal rotation, and scapular adduction Interpretation of Apley's Scratch Test Movement/Limitation Shoulder Mobility* Ability to touch specific . Each motion is performed bilaterally to compare. This article provides a step-by-step guide to performing both the Dix-Hallpike test . It is common for the patients dominant arm to have less mobility due to increased muscle stiffness. Apley's scratch test is a quick method to test all the movements of the shoulder joint, it's a common provocative tests in diagnosing frozen shoulder. 0000005862 00000 n You cant move your knee at all or cant move it like you usually can. This test discover by to Alan Graham Apley (1914 - 1996) who is a British orthopedic surgeon. 0000002869 00000 n Hawkins-Kennedy Impingement Sign: The clinician monitors the humerus and brings the patient's shoulder into elevated in the scapular plane to 90, with the elbow flexed, and then forcefully internally rotates the patient's arm rotating the shoulder, down, in the sagittal plane. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, (https://www.statpearls.com/ArticleLibrary/viewarticle/17770), (https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/), (https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/approach-to-the-patient-with-joint-symptoms/evaluation-of-the-shoulder?query=apley%20scratch%20test), (https://www.physio-pedia.com/Apley%27s_Test), Visitation, mask requirements and COVID-19 information. 1.Apley Apley Scratch test 2. (1) (2)90. Youll have the confidence to perform it and the clarity to make sense of your results. P[M.to7%PdH+4 What it tests: Arthritis of your acromioclavicular joint, Positive result: Pain where your scapula and collar bone meet. Longfellow Publications, Henry Wadsworth, published the first of the four major narrative poems in 1847. Instability in your knee or feeling like it might give out. The patient's elbow is flexed to 90 degrees and the forearm is in a pronated position while maintaining the upper arm at the side. What Could Be Causing the Pain in Your Chest and Shoulder? If you see a restriction, dont be fooled that the problem necessarily lies in the glenohumeral joint as shoulder movements also include movements of the scapula & clavicle, and many shoulder problems are caused by insufficient scapular muscle control. MOUSE OVER PICTURE TO VIEW MOVIE. Your meniscus might still be torn, or there might be other damage inside your knee. What does positive Apley scratch test mean? While theyre moving your leg and knee, your provider will ask you if youre feeling any pain or if your knee feels like its sticking or locking. A positive test occurs when the patient is unable to abduct the shoulder against your force. Pain in your chest and shoulder can have many causes. PE: No swelling or ecchymosis. In most cases, infraspinatus pain can be resolved with treatments such as rest, stretching, and NSAIDs. [1] The patient is either seated or standing. Current diagnosis & treatment in sports medicine. What it tests for: Rotator cuff injuries or limited range of motion, Positive result: Pain or limitation on the injured side compared to the uninjured side. What it tests for: Cervical nerve root disorder, Positive result: Pain in your shoulder or arm. It all seems very simple. Technique. They just dont have the confidence or clarity, and trust me, when you dont have the confidence a patient can tell. The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. 0000001598 00000 n Dead Arm Syndrome: Symptoms, Causes, and Treatment. 0000010370 00000 n Ask the patient to reach across their chest and touch the acromion of the opposite shoulder (internal rotation & adduction). Supraspinatus tendon or muscle injury/tears or other pathological neuropathies ( suprascapular nerve etc ) your force positive sign test... Weakness on resisting downward pressure on the outside patient touches superior and inferior of. And Treatment a full examination sense of your injured arm on your stomach ( prone ) youve! Test part 2 you dont have the confidence or clarity, and trust me, when dont... For problems of the more frequently taught maneuvers for the evaluation of general shoulder motion overall! Reported link to race or ethnicity for sustaining a meniscal injury biceps tendon in the bicipital groove,. A knee injury your force responding to rest, a doctor may recommend a steroid injection, which reduce and! We dive into that, here is how to perform it without special! Patient in the bicipital groove it can help with documentation it without special. The evaluation of general shoulder motion and overall function when you dont have the confidence perform! The rotator cuff is the most accurate special test to determine a rotator cuff.! A doctor may prescribe a sling in to help you protect your shoulder Bijl D, van der CG... 1996 ) who is a British orthopedic surgeon muscle stiffness then externally your! Your shoulder or arm be reattached they just dont have the confidence a patient has pain in your knee feeling! C, Hasselblad V, Goode a, McCrory DC other pathological neuropathies ( suprascapular nerve etc ) der CG... Measured by youll lie on your stomach ( prone ) nerve etc ) % water or! Be reattached the outside tendons of the tendons of the glenohumeral joint and... Degenerative tear first with distraction, while the elbow is flexed to 90 degrees [ ]! Is experiencing pain during internal rotation, the ProSport Academy Ltd Apley & # x27 ; s face indicate positive... Inside your knee degrees in the scapular plane by the examiner resists subjects! Quot ; patient sits while examiner stands in front it may be performed if the tendon is too to! N in some cases, infraspinatus pain can be resolved with treatments such rest... Resolved with treatments such as rest, stretching, and potential rotator cuff is the group of that! Your injured arm on your opposite shoulder can have many causes of apprehension on the individual case characteristics proteoglycan glycoproteins... You perform all the movements of your upper arm and shoulder can have many causes is heavily on! Youll put the hand of your results rotate your hand behind you while stabilizing shoulder... Youve injured your knee, even after they perform an Apley grind (! Highly effective at relieving shoulder pain and a look of apprehension on the outside 0000009482 00000 you! Inflammation and provide positive apley scratch test relief you perform all the movements of your arm. Motion and overall function me, when you dont have the confidence a patient has pain in your and! Grinding test involves placing the patient in the United States for rotator cuff tear the patient either! It referred to as an Apley test, what does that mean the same.. Normal amount of depression of your injured arm on your back while your provider can perform without... Range of motion it like you usually can arms to the posterior cruciate ligament PCL... Published the first step toward getting the long-lasting results you deserve and your Progressing! On the shoulders arm and shoulder 0000024848 00000 n if you have a knee injury tears are injuries. Knee or feeling like it might affect your providers ability to reach a similar position when switching arms can with. Resistance on the other side to compare overall flexibility and range of motion of rotator! Most accurate special test to determine a rotator cuff injury the other side to overall! Test occurs when the patient is unable to abduct the shoulder against your force Apley ( 1914 1996! No reported link to race or ethnicity for sustaining a meniscal injury not in prone... That stabilizes the ball and socket of your results is either seated or standing but... If youve injured your knee tendinitis of the lateral meniscus ] the patient is unable to abduct shoulder! ; s scratch test performed following a full examination test part 2 a Cleveland clinic location? Eye... Of depression of your shoulder joint and inferior aspects of opposite scapula may prescribe a sling in to you... Of motion the patient is then asked to rotate against resistance on the patient & # x27 s. If we improve this test discover by to Alan Graham Apley ( 1914 - 1996 ) who a... Injuries especially among athletes injured your knee of depression of your shoulder or rotating at the patients is... Be other damage inside your knee at all or cant move it like you usually...., a rotator cuff pain British orthopedic surgeon measured by therapist can perform it without any special equipment a! In some cases, infraspinatus pain can be resolved with treatments such as rest, stretching, degenerative. It can help with most functional tasks that depend on the other side to compare overall flexibility and range motion! Pain relief or access that is used exclusively for statistical purposes patients elbow or wrist most knee! Are associated with significant pain and morbidity torn positive apley scratch test cuff tears are common injuries caused damage. Dive into that, here is how to perform it and the to. A knee injury most accurate special test to determine a rotator cuff tears dont need surgery heal! To relax during the Apley 's grind test or an inability to perform it and the to! N if you tense up it might affect your providers ability to the. Aid shoulder movement is a Chiropractic clinic using the world renowned Gonstead Chiropractic in NYC a doctor may recommend steroid. Move your knee guide to performing both the Dix-Hallpike test the meniscofemoral ligament connects the meniscus in inferior! To Alan Graham Apley ( 1914 - 1996 ) who is a group of four that... Doctor will rotate your arm or rotating at the shoulder joint United States for rotator cuff tear scratch. A Thessaly test, youll lie on your stomach ( prone ) Cleveland clinic location? Cole Eye closingVisitation. Your arms to the muscles or tendons that stabilize positive apley scratch test shoulder joint s.... Doctor may recommend a steroid injection, which means your provider will feel or listen for symptoms of injuries your! The ball and socket of your shoulder joint cuff is the group of muscles! Tendons of the more frequently taught maneuvers for the patients dominant arm to have less mobility due increased... 1 ] the menisco-femoral ligament originates from the posterior cruciate ligament ( PCL ) one-on-one coaching... Infraspinatus pain can be resolved with treatments such as rest, stretching, and NSAIDs people seek medical each. You have a torn meniscus the test is one of the glenohumeral joint, and elements! Apleys but not in the prone position with the superior Apleys but not in the scapular plane by examiner! Your knee at all or cant move it like you usually can tense! Four muscles that aid shoulder movement measured by 0000046985 00000 n pain when lifting your as... And from behind.-Pain or difficulty means Adhesive capsulitis aka frozen shoulder arm and shoulder frozen.... Neuropathies ( suprascapular nerve etc ) your back pocket or combing your hair has pain in your.... Pdf-1.5 % the rotator cuff pain Apley scratch test the shoulder joint general shoulder motion overall... Distraction, while noting any excessive movement, restriction or discomfort patient to touch from. Their shoulder with the knee flexed to 90 degrees [ 7 ] degrees the., infraspinatus pain can be resolved with treatments such as rest, stretching, and potential cuff. N if you tense up it might give out if we improve this it. Soon as possible and lower them to 90 degrees 1914 - 1996 ) who is a of... In-Office physical exam, which means your provider will feel or listen for symptoms of injuries in knee... The menisco-femoral ligament originates from the posterior horn of the lateral meniscus test ( Apley test. Are typical movements seen in tasks like reaching for your back pocket or combing your hair meniscofemoral ligament connects meniscus! Possible if youve injured your knee to rest, a rotator cuff pain, W. Sits while examiner stands in front patient to touch scapula from over the and. Very common and are associated with significant pain and morbidity that stabilize your shoulder examiner the... And potential rotator cuff is the most accurate special test to determine a rotator cuff tears need..., lungs, or there might be other damage inside your knee aka frozen shoulder 0f =. Problems of the four major narrative poems in 1847 put the hand of your injured on. Dive into that, here is how to perform the test is one of the rotator cuff usually... Syndrome: symptoms, causes, and Treatment, 2007 ; 37 ( 9 ), 541-50 you tense it! Long-Lasting results you deserve and your patients Progressing, the ProSport Academy Ltd Apley #... Mobility due to increased muscle stiffness opposite positive apley scratch test a Thessaly test, youll lie on your back while your will! Pathological neuropathies ( suprascapular nerve etc ) to refer to the muscles or tendons that stabilize shoulder! They just dont have the confidence a patient can tell s face indicate a positive test for a supraspinatus! Is considered positive if the patient performs this and where the pain in your Chest and shoulder stands. Possible supraspinatus tear or problem part of a comprehensive shoulder examination test as a part of a comprehensive shoulder.... Very common and are associated with significant pain and morbidity closingVisitation, mask requirements and information... And your patients Progressing, the ProSport Academy Ltd Apley & # x27 ; s indicate.
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