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Trial registered on ANZCTR
Registration number
ACTRN12616001288415
Ethics application status
Approved
Date submitted
1/09/2016
Date registered
13/09/2016
Date last updated
18/07/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Repetitive Exercise for People after Stroke (REPS): a pilot randomised controlled trial
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Scientific title
Repetitive Exercise for People after Stroke (REPS): effects on functional performance.
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Secondary ID [1]
290053
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acquired Brain Injury
300106
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Stroke - Haemorrhagic and Ischaemic
300107
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Condition category
Condition code
Neurological
299989
299989
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0
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Other neurological disorders
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Injuries and Accidents
300054
300054
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0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants allocated to the experimental group will receive usual care (see Usual care) and a 2-week package of exercises and strategies that will provide them with additional opportunities to practice a functional task*.
This package will include a range of strategies* individualised to the needs of the participant for increasing the amount of practice of a functional task. Participants will be required to perform as many repetitions of this task as they can per day.
*Details of functional tasks and strategies used to increase repetitive practice have been omitted to minimise contamination between groups.
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Intervention code [1]
295806
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Rehabilitation
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Comparator / control treatment
Participants allocated to the control group will receive usual care (see Usual care),
Usual care
Usual care for both groups will consist of two one-hour sessions of physiotherapy a day and will include one-to-one or group therapy with a physiotherapist. This therapy will involve strength, endurance, balance and coordination exercises as well as task-specific practice of sitting, sitting-to-standing, standing, and walking. All exercises will be tailored to the needs of each participant.
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Control group
Active
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Outcomes
Primary outcome [1]
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Clinicians’ impression of functional change over two weeks
A video recording of a participant performing a functional task* will be taken at baseline and again at two weeks. A Global Impression of Change (GIoC) scale will be used to rate the functional change of a participant. The GIoC scale is a 15-point scale with -7 representing ‘very much worse’, 0 representing ‘no difference’, and +7 representing ‘very much better’. A mean between-group difference of 2/15 points is considered clinically important.
*Details of functional tasks have been omitted to minimise contamination between groups.
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Assessment method [1]
299471
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Timepoint [1]
299471
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Baseline and at 14 days (Two weeks)
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Secondary outcome [1]
327285
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Sit-to-Stand (STS) ability
STS ability will be assessed using the STS item of the Mobility Scale for Acute Stroke Patients (MSAS). This item will be rated on a 6-point scale based on level of assistance required to complete the task of STS with a score of 1 denoting inability to complete the task and a score of 6 denoting completion of the task unassisted and safely.
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Assessment method [1]
327285
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Timepoint [1]
327285
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Baseline and at 14 days (Two weeks)
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Secondary outcome [2]
327286
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Composite strength of the key muscles of the affected lower limb
The strength of the hip extensors, knee extensors, and plantar flexors will be assessed using manual muscle testing. Scores for the three muscle groups will be combined and treated as a composite measure of lower limb extensor strength, with 15 points representing the maximum score.
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Assessment method [2]
327286
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Timepoint [2]
327286
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Baseline and at 14 days (Two weeks)
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Secondary outcome [3]
327287
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Gross lower limb extension strength
Gross lower limb extension strength will be measured using an inclinometer on a sliding tilt table. A participant will be transferred to a sliding tilt table and positioned with only their affected lower limb on the foot plate and knee placed in 60deg flexion. The tilt table will be raised and the participant will be instructed to extend their lower limb. The highest degree of incline against which the participant can extend their lower limb will be recorded.
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Assessment method [3]
327287
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Timepoint [3]
327287
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Baseline and at 14 days (Two weeks)
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Secondary outcome [4]
327288
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The Goal Attainment Scale (GAS)
Prior to baseline assessments, participants will identify one personal goal related to a functional task* in conjunction with a physiotherapist. The goal will be set according to the SMART principle, that is, the goal will be specific, measurable, attainable, realistic and timely. A blinded assessor will rate attainment of the goal at the 2-week assessment. The goal will be rated on a 5-point scale, where “0” denotes the expected level of achievement; “+1” and “+2” are respectively “a little” and “a lot” better than expected, whilst “-1” and “-2” are correspondingly “a little” and “a lot” less than expected. A higher score will reflect better achievement of goals than a lower score.
*Details of functional tasks have been omitted to minimise contamination between groups.
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Assessment method [4]
327288
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Timepoint [4]
327288
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Baseline and at 14 days (Two weeks)
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Secondary outcome [5]
327370
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Ranking of change in participants' ability to perform a functional task*
A blinded assessor will rank each of the 30 participants in order from most improved to least improved. The assessor will use the videos collected as part of the primary outcome to determine participants’ ranking.
*Details of functional tasks have been omitted to minimise contamination between groups.
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Assessment method [5]
327370
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Timepoint [5]
327370
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Baseline and at 14 days (Two weeks)
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Eligibility
Key inclusion criteria
Diagnosis of a first time stroke or any other acquired brain injury (ABI) that is not progressive
Acute event < 6 months before the study onset
Sufficient communication skills to indicate yes/no verbally or via gestures
Sufficient cognition to consent or consent will be obtained from the person responsible
Stroke/ABI has affected the ability to STS
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Limited joint range of movement or musculoskeletal conditions that would prevent participation
Inability to participate in exercise i.e. Medically unwell
Unable to follow instructions
Expected length of stay of < 2 weeks
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/09/2016
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Actual
22/09/2016
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
26
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Graythwaite Rehabilitation Centre
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Address [1]
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Graythwaite Rehabilitation Centre
Ryde Hospital
Denistone Road
Eastwood
NSW 2122
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Country [1]
294421
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Australia
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Primary sponsor type
Individual
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Name
Davide de Sousa
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Address
Graythwaite Rehabilitation Centre
Ryde Hospital
Denistone Road
Eastwood
NSW 2122
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Prof. Lisa Harvey
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Address [1]
293271
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John Walsh Centre For Rehabilitation Research
Kolling Institute
Northern Sydney Local Health District
Royal North Shore Hospital
St Leonards
NSW 2065
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Country [1]
293271
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Sydney Coast Human Research Ethics Committee
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Ethics committee address [1]
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Level 13, Kolling Building Royal North Shore Hospital St Leonards NSW 2065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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27/07/2016
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Approval date [1]
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12/08/2016
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Ethics approval number [1]
295846
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HREC/16/HAWKE/252
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Summary
Brief summary
Following acquired brain injury (ABI) caused by stroke or trauma many people cannot move around independently due to motor impairments such as weakness and poor coordination. These people require intensive repetitive practice to improve their ability to move around. Therefore the aim of this study is to determine if a two-week intensive package of functional training improves functional performance more than usual care in people with ABI admitted to a sub-acute ward for rehabilitation. Experimental design: An assessor blinded randomised controlled trial will be conducted. Each participant will be randomly allocated to an experimental or control group using the principles of concealed allocation. Participants allocated to the experimental group will receive usual care and a 2-week package of exercises and strategies that will provide them with additional opportunities to practice a functional task. This package will include a range of strategies individualised to the needs of the participant for increasing the amount of practice of a functional task. Participants allocated to the control group will receive usual care. Usual care for both groups will consist of two one-hour sessions of physiotherapy a day and will include one-to-one or group therapy with a physiotherapist. This therapy will involve strength, endurance, balance and coordination exercises as well as task-specific practice of sitting, sitting-to-standing, standing, and walking. All exercises will be tailored to the needs of each participant. Participants: 30 consecutively admitted patients to a sub-acute general adult rehabilitation unit.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Davide de Sousa
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Address
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Physiotherapy Department
Graythwaite Rehabilitation Centre
Ryde Hospital
Denistone Road
Eastwood
NSW 2122
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Country
34759
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Australia
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Phone
34759
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+61298587144
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Fax
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Email
34759
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[email protected]
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Contact person for public queries
Name
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Davide de Sousa
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Address
18006
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Physiotherapy Department
Graythwaite Rehabilitation Centre
Ryde Hospital
Denistone Road
Eastwood
NSW 2122
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Country
18006
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Australia
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Phone
18006
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+61298587144
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Fax
18006
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Email
18006
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[email protected]
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Contact person for scientific queries
Name
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Davide de Sousa
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Address
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Physiotherapy Department
Graythwaite Rehabilitation Centre
Ryde Hospital
Denistone Road
Eastwood
NSW 2122
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Country
8934
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Australia
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Phone
8934
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+61298587144
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Fax
8934
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Email
8934
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Study results article
Yes
https://www.sciencedirect.com/science/article/pii/...
[
More Details
]
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Two weeks of intensive sit-to-stand training in addition to usual care improves sit-to-stand ability in people who are unable to stand up independently after stroke: a randomised trial.
2019
https://dx.doi.org/10.1016/j.jphys.2019.05.007
N.B. These documents automatically identified may not have been verified by the study sponsor.
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