Abstract

An investigation of existing lit- erature reveals that guitar players are most prone to musculoskeletal injuries amongst all musicians. In the light of recent injuries to prominent guitar players such as Eddie Van Halen, this article ex- plores ergonomics of electric gui- tars. Viewing the problem from various lenses -- surveys, obser- vation, biomechanical analysis, laboratory measurements -- allows zooming in to the issue to deter- mine the root of the problem. Bad posture while playing and lack of balance in the instrument seem to be the two prominent issues that are omnipresent. The article cul- minates with the design of an elec- tric guitar that presents a solution to the ergonomic issues associated with the existing design.
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Tijdschrift voor Ergonomie jaargang 38 nr. 2 juni 2013
North Texas Musician Health Survey, out of 520 electric
guitar players, 74% experienced one or more musculoskel-
etal problems (Fjellman-Wiklund e.a., 2006). In another
survey with 261 professional and student guitars, most com-
mon reported location was the fretting hand (40%) fol-
lowed by back and neck (17% and 14%) (Rigg e.a., 2003).
Postures that require flexion at the elbow and wrist togeth-
er with rotation and upward turning of the palm (supina-
tion) – for example, the left hand position while playing the
violin or guitar – present a risk of cubital tunnel syndrome
(Chong e.a., 1989). Musicians are also likely to develop epi-
condylitis when playing instruments, like the guitar,
because of complex postures with rotation of forearms,
bending of wrist and independent finger movements. (Fry,
1986; Chong e.a., 1989). Carpel Tunnel Syndrome is common
amongst guitar players, not only because of playing exces-
sively, but also a cumulative effect of poor posture com-
bined with other activities that employ using the hands
excessively with little movement of the body (Sternbach,
1991).
MSI has become common in the music industry. Some of
the top players of the era, such as Eddie Van Halen and
Dave Mustaine, have been diagnosed with MSI multiple
times putting their entire careers at risk. It can be con-
cluded that guitar players are pushing the limits of physical
ability, but putting more strain on their body. A new design
of an electric guitar that not only compliments a musicians
ever growing repertoire but also aids in his development
while minimizing the risk of injuries is needed.
Goal
The focus of the project was on understanding why guitar
players get injuries and device a solution for prevention of
MSI. Based on the analysis of probably injury causes, an
ergonomic guitar design with the aim to reduce discomfort
An investigation of existing literature reveals that guitar
players are most prone to musculoskeletal injuries amongst
all musicians. In the light of recent injuries to prominent
guitar players such as Eddie Van Halen, this article explores
ergonomics of electric guitars. By means of surveys, user
observations, biomechanical analysis and laboratory
measurements, the root of the problem has been deter-
mined. Bad posture while playing and high wrist flexion
seem to be the two prominent issues that are omnipresent.
The article culminates with the design of an electric guitar
that presents a solution to the ergonomic issues associated
with the existing design.
Introduction
A musician is a unique form of an athlete. The physical
demands on the muscles and tendons of a guitarist may not
be far from those of a sportsman. The difference is that
playing music usually involves smaller muscles which are
more prone to repetitive strain injuries. Although profes-
sional athletes constantly train with physiotherapists, most
musicians do not even realize the amount of strain they put
on their bodies, until they are down with injury. Lead-ing
guitar manufacturers continue to produce models that
were designed in the ‘50s, even though musculoskeletal
injuries amongst guitarists have become common.
Playing a musical instrument may be second only to com-
puter use in terms of population exposure to a risk factor
for MS I or Musculoskeletal Injury (Morse e.a., 2000). Some
studies have shown that approximately half of professional
musicians and music students experience significant symp-
toms (Chong e.a., 1989; Fry, 1986; Norris, 1993; Zaza, 1998).
Although MSI is common across the entire industry, the risk
of MSI is apparently greater for string players (such as gui-
tar) and keyboardists (such as piano) than other musicians
(Zaza & Farewell, 1997). In a study done by University of
Gaurav Genani, Marijke Dekker and Johan Molenbroek
Design of an ergonomic electric guitar
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44
while playing and prevent musculoskeletal injuries is
described in this paper.
Analysis
To determine the requirements for an ergonomic electric
guitar, various techniques were used. These include user
surveys and discussions, observations and laboratory study.
User survey
A questionnaire was sent to a number of guitar players,
both amateur and professional, with varied experience to
determine the complaints of a sample population. They
were asked to describe their playing habits and introspect
on their experience with the instrument through both open
and close ended questions. 25 guitarists from different
parts of the world responded to the questionnaire. The list
included amateur hobbyists, music students (including PhD
candidates) and professional musicians with upto 25 years
of experience.
Most experienced guitarists practice about two hours a day.
80% of the time, users prefer to play in a sitting position.
Most users concurred practicing while sitting causes back
pain, whereas practicing while standing leads to neck pain,
after prolonged playing. Almost 75% reported one or more
of lower back pain, left wrist ache and pain in shoulder and
neck.
User Observation
It was observed that playing the electric guitar in a neutral
sitting posture poses certain challenges. The guitar is usu-
ally supported on the users lap and has a natural tendency
to rotate in the coronal plane known as ‘neck dive’ (figure
1a). As a result, the user needs to hold the guitar in his pre-
ferred position using his arms even while playing (figure 1b).
Neck dive is an issue while standing as well. A strap is used
to fasten the guitar around the neck and torso. The guitar
neck tends to become horizontal to keep its balance. The
effect is strongest for bass guitars where the neck is longer
and heavier, and extended range guitars that have more
than 6 strings.
Most users were in spinal kyphosis while playing in the sit-
ting posture. This allowed them to see the guitar neck when
it rests horizontally in the normal sitting posture (figure 3).
Neck flexion and spinal kyphosis result in unfavorable loads
on the musculoskeletal structure. Even slight neck flexion
creates a bending moment three times greater than the
neutral position in the C7T1 joint (Harms-Ringdahl, 1986).
The existing design of the guitar body does not take into
consideration size of the user. For most users, guitar neck
was too low and some users prefer to use a guitar strap
Figure 1a. Guitar neck tends
to ‘dive’ down
Figure 2. User standing with the guitar in three different
positions according to strap length; the tendency to neck
dive increases as the strap length increases
Figure 3. Most users can be seen in a ‘drooping’ posture which
allows them to see the fretboard (neck) while playing
Figure 1b. Guitar neck needs
to be held in position while
playing
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Tijdschrift voor Ergonomie jaargang 38 nr. 2 juni 2013
even while sitting to allow for height adjustment of the
neck as per their preference.
However, the conventional C shaped profile is inherently
unstable as can be seen in the figure 5. When a force is
applied to fret the string, the thumb tends to rotate about
the curvature requiring constant adjustment in the direc-
tion of applied thumb force.
Another aspect of observation was the grip. It was observed
that the grip is not constant, but keeps changing as one plays
different passages at various locations of the fretboard.
Most players predominantly use one of the following three
grips : (a) classical, (b) pinch and (c) thumb around (figure 4).
Wrist flexion was commonly observed in electric guitar
players. It was observed that there are some instances dur-
ing the act of playing where wrist flexion was really high.
Laboratory Study
High wrist flexion observed during playing was considered
an important factor that contributes to MSI in guitar play-
ers. Further analysis was carried out to study the range of
wrist flexion and device means to reduce it.
One hypothesis is that wrist flexion can be reduced by
allowing the neck to be oriented at an angle to the horizon-
tal (figure 6).
A goniometric study was done in which wrist flexion and
ulnar deviation were measured using a Biometrics MWX8
kit on three subjects who are amateur guitar players. The
experiment was carried out in the laboratory of Depart-
ment of Design Engineering, Faculty of Industrial Design,
Delft University of Technology. The objective of this study
was to measure wrist flexion for extreme scenarios and
compare the same while using an ergonomic aid. The aid
Figure 4. Various grips and interaction of forces. These grips
are not constant but vary dynamically during the act of play-
ing. Images are extracted from a video of user playing his
favorite piece
Figure 5.
Balance
of forces when
a
lower string is fretted on a
conventional guitar neck
Figure 6. Wrist flexion when the guitar neck is a) horizontal
b) at 45 degree elevation, while holding the same chord
Figure 7. User during the goniometric evaluation with the
ergonomic aid
1. Classical Grip
Thumb padding rests at the
back of the fretboard
2. Pinch Grip
Fretboard is pinched between
the thurn padding and right
below the Metacarpophalan-
geal Joint of the index finger
3. Thumb Around Grip
The whole area between the
thumb Interphalengeal Joint
and the Metacarpophalangela
Jont of index finger is used to
wrap around the neck
F Fretting
F Fretting
F Fretting
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46
allowed users to position the instrument as per their prefer-
ence by adjusting the height and orientation of the guitar
neck.
The maximum wrist flexion at one instance was as high as
68.5 degrees. Mean wrist flexion for all three subjects while
playing two different chords was 47.5 degrees. A mean
reduction of 13 degrees was observed in wrist flexion by
orienting the guitar neck according to the user’s preference
with the ergonomic aid.
Mean wrist flexion values for three subjects are compared
with and without the ergonomic aid in the graph (figure 8).
Maximum ulnar deviation was 41 degrees. Mean ulnar
deviation for three subjects was 30.5 degrees. A mean
reduction of 6.5 degrees in ulnar deviation was observed
using the ergonomic aid.
Design criteria
Based on user surveys and observations, it can be conclud-
ed that most users prefer to play while sitting (upto 80% of
the time), but the existing design does not compliment the
sitting posture. This is apparent in the drooping posture
that most guitar players can be seen in while sitting which
allows them to see the fretboard while playing. Pain in the
neck and back can be attributed to this. Moreover, the arms
need to hold the instrument in place which puts more con-
straint on the body.
The conventional C shaped neck profile puts more stress on
the wrist based on biomechanical analysis. The neck profile
should provide stability to the wrist and minimize grip
forces.
Wrist flexion while gripping can result in high moments on
the wrist that can cause inflammation or even misalign-
ment of carpal bones in the long run as per literature
research. These instances can contribute to musucloskele-
tal injuries in the wrist and explains why almost half of
guitar players experience pain in the area. By positioning
the neck at an angle, wrist flexion can be reduced based on
laboratory experiments. The design should:
- have the guitar neck at an angle rather than horizontal;
- provide adjustability of the neck orientation according
to user preference and size;
- provide optimum balance to support the instrument
without having to hold it;
- minimize grip forces;
- fit the context of playing music and be aesthetically
pleasing.
Design
As per the criteria set earlier, the design of the body should
allow the neck to be at an angle to the horizontal and
should also be adjustable as per user preference and size in
order to minimize wrist flexion. The body should be bal-
anced minimizing the need to hold the instrument while
playing. The design of the neck should minimize grip forces
and provide stability to the wrist.
Design of the body
The design shown in figure 10 resolves these issues. The
body is supported between both legs, keeping the instru-
ment more stable while playing. This configuration also
allows the guitar neck to be at an angle rather than horizon-
tal.
The guitar body also needs be adaptable to different sizes
and preferences of users. Hence, instead of using a solid
block of wood for the lower half of the body, a hollow plas-
tic shape was chosen. The plastic shape can pivot about the
Figure 8. Wrist Flexion of three subjects using goniometry;
positioning the guitar neck at an angle reduces flexion of the
wrist
Figure 9. Ulnar Deviation of three subjects using goniometry;
positioning the guitar neck showed reduction in ulnar devia-
tion in subjects
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Tijdschrift voor Ergonomie jaargang 38 nr. 2 juni 2013
body providing adjustability in the coronal plane. Users can
orient the guitar neck, and adjust its height and position as
per their preference and body size.
A headless design was chosen as it allows better balance
and reduces the tendency to neck dive. A headless design is
one in which the tuners, usually located at the headstock,
are placed on the body rather than the neck (figure 15).
Design of the neck
Guitar neck is the main interface between the player and
the instrument. The neck cross-section (or neck profile)
plays an important role in determining grip force. A neck
profile that provides stability to the hand while allowing
enough flexibility to the fingers for movement is desirable.
Various concepts were generated to determine the ideal
mating surface for the grip. This would minimize grip forces
and provide more stability to the wrist while playing.
The first concept consists of a neck cross section with flat
surfaces forming a trapezoid (figure 12 (ii)) in comparison
with the usual C shaped cross section (figure 10 (i)). The
thumb rests on a flat surface providing more stability to the
grip compared to the conventional C profile (figure 13 (i)).
The second concept (figure 12 (iii)) uses an asymmetrical
trapezoidal cross section which varies along the neck, lean-
ing towards the thumb at the headstock end and towards
the palm at the body end. This varying section acts as a
guide to help the user straighten his wrist when playing at
different areas of the neck.
The third concept (figure 12 (iv)) consists of a concave mat-
ing surface for the thumb and flat top and bottom surfaces.
The concave surface not only follows the curvature of
thumb to maximize contact area, but also cancels out
moments naturally so that the thumb muscles do not have
to make constant adjustments in the direction of force.
Evaluation
In order to determine the ideal neck profile, four proto-
types were made and tested on users. First a foam model of
the profile was made, which was then vacuum formed to
Figure 10. Users can position the guitar in different ways; the
lower body can pivot about A allowing adjustable orientation
of the neck
Figure 11. Design with two cutaways on the lower half allows
the instrument to rest between the legs of the user. Equilib-
rium of forces is also shown
Figure 12. Various concepts for the neck profiles (rear view).
(i) Conventional C shape profile (ii) concept 1 - trapezoidal
profile (iii) concept 2- assymetrical trapezoidal profile (iv)
concept 3-concave profile
Figure 13. Various concepts for neck profiles (cross sections
shown) were generated ranging from convex to concave to
optimize the cross section; (i) Conventional convex shaped
neck is inherently unstable; (ii) trapezoidal section with flat
surfaces (concept 1 &2) & (iii) concave section (concept 3)
provide more stable alternatives
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48
create a hollow plastic neck. These were then fastened to
an actual guitar neck and tested with users.
Two amateur players were asked to evaluate the designs.
Both users agree that flat mating surfaces seem a lot more
comfortable to the standard ‘C’ shaped profile, but a bigger
radius was needed between the top (1), middle(2) and bot-
tom(3) surfaces (figure 13). Not much difference was felt
between Concept 1 & Concept 2. Concept 3 was also taken
positively, but during some instances, the ‘bump’ between
surfaces 1 & 2 was not seen positively (figure 13 (iii)). The
conventional ‘C’ shaped profile (figure 13 (i)) was taken least
positively. Both users concurred that a trapezoidal profile
feels the most comfortable but all surfaces should have a
large rounding between them. Hence, concept 1 was finally
selected as it provides optimization between all possible
solutions for neck profile.
Final Design ERG
The final design is aesthetically pleasing and fits within the
context of playing music. A clear wood finish is chosen for
the body taking inspiration from classical instruments such
as violin and cello. The choice of wood is based on tone and
sustain. In electric guitars, the weight of the instrument is
directly proportional to the duration a note is sutained. A
longer sustain is a desirable quality. Since only half the body
is made of solid wood, heavy wood such as Mahogany is
chosen as the material to optimize sustain while still keep-
ing the instrument lightweight. The final weight of the
instrument is around 2 kgs. Dark soft touch plastic is used
to create contrast with natural wood.
Stowing an electric guitar away is sometimes a problem due
to its bulky shape. The ERG design has a hole on the head-
stock which allows it to be hung on a wall using just a peg.
This eliminates the need for buying a ‘guitar stand’ or a ‘wall
hanger’.
The instrument fits within 0.9 m case which makes it highly
portable and acceptable on most flight cabins. Although
the design is applicable to 6 string guitars, it is especially
relevant for 7 & 8 string guitars. This is due to the fact that
wider necks and higher string tensions make extended
range guitars more difficult to play. This makes ergonomic
designs more useful. 7 & 8 string electric guitars are gaining
popularity and this design aims to alleviate problems of
future generations of instrumentalists.
Conclusions
Musculoskeletal pain and injuries are common amongst
guitar players. Almost 75% of musicians report having dis-
comfort in one or more of the following body regions lower
back, fretting hand, neck and shoulder based on literature
survey and user research. Discomfort experienced in lower
back, neck and shoulders can be attributed to poor posture,
as these are not directly involved in playing but allowing the
user to see the guitar neck while playing. Discomfort in the
tendons and joints of fingers, wrist and elbow are a result of
repetitive strains experienced during the act of playing, and
can be attributed to the grip when wrist is in flexion.
In order to improve posture and reduce wrist flexion while
playing, a new design of an electric guitar is presented. The
new shape of the guitar body allows the guitar neck to be
oriented at an angle. As a result, wrist flexion is reduced as
deduced from laboratory experiments. The guitar body is
adjustable so users can orient the neck as per their prefer-
ence and body size. Since the guitar rests between the two
legs, it is more stable minimizing the need for support while
playing. The new shape of the guitar also allows the user to
sit straight and reduces neck flexion since the fretboard is
closer to the head.
A trapezoidal cross section profile of the guitar neck pro-
vides optimum support for the grip and stabilizes the wrist
based on user tests. More research on this topic, such as
EMG measurements on the muscles of the forearm while
playing on different neck profiles, can provide conclusive
evidence. A wooden prototype of the instrument is under-
way to test the findings on a playable instrument, prefera-
bly on a larger sample group (n>= 10).
The design presented in this article is part of the research
to design a guitar of the future. It has been sixty years since
Leo Fender took the last giant step from converting an
acoustic guitar to an electric one. And it is about time to
climb the next one – from an electric guitar to an electronic
one. If you would like to contribute to this project, or would
like more details on the design, kindly contact the author
through his website : www.golden-ratio.nl
Acknowledgement
The author would like to express his gratitute to the Depart-
ment of Design Engineering, Faculty of Industrial Design,
Delft University of Technology, where the research was car-
ried out as part of his Master’s thesis. The author would also
like to thank his mentors, Dr Johan Molenbroek and Ir Marijke
Dekker for providing valuable guidance during the project.
Figure 14. Users testing four different neck profiles for com-
fort; concepts with flat surfaces ((i) & (iv)) seem more com-
fortable compared to (ii) & (iii)
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Tijdschrift voor Ergonomie jaargang 38 nr. 2 juni 2013
References
Chong, J., M. Lynden, D. Harvey, and M. Peebles (1989). Occupational he-
alth problems of musicians. Canadian Family Physician 35:2341-2348.
Fjellman-Wiklund, A. & Chesky K. (2006). Musculoskeletal and General
Health Problems of Acoustic Guitar, Electric Guitar, Electric Bass, and
Banjo Players; Medical Problems of Performing Artists (2), 1, 4: 169.
Fry, H. (1986a). Incidence of overuse syndrome in the symphony orches-
tra. Medical Problems of Performing Artists (June): 51-55.
Fry, H. (1986b). Overuse syndrome of the upper limb in musicians. The
Medical Journal of Australia 144:182-185.
Harms-Ringdahl, K. On assessment of shoulder exercise and load-elicited
pain in the cervical spine. Biomechanical analysis of load –EMG – metho-
dological studies of pain provoked b extreme position. Thesis, Karolinska
Institute, University of Stockholm, Sweden.
Marmaras, N., Zarboutis, N. (1997). Ergonomic redesign of the electric
guitar, Applied ErgonomicsVolume 28, 1, 59-67.
Matheson, A.B., Sinclair, D.C. and Skene, W.G. (1970). The range and po-
wer of ulnar and radial deviation of the fingers. Journal of Anatomy 107(Pt
3): 439-458.
Morse, T., Ro, J. e.a. (2000). A pilot population study of musculoskeletal
disorders in musicians. Medical Problems of Performing Artists Journal
15(2): 85.
Nordin, M., Frankel, V.H. (2001). Basic Biomechanics of the Musculoskel-
etal System, (3rd edition). Lippincott Williams & Wilkins, ISBN 978-
0683302479.
Norris, R. (1993). The musician’s survival manual: A guide to preventing and
treating injuries in instrumentalists. St. Louis: MMB Music Inc.
Rigg, J.L., Marrinan, R., Thomas, M.A. (2003). Playing-related injury in gui-
tarists playing popular music. Medical Problems of Performing Artists (18),
4: 150.
Sternbach, D. (1991). Carpal tunnel syndrome: What to know about it,
what to do about it. International Musician (July): 8-9.
Volz, R.G., Lieb, M., and Benjamin, J. (1980). Biomechanics of the wrist.
Clin. Orthop., 149:112-117.
Zaza, C. (1998). Playing-related musculoskeletal disorders in musicians: A
systematic review of incidence and prevalence. Canadian Medical Associ-
ation Journal 158(8): 1019-1025.
Zaza, C., and Farewell, V. (1997). Musicians’ playing-related musculoskel-
etal disorders: An examination of risk factors. America Journal of Indu-
strial Medicine 32:292-300.
Figure 15. Author with a virtual prototype of the instrument
Figure 16. Realistic rendering of the new electric guitar design
Team: Ir Gaurav Genani graduated from Delft University of
Technology in 2012 with this project.
Ir Marijke Dekker is an Assistant professor at Delft Unversity
of Technology, faculty of Industrial Design Engineering, sec-
tion Applied Ergonomics and Design.
Dr. ir. J.F.M. Molenbroek is associate professor at Delft
Unversity of Technology, faculty of Industrial Design
Engineering, section Applied Ergonomics and Design.
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... Also, several instrument makers have developed ergonomic guitars, especially for the electric variants. [75,76,77] ...
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Biomechanical analyses of load on locomotor structures are essential parts of physical therapy. Load moments of force, compressive and shear joint forces are associated with the risk of eliciting pain or causing excessive load during work and leisure activities as well as during rehabilitative training exercises. Two common therapeutic exercise movements were analysed with special emphasis on the effects of patient positioning on the load relations. Resistance was provided by an ordinary pulley apparatus. A computerized static model was developed, where positioning angle, pulley cord force and pulley distance could be varied. The best adaptation between the curves for induced load moment about the shoulder joint and maximum isometric muscle moment through joint angles was obtained when the subject during internal rotation exercises sat with the pulley located 40 degrees anterior to, and during external rotation exercises 20 degrees posterior to, a frontal plane through the shoulders at a distance of 1.3 m from the joint. EMG was recorded from the pectoralis major, latissimus dorsi and anterior deltoid muscles during internal rotation exercises, and from infraspinatus, deltoid and trapezius during external rotation. Pectoralis major and infraspinatus were the most active muscles during internal and external rotation respectively. Two methodological studies were made concerning pain provoked by loading joints in maintained extreme positions (i.e. positions at the limit of the motion sector). Sensations of discomfort/pain from healthy elbow and knee joints maintained in an extreme position increased with duration of provocation and decreased slowly after removal of loading weight. Using such joint loadings, a comparison of the Visual Analogue Scale with Borg's category-ratio scale showed that both be can be used for reliable assessments of load-elicited pain intensity. In one study cervical spine extreme position was found to be associated with sitting work postures where the thoraco-lumbar spine was slightly inclined backwards or where the whole spine was flexed. Healthy subjects participated in an experimental study in which a position involving extreme flexion of the lower-cervical-upper-thoracic spine (similar to a common work posture) was maintained. Pain was experienced by all ten subjects within 15 minutes, disappeared 15 minutes after the end of provocation, but was again experienced by nine subjects the same evening or the next morning and lasted up to four days. Neck extensor muscle activity was low.(ABSTRACT TRUNCATED AT 400 WORDS)
Article
A series of 379 musicians with painful overuse syndrome ("RSI") were examined and studied. The commonly used diagnosis for the condition of "tenosynovitis" or "tendinitis" could not be substantiated as it appeared to be a distinct clinical entity rather than a collection of unrelated disorders. The patients in this series showed muscular and joint capsule overuse. Those with painful hands and wrists showed persisting tenderness in the intrinsic muscles and joint ligaments, notable in the carpometacarpal joints of the thumb and the radial side of the wrist. Tenderness of more proximal muscle groups was also usually present. Pain generally started in a particular area, then spread both proximally and distally. The patients felt depressed. The treatment that evolved from the study was radical rest of the tender structures by the total avoidance of pain-inducing activities. The condition did not appear to be inflammatory in nature. The prevention of overuse lies in the control of use.