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An Intermittent Pneumatic Compression Device Reduces Blood Lactate Concentrations More Effectively Than Passive Recovery after Wingate Testing

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An Intermittent Pneumatic Compression Device Reduces Blood Lactate Concentrations More Effectively Than Passive Recovery after Wingate Testing

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An Intermittent Pneumatic Compression Device Reduces Blood Lactate Concentrations More Effectively Than Passive Recovery after Wingate Testing With the advancement of technology, therapeutic modalities mimicking “cool down” have become an option for active individuals to try and decrease the recovery time between training sessions and competition. A wide variety of companies that manufacture these modalities have claimed their machines can decrease recovery time by decreasing lactic acid, a known cause of muscle fatigue following exercise. The aim of this study was to investigate an intermittent pneumatic compression (IPC) unit as a recovery modality by evaluating its effectiveness in clearing blood lactate (BLa) when compared to alternate recovery methods following an anaerobic Wingate cycling test (WAnT).

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... 2 More recently, athletes have incorporated the use of intermittent sequential pneumatic compression (ISPC), a form of dynamic compression, to enhance recovery postexercise. 8 Similar to compression garments, ISPC derives from the medical sector where comparable devices have been used for the treatment of lymphedema and posttraumatic edema. 9,10 ISPC, however, differentiates from compression garments; by exerting up to 4 times greater levels of pressure (∼80 mm Hg) to the applied area, when compared with commercially available compression garments. ...
... 11 In addition, ISPC mimics the anatomical muscle venous pump by providing a mechanical "squeezing" of the limb through inflatable cuffs/sleeves, from distal to proximal, in a sequential fashion. 8 This dynamic application of pressure has been shown superior when compared with uniform/static compression (constant application of pressure) at enhancing venous blood flow and may further increase the removal of metabolic waste when compared with static compression methods. 12 Research evaluating ISPC for exercise recovery and/or subsequent performance is limited and contradictory, with an array of methods used to assess its efficacy. ...
... 12 Research evaluating ISPC for exercise recovery and/or subsequent performance is limited and contradictory, with an array of methods used to assess its efficacy. [8][9][10][13][14][15] Hanson et al 8 and O'Donnell and Driller 9 discovered a trend toward improved BLa clearance following cycling exercise with the use of ISPC (60-80 mm Hg) during recovery when compared with a passive control. Hanson examined 21 female club level lacrosse and field hockey athletes to reveal a statistically significant improvement in BLa clearance 20 minutes following a 1-minute maximal cycling ergometer sprint (P = .04). ...
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Purpose: To examine the efficacy of Intermittent Sequential Pneumatic Compression (ISPC) on exercise recovery and subsequent performance, when implemented between a 20-min cycling bout (simulated scratch race) and a 4-min cycling test (simulated individual pursuit), as experienced during an Omnium track cycling competition. Methods: Twenty-one (13 male, 8 female, mean ± SD; age: 36 ± 14 years) trained cyclists completed a familiarisation trial followed by two experimental trials in a counterbalanced, crossover design. Participants performed a fixed-intensity 20-min cycling bout on a Wattbike cycle ergometer, followed by a 30-min recovery period where ISPC recovery boots or passive recovery (CON) was implemented. At the conclusion of the recovery period, participants performed a 4-min maximal cycling bout (4-minTT). Average power (Watts) for the 4-minTT, blood lactate concentration (BLa) and perceived total quality recovery (TQR) during the recovery period were used to examine the influence of ISPC. Results: There were no significant differences between trials for the 4-minTT (p = 0.08), with the effect deemed to be trivial (d = -0.08). There was an unclear effect (d ±90%CI = 0.26 ±0.78, p = 0.57) for ISPC vs CON in the clearance of BLa during the recovery period. There was a small but not significant difference for TQR in favour of ISPC (d ±90%CI = 0.27 ±0.27, p = 0.07). Conclusion: There was little additional benefit associated with the use of ISPC to enhance recovery and subsequent performance when used during the recovery period between two events in a simulated Omnium track cycling competition.
... Les éléments clés des études retenues ont été résumés dans le Tableau 1. Au terme de nos recherches, neuf études ont été retenues, dont 3 essais contrôlés randomisés [6,10,11], quatre études croisées [7][8][9]14] et deux études contrôlées expérimentales [12,13] utilisant la jambe gauche non traitée des participants comme contrôle de la jambe droite traitée par le dispositif Normatec. Toutes les études retenues ont été réalisées sur des sujets en bonne santé, âgés de 18 à 40 ans. ...
... Hanson et al. [6] ont comparé la concentration sanguine en lactate (LaS) entre une récupération active par vélo ergométrique stationnaire à environ 40 % de la Fréquence cardiaque maximale, une récupération passive en station assise (hanche fléchie à 90 • , extension complète des genoux) ou une récupération par Normatec (hanche fléchie à 90 • , extension complète des genoux), chacune durant 20 minutes après réalisation d'un test anaérobique de Wingate standardisé sur vélo ergométrique (WanT) pendant 1 minute chez des étudiants athlètes. Il en résulte une efficacité supérieure de la récupération par Normatec sur la baisse de LaS par rapport à la récupération passive mais une absence de différence significative d'efficacité entre la récupération active et la récupération par Normatec (récupération passive = 12,61 mM/L ± 2,82 ; récupération active = 7,49 mM/L ± 3,34 ; récupération par Normatec = 8,36 mM/L ± 3,04). ...
... Les résultats obtenus par Hanson et al. [6] démontrent une efficacité supérieure de la récupération par Normatec par rapport à la récupération passive sur la clairance en LaS, résultats appuyés par ceux de Martin et al. [7], et une efficacité similaire de la récupération par Normatec par rapport à la récupération active, après une session de récupération de 20 minutes. La récupération active étant considérée comme étant un des moyens, voire le moyen le plus efficace pour augmenter la clairance de LaS [26,27], et compte tenu du peu d'effet démontré du massage manuel sur la clairance de LaS [28][29][30], il est suggéré par Martin et al. l'utilisation du Normatec lorsqu'une clairance « passive » du LaS est désirable, notamment pour épargner l'énergie du sportif. ...
Article
Récemment, plusieurs études ont émergé afin d’évaluer les effets sur la récupération sportive du dispositif de compression pneumatique externe dynamique péristaltique mis au point au Newton Center, MA, États-Unis et commercialisé sous le nom de Normatec Pulse Recovery System, dont l’utilisation a été accrue ces derniers temps au sein des communautés sportives professionnelles et amatrices. Notre objectif à travers cette revue est d’évaluer les effets du Normatec sur les performances et la récupération sportive en passant en revue les études publiées à ce jour le concernant.
... A study finds that active recovery does not affect the autonomic and hemodynamic response after moderate-intensity aerobic exercise compared with passive recovery [19]. Hanson et al. reported that IPC and active recovery are equally efficient tools for reducing blood lactate after Wingate testing [20]. O'Connor et al. find that the active recovery is better than the NormaTec IPC device and passive recovery after 15 min of post-Tabata workout on a cycle ergometer [21]. ...
... Previous studies showed that the IPC and active recovery are effective tools for reducing blood lactate, decreasing fatigue, and enhancing performance compared with passive recovery [12,14,17,42,43]. Hanson et al. found no difference in reducing blood lactate between IPC and active recovery [20]. Whereas O'conner et al. found no difference in reducing blood lactate up to 10 min after IPC and active recovery, but after 15 min, the active group is better in removing the blood lactate levels [21]. ...
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Purpose The present study aimed to investigate the effect of intermittent pneumatic compression (IPC) and active recovery on heart rate recovery (HRR), heart rate variability (HRV), blood pressure (BP) and rate of perceived exertion (RPE) after sub-maximal aerobic exercise in collegiate soccer players. Methods Fifteen male collegiate soccer players aged between 18 and 25 years were recruited in this cross-over study design with two groups (IPC and Active recovery group). Subjects were performed with an incremental treadmill test at sub-maximal intensity followed by 15 min of recovery methods (IPC or active recovery). After sub-maximal exercise testing, heart rate recovery at the first minute (HRR1) and second minute (HRR2) were observed. Heart rate, HRV, BP and RPE measures were taken before the exercise and 25 min of post-sub-maximal exercise. Results HRR1 and HRR2 showed a significant difference between IPC and active recovery (p < 0.001). Time-domain and frequency-domain measures of HRV showed only significant time effect (p ≤ 0.04), whereas group effect and time × group interaction were found to be non-significant. There was a significant time effect (p = 0.04), group effect (p = 0.003) and time × group interaction (p = 0.01) for systolic BP, while diastolic BP only showed a significant time effect (p = 0.02). There was a significant time effect (p < 0.001) and time × group interaction (p = 0.001) for RPE. Conclusion IPC is a better recovery tool in terms of HRR, BP and RPE than active recovery while no such difference was found in the time- and frequency-domain measures of HRV.
... IPC comprises of pumped inflation and deflation of air bladders inside cuffs that can cover the foot, calf, or whole leg. Due to anti-inflammatory and localized muscle recovery mechanisms of IPC [31], it is used for the treatment of delayed onset of muscle soreness [32] as well as for the removal of blood lactate [33,34]. IPC has shown a 45% improvement in performance following an exhaustive exercise bout [35] supporting its efficacy as a tool in assisting post-exercise recovery in athletes. ...
... However, the present study did not directly measure blood pressure variability or muscle sympathetic nerve activity, which reflects the sympathetic outflow. However, previous studies have reported the removal of blood lactate after the intervention of IPC [33,34]. To the best of our knowledge, this is the first study to report the immediate effect of IPC post submaximal exercise on cardiac autonomic function. ...
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PurposeThe aim of the study is to assess the effect of intermittent pneumatic compression (IPC) on heart rate recovery and heart rate variability (HRV) after submaximal aerobic exercise in collegiate basketball players.Methods Sixteen male collegiate basketball players aged between 18 and 25 years were included in this cross-over design with two groups (IPC group and placebo-control group). All participants performed an incremental treadmill test at submaximal intensity followed by 15 min of different recovery modes application. Heart rate recovery at the first minute (HRR1) and second minute (HRR2) after submaximal exercise testing were observed. HRV measures were obtained from 5-min R-R intervals during 10 min of ECG recording before the exercise (baseline) and after 15 min recovery period post-exercise.ResultsHRR1 (p = 0.008) showed a significant difference, while HRR2 showed a non-significant difference between IPC and placebo-control groups. There was a significant time effect for all time- and frequency-domain HRV parameters (p < 0.001). Group effect was significant for LF (p = 0.002) and LF/HF (p = 0.001). Also, group × time interaction was found to be significant in all frequency-domain HRV variables (p ≤ 0.003).Conclusion The results of the present study suggest that IPC is a useful recovery tool for faster HRR1 and changing frequency-domain HRV recovery, suggesting positive vagal reactivation after submaximal exercise in collegiate basketball players.
... A previous study (Hanson, Stetter, Thomas, 2013) emphasized that using IPC for recovering was faster especially after a multitude of competition (Jones, 2016). There was used graduated low-pressure 20:15:10 mm Hg IPC use and graduated high-pressure 70:65:60 mm Hg IPC. ...
... The highest enhancement was in sake of Exp1 with mean of 8.717 mmol·L, emphasizing on the role of intermittent compression pressure in lactate recovery. Our findings matched the studies of S. Baker and N. King (1991), I. Barbas et al. (2011), E. Hanson et al. (2013 and L. Sharma and S. Verma (2017). ...
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The aim of the study was to investigate the effect of different compression modalities as to recovery enhancement on some biomarkers in wrestlers. Serum creatinine, lactic acid and glucose level were tested in elite wrestlers before a match-up, 3 minutes post-match up and 19 minutes after applying recovery compression model. The results showed insignificant differences between pre-post 3-minute tests among research groups due to sample equality, 3-minute and 19-minute post match-up tests showed efficacy of compression technique in enhancing recovery in sake of 160/20 mmHg compression modality with enhancement percentage of 16.614% for serum creatinine, 43.214% for lactic acid and 22.505% for glucose level. The compression band with 160/20 mm Hg exceeds recovery after match-up.
... Lactate concentrations were lower using IPC boots 20 minutes after a Wingate test as compared to a passive recovery (6), although no differences were found between boot use and an active recovery. Lactate was also significantly lower at 25 and 35 minutes post-repeated anaerobic exercise as compared to a sham condition, but not at 5 and 15 minute post-exercise time points (11). ...
... Twelve (11 M, 1 F) trained participants were recruited for the present study from a local cycling training facility. Sample size estimation was based effect sizes reported by Hanson et al. (6) Criteria for participation included an age range of 16-60 years and an absence of signs or symptoms suggestive of cardiovascular, pulmonary, or metabolic disease as outlined by the American College of Sports Medicine. Additionally, all participants were at minimum a Category V (male) or IV (female) cyclist as defined by USA cycling. ...
Article
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The purpose of the present study was to investigate the influence of intermittent pneumatic compression (IPC) boot use between submaximal cycling trials on heart rate (HR) and blood lactate concentrations. Ten healthy participants (9M; 1F) performed two consecutive 60 minute rides at 60% of functional threshold power with a 30 minute rest between rides. The rest period was spent in a supine position using IPC boots (BOOT) or sitting in a similar position without boots (CON). HRs were collected every 15 minutes during cycling rides, and lactate was measured at the 30-minute mark during both rides. An identical trial was performed 7 days later with conditions (BOOT or CON) crossed. There were no between-trial differences (p > 0.05) in HR; between-trial differences were found for lactate concentrations during the second ride (3.9 ± 1.0 mmol/L BOOT vs. 2.7 ± 1.5 mmol/L CON, p < 0.05). The use of IPC boots between cycling trials as compared to laying in a supine position did not affect heart rate responses but did stimulate higher lactate concentrations during subsequent exercise.
... The NMES groups in the present study was administered a low frequency electrical stimulation during the recovery period showed a significant recovery of blood lactate and anaerobic performance as compared to control group, which is similar to the results found in previous studies [21,24,26,27,30,[38][39][40][41], although some studies have also reported contrasting findings [21,[42][43][44]. IFT used produces biphasic pulses within the tissues & has an advantage in that it does not cause skin irritation unlike some other electrical techniques [45]. ...
... The reasons for the IPC's success in decreasing BLa more than the passive recovery in this study might be due to its ability to mimic the muscle venous pump [39,49]. IPC has a potential role in altered limb circulation, lymphatic flow & general metabolic clearance [30,40,[50][51][52][53]. The results suggest that IPC may be superior option to passive recovery when -inactive'' BLa clearance is desirable (eg. ...
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Objective: To compare the effects of Intermittent Pneumatic Compression (IPC) vs. Neuromuscular Electrical Stimulation (NMES) on recovery following anaerobic exercise. Design: Three-arm comparative pretest-posttest experimental design Setting: University Sports complex and Physiotherapy Clinic. Participants: Twenty-four male collegiate basketball players aged 18-25 yrs (mean± SD 20.4±1.8 yrs) Interventions: Participants were randomly assigned into one of the 3 groups; IPC group (n=8), NMES group (n=8) or control group (n=8). Each group performed a repeated sprint test (RAST) following which, the subjects received IPC, NMES or no intervention as a recovery mode, for 20 minutes. Main outcome measures: Blood lactate recorded prior to and at 5, 15 and 25 min following the RAST. Following recovery, subjects performed another bout of RAST to assess for peak power, mean power, and fatigue index, as parameters of anaerobic performance. Results: There was a significant difference in the clearance of blood lactate between three groups (p=0.006*), with NMES group showing greatest drop. The performance decrements in the second bout of RAST were significantly less for the NMES group as compared to control (p<0.05). Conclusion: NMES was more effective than IPC or passive rest, in clearing blood lactate and minimizing performance decrements following an anaerobic exercise bout.
... In addition, we evaluated BLa at regular 10-minute intervals for a 30-minute treatment period. Our results extend those previously reported by Hanson et al. (6) as we observed a significantly improved BLa clearance (;25%) with EPC compared with sham BLa at 20 and 30 minutes of the recovery treatment (25 and 35 minutes postfatigue protocol, respectively) indicating that the effect persists further into recovery. Heinonen et al. (7) have previously noted that local heating increases skeletal muscle blood flow. ...
... Although this study did not include an active recovery group, Hanson et al. (6) reported similar BLa clearance between EPC and active recovery conditions. Given recent evidence indicating that manual massage has little to no effect on BLa (20), our data suggest that EPC may be a superior option to sports massage when "inactive" BLa clearance is desirable (e.g., energy sparing). ...
Article
External pneumatic compression (EPC) use in athletics is increasing. However, there is a paucity of evidence supporting the effectiveness of EPC in aiding recovery and/or performance. We sought to determine the efficacy of EPC for acute recovery of anaerobic power and lactate clearance following a fatigue protocol. Fourteen (n=14; female = 7, male = 7), apparently healthy, active subjects (aged 22.73 ± 4.05 years) were enrolled in this randomized, crossover design study. Following familiarization sessions, subjects completed 2 study trials separated by 3-7 days. Trials consisted of a fatigue protocol (two 30-second Wingate Anaerobic Tests (WAnT) on a cycle ergometer separated by 3 minutes of rest), 30 minutes of treatment with EPC or sham, and, finally, a single 30-second WAnT. A peristaltic pulse EPC device was employed with target inflation pressures of ∼70 mmHg applied to the lower limbs. Peak power (PkP), average power (AP) and the fatigue index (FI) were recorded for each WAnT. Moreover, blood lactate concentration (BLa) was evaluated at baseline and at regular intervals during recovery (5, 15, 25, and 35 minutes post-fatigue protocol). No significant differences in PkP, AP, and FI were observed. However, BLa was significantly lower at 25 and 35 minutes of recovery (8.91 ± 3.12 vs. 10.66 ± 3.44 mmol/L [P=0.021] and 6.44 ± 2.14 vs. 7.89 ± 2.37 mmol/L [P=0.006] for EPC vs. sham, respectively). Application of EPC during recovery may be a viable alternative when "inactive" recovery is desirable.
... When the calf muscle contracts, blood is forced through the vessel towards the heart. Compression devices mimic such action by applying external pressure to the calf, which has been shown to reduce venous stasis and thus mitigate the risk of venous disorders [1] and suggested as a mechanism for improving recovery from exercise [2], [3] External compression devices principally employed as inpatient medical devices. The most common use is for deep vein thrombosis (DVT) prevention [1], a disorder that had an estimated health care cost of $39.5 billion in the United States in 2010 [4]. ...
... The IPC + CWI protocol was applied ~45 min after each match. IPC consisted of a sequential (circulation mode) 20 min [25,43,44] compression at 200 mmHg [24]. The air compression system (LX7 [E0651], Doctor Life ® Healthcare, Seoul, Korea) had 4 chambers (foot, calf, knee, thigh) that applied intermittent compression from foot to groin in both lower limbs independently in cycles of 60 s (inflation 40 s [10 s per chamber] and pause time 20 s) [45]. ...
Article
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Background: Congested-fixture championships are common during the selection of the athletes and teams participating in the Olympic Games. Throughout these tournaments, it is fundamental to perform optimally, rest well, and recover between competitions. This study aimed to a) explore the effectiveness of the use of intermittent pneumatic compression (IPC) and cold water immersion (CWI) to recover muscle mechanical function (MuscleMechFx), hydration status (HydS), pain perception (PainPercep), rate of perceived exertion (RPE), sleep hours, and sleep quality (SleepQual) during a regional multi-sports international championship and b) compare these results by sex. Methods: A total of 52 basketball and handball players were exposed to a recovery protocol after the competition as follows: IPC, sequential 20 min at 200 mmHg, and CWI, continuous 12 min at 12 °C. Results: MuscleMechFx presented differences by match and sex (p = 0.058) in time of contraction of biceps femoris; SleepQual and sleep hours were different between matches (<0.01). Conclusions: IPC + CWI seems to be effective to maintain some MuscleMechFx, HydS, and recovery and pain perception during a congested multi-sport tournament.
... The treatment has been found to improve performance (Zelikovski et al., 1993), decrease swelling and stiffness but not attenuate strength loss (Chleboun et al., 1995), enhance recovery of muscle function following fatigue (Wiener, Mizrahi, & Verbitsky, 2001), but offer no effect in a range of performance measurements following acute eccentric exercise when applied for three consecutive days (Cochrane, Booker, Mundel, & Barnes, 2013). Additionally, IPC treatment has been shown to reduce blood lactate levels following anaerobic cycle tests (Hansen, Stetter, Li, & Thomas, 2013;Martin, Friedenreich, Borges, & Roberts, 2015) and reduce muscle stiffness and tenderness in elite athletes from a variety of sports (Sands et al., 2015). Both IPC and control protocols that were employed in the present study were exactly the same as the prior report from Hoffman et al. (2016) Besides the assigned treatments, participants were asked to avoid the use of any pain medication or other modality of recovery during the two weeks following the race which might interfere with our interpretation of results. ...
Article
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Manual therapy (MT) and intermittent pneumatic compression (IPC) are recovery methods used by endurance athletes with little evidence supporting effectiveness. This randomized controlled trial evaluated effectiveness of four daily post-race treatments of a specific MT protocol and IPC compared with supine rest on recovery following an ultramarathon among 56 ultramarathoners. Groups were comparable across all characteristics examined, including post-race plasma creatine kinase concentration. Subject completed timed 400 m runs before the race and on days three, five, seven and 14 post- race, and also provided muscle pain and soreness ratings and fatigue scores immediately before and after treatments, and during the 14 days post- race. Daily subjective measures and 400 m run times were not improved by either treatment, but both treatments reduced (p < .05) muscular fatigue scores acutely after treatment following the race and on post-race day 1, and MT improved (p < .05) muscle pain and soreness acutely following the race.
... In athletic populations, intermittent pneumatic compression (IPC) has been used to enhance localized muscle recovery and performance higher than that of the passively recovery. [71,72] Reason for the IPC's success in decreasing blood lactate more than passive might be attributed to its ability to mimic the muscle venous pump. [73] Zelikovski et al. [74] found 45% improvement in exercise performance following an exhaustive exercise bout after 20-min application of modified intermittent sequential pneumatic device. ...
Article
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Background: It has been demonstrated that pressotherapy used post-exercise (Po-E) can influence training performance, recovery, and physiological properties. This study examined the effectiveness of pressotherapy on the following parameters. Methods: The systematic review and meta-analysis were performed according to PRISMA guidelines. A literature search of MEDLINE, PubMed, EBSCO, Web of Science, SPORTDiscus, and ClinicalTrials has been completed up to March 2021. Inclusion criteria were: randomized control trials (RCTs) or cross-over studies, mean participant age between 18 and 65 years, ≥1 exercise mechanical pressotherapy intervention. The risk of bias was assessed by the Cochrane risk-of-bias tool for RCT (RoB 2.0). Results: 12 studies comprised of 322 participants were selected. The mean sample size was n = 25. Pressotherapy significantly reduced muscle soreness (Standard Mean Difference; SMD = -0.33; CI = -0.49, -0.18; p < 0.0001; I2 = 7%). Pressotherapy did not significantly affect jump height (SMD = -0.04; CI = -0.36, -0.29; p = 0.82). Pressotherapy did not significantly affect creatine kinase level 24-96 h after DOMS induction (SMD = 0.41; CI = -0.07, 0.89; p = 0.09; I2 = 63%). Conclusions: Only moderate benefits of using pressotherapy as a recovery intervention were observed (mostly for reduced muscle soreness), although, pressotherapy did not significantly influence exercise performance. Results differed between the type of exercise, study population, and applied treatment protocol. Pressotherapy should only be incorporated as an additional component of a more comprehensive recovery strategy. Study PROSPERO registration number-CRD42020189382.
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