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A Guide to Stroke Recovery: Take Charge of Your Rehabilitation Journey

Introduction

According to the American Stroke Association, stroke is the most frequent cause of long-term disability in the United States and the fifth-leading cause of death. Recent statistics from the Centers for Disease Control and Prevention (CDC) showed that one in six deaths (17.5%) from cardiovascular disease was due to stroke, and more than 795,000 people in the U.S. have a stroke every year. 

A stroke can significantly impair motor skills, language, cognition, and physical function. The good news is that we can optimize stroke recovery with the right protocols and the latest technologies applied early in the rehabilitation journey. 

Let’s review what you need to know about stroke warning signs and side effects, why post-stroke rehab is essential, how stroke rehabilitation techniques facilitate recovery, the latest technologies that aid stroke rehab, and how patients can embark on a new beginning with proper stroke recovery protocols. 

Read below or download the PDF to save for later:

When you’ve had a stroke, you can be left with more questions than answers. We can help. This book pinpoints the essential information that will help you understand your situation and navigate each stage of your recovery.

Read below or fill out the form to download our free guide to start charting your course.

Chapter 1: Understanding Strokes and Stroke Recovery

What Is a Stroke?

A stroke occurs when a vessel that supplies blood to the brain ruptures or becomes blocked, starving brain cells of oxygen and resulting in brain damage. When an area of the brain experiences a sudden reduction or loss of blood flow, the affected brain cells are deprived of oxygen and begin to die within seconds. 

There are five types of strokes:

  • Ischemic strokes (clots) account for about 87% of all strokes. They are caused by an obstruction in a blood vessel supplying blood to the brain.
  • Hemorrhagic strokes (bleeds), also called aneurysms or arteriovenous malformations (AVMs), are often caused by uncontrolled high blood pressure. They occur when weakened blood vessels rupture.
  • Transient ischemic attacks (TIAs), or “mini-strokes,” are temporary blood flow blockages to the brain. They are often early warning signs of a major stroke.
  • A cryptogenic stroke occurs when the cause cannot be determined.
  • Brain stem strokes impair the brain stem’s functions, such as controlling the central nervous system (e.g., consciousness, blood pressure, and breathing) and physical movements. 

8 Stroke Warning Signs Everyone Should Know

Knowing the early warning signs of a stroke is crucial because prompt medical treatment can significantly minimize brain damage, improve stroke recovery outcomes, and reduce the risk of long-term disability or death. Here are eight stroke warning signs to watch for: 

  1. Facial numbness or drooping, often indicated by a lopsided smile or drooping of the eyelid and/or cheek on one side of the face.
  2. Weakness or numbness in an arm or leg or trouble controlling one side of the body, such as a weak grip or one leg shuffling along while walking.
  3. Confusion and trouble understanding other people or the environment.
  4. Difficulty with speech, like slurred speech or difficulty with word retrieval.
  5. Sudden vision changes, including blurred vision, double vision, or significant gaps in vision.
  6. Trouble walking or standing, feeling dizzy, or having sudden difficulty with balance and coordination.
  7. Severe and sudden headaches.
  8. Nausea and vomiting with no obvious explanation. 

Research suggests that women may experience additional, atypical, or less common stroke warning signs. These may include sudden hiccups, general weakness, chest pain, palpitations, shortness of breath, and behavioral changes. 

Take immediate action if you or a loved one shows any combination of these stroke warning signs. Note the approximate time the first symptoms appeared and get emergency medical attention as quickly as possible. 

Stroke Side Effects and Symptoms

Understanding what to expect after a stroke helps facilitate effective stroke recovery planning. Individuals can proactively manage risk factors and adjust their lifestyles by anticipating stroke side effects and potential challenges. 

The Physical Side Effects of a Stroke

The most common physical stroke side effects include dysphagia (difficulty swallowing), fatigue, pain, spasticity, and vision impairment like partial blindness, tunnel vision, double vision, and blind spots. 

Some patients may suffer from muscle impairment, such as hemiparesis (weakness on one side of the body), incontinence (the inability to control the bladder and/or bowel movements), foot drop (dragging one’s toes when walking), or paralysis (the inability to move muscles or muscle groups). 

Moreover, the brain damage caused by a stroke can trigger seizures and/or epilepsy. Around 5% to 20% of patients experience a seizure after a stroke, with some developing chronic seizures and epilepsy. 

Post-Stroke Depression and Other Emotional Side Effects

Patients may also suffer from post-stroke depression and other emotional or mental stroke side effects 

  • Post-stroke depression may be caused by physical and chemical changes in the brain related to brain injury. Patients may feel overarching sadness, lack of pleasure in activities they used to enjoy, or changes in eating and sleeping patterns.
  • Anxiety affects 20% of stroke survivors. Stroke-related brain injury can cause chronic, severe anxiety.
  • Emotional liability occurs when a person has trouble controlling their emotions. It can be a stroke side effect caused by brain injuries.
  • Cognitive impairments may impact memory, attention, and impulse control. Research suggests that approximately 30% of stroke patients develop dementia within one year of stroke onset.  

What Does a Stroke Recovery Timeline Look Like?

stroke-rehab-sadThe stroke recovery timeline is unpredictable. Some patients may recover completely within weeks, while others may take months or even years to recover fully. Some patients may experience moderate to severe stroke side effects permanently. 

Several factors affect the stroke recovery timeline, such as the stroke's type, location, and severity. Additionally, the timeline may be shorter if the patient received prompt treatment immediately after the stroke. 

Here’s an overview of a typical stroke recovery timeline: 

  • Stage 1: Initial recovery. The stroke recovery process starts as soon as the patient has been treated for critical symptoms. Doctors will take preventive measures to avoid further strokes, and the patient is encouraged to start rehab by sitting up, moving around, standing, and even walking.
  • Stage 2: First two weeks. Once discharged from the hospital, patients with severe stroke side effects will likely be transferred to a long-term acute care facility. Those with less serious issues will be referred to an inpatient or outpatient rehab center. Most patients will experience a 50% recovery during this phase.
  • Stage 3: One to three months. All patients should undergo intensive rehabilitation therapy during the first two to three months of stroke recovery. During this time, neuroplasticity allows patients to regain functions more quickly.
  • Stage 4:  Beyond three months. After completing a course of intensive rehab, patients will continue their stroke recovery journey at home. They should follow the rehab team’s guidance to improve their quality of life, minimize remaining stroke side effects, and reduce the risks of another stroke. 

While this stroke recovery timeline varies based on each patient’s circumstances, post-stroke rehab should be a critical part of this period to facilitate the healing process.

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Chapter 2: Why Post-Stroke Rehabilitation Is Essential for Stroke Recovery

Recovering From A Stroke

A well-designed rehabilitation program is critical to speeding up the stroke recovery timeline. It can improve physical outcomes and address long-term emotional and mental stroke side effects. Let’s explore why post-stroke rehabilitation is essential.

The Importance of Post-Stroke Rehabilitation

Post-stroke rehabilitation helps patients relearn the skills they lost due to the brain damage caused by the acute care episode. These may include coordinating leg movements to walk again or performing steps in a complex activity. Therapists also teach stroke survivors new ways to perform tasks to compensate for the loss of movement.  

Some patients may lose their ability to speak and communicate after a stroke, while others may not be able to perform daily tasks like dressing or bathing. Post-stroke rehabilitation helps them regain these skills and their independence, which is essential for improving their quality of life and mental well-being. 

How Physical Therapy for Stroke Patients Improves Outcomes 

Physical therapy is a form of rehabilitation treatment that focuses on rebuilding physical strength and mobility through a supervised and structured regime of exercises. Physical therapy treatment is an essential component of stroke recovery, and the first stage should begin in the hospital within one to two days of a stroke. 

While stroke patients may experience natural recovery without rehab, evidence suggests that physical therapy for stroke patients helps facilitate better and faster stroke recovery. For example, physical therapy helps patients improve overall strength and mobility, prevent muscle atrophy, improve quality of life, regain independence, and overcome mental and emotional challenges like post-stroke depression. 

How Counseling and Therapy Address the Long-Term Effects of Stroke 

Counseling groupBrain injury caused by a stroke can cause post-stroke depression or exacerbate a patient's previous mental conditions. Individuals who have experienced a cerebellar stroke may face long-term depression. Ischemic strokes, caused by blockages in blood vessels supplying the brain, may also have long-term effects on mood and mental health. 

It’s not uncommon for patients to need psychiatric help after a stroke. Counseling and psychotherapy ("talk therapy") can help relieve post-stroke depression and facilitate stroke recovery. Some patients may also benefit from using antidepressants to help them recover from long-term stroke side effects 

Physical therapy and counseling, along with other techniques, play a critical role in stroke recovery. Let’s look closely at how they stabilize a patient’s condition, help them regain optimal function, and promote the best quality of life. 

A Guide to Stroke Recovery: Take Charge of Your Rehabilitation Journey

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Chapter 3: Facilitating Stroke Recovery Through Rehabilitation

What Is Stroke Rehabilitation?

A stroke rehabilitation team often includes a physical therapist, occupational therapist, speech-language pathologist, social worker, neurologist, and other professionals to meet the diverse needs of stroke patients. They use different techniques to help facilitate the stroke recovery journey. 

6 Most Common Stroke Rehabilitation Techniques 

The majority of rehab facilities use these stroke rehabilitation techniques to help patients regain their functions and accelerate their stroke recovery journey: 

Speech-Language Therapy 

Speech and language pathologists help patients recover their ability to communicate and swallow after a stroke. They also help improve patients' reading and writing skills. Techniques may include cadence and breathing exercises and word meaning and repetition practice.  

Physical Therapy 

An individualized physical therapy program helps stroke patients regain their physical function or compensate for physical deficits after a stroke, improving mobility and movement where there’s impairment. Therapists may also incorporate e-stimulation and other therapies into their treatment plans. 

Occupational Therapy 

This stroke rehabilitation technique helps restore a patient’s ability to perform routine daily activities, such as cooking, driving, household chores, and grooming. An occupational therapist also helps patients overcome physical limitations, adjust their living spaces, avoid safety concerns, and improve their quality of life. 

Neurological Therapy 

Neurological therapies encourage neuroplasticity to build new neural pathways and improve cognitive and motor impairments caused by brain and nerve damage from a stroke. Magnetic brain stimulation may help patients walk and move better, while brain exercises help sharpen cognitive function. 

Mirror Therapy 

Mirror therapy addresses one-sided paralysis or weakness. The patient moves the unaffected limb and watches it in a mirror. The brain processes the movement in the mirror as if it happens to the affected limb. Many patients notice improvements in strength and mobility on the weak or paralyzed side.

Recreational Therapy 

This stroke rehabilitation technique helps patients return to activities they enjoy or learn new ones to improve mental well-being and health. Patients can also practice communication skills and physical abilities gained from physical and occupational therapies during these activities. 

Speech and physical therapies are the most critical and impactful of these stroke rehabilitation techniques. Let's explore how they support stroke recovery. 

Speech Therapy for Stroke Recovery 

The severity of injury from a stroke can impact the ability to communicate in multiple ways. For example, a stroke that affects the left side of the brain, which controls speech and language, may alter the patient’s ability to speak or understand what others say, leading to a condition called aphasia.  

In speech therapy for stroke patients, therapists pinpoint the exact issues faced and develop a plan to address them — restoring language abilities where possible, working around remaining challenges, and devising other ways for patients to express themselves. 

Speech therapy for stroke patients often includes breathing exercises, tongue and lip exercises, articulation coaching, voice training, and word and sentence articulation. These techniques aim to help patients regain communication abilities, modulate their voice, and recognize verbal cues.  

To achieve the best outcomes, speech therapy for stroke patients should start as soon as possible. 

The Role of Speech Therapy for Stroke Patients 

Speech therapy helps stroke patients build communication skills for relationships, work, and everyday activities to regain independence and improve their quality of life. It also retrains swallowing skills to avoid choking issues, malnourishment concerns, and embarrassment associated with the inability to swallow. 

Physical Therapy After Stroke 

Stroke reduces mobility in more than half of stroke survivors 65 and older. Physical therapy after stroke takes a diverse approach to addressing mobility challenges. It targets various aspects of recovery (e.g., physical, neurological, and functional) and each patient's unique challenges to achieve the best outcomes.  

Mobility and gait training restores the ability to walk. A therapist may use parallel bars or treadmills to help patients relearn walking skills and introduce walking aids to support stroke recovery. Meanwhile, strength and flexibility exercises rebuild power and endurance while addressing stiffness to lower the risk of contractures (permanent tightening of muscles or tendons).  

Physical therapy after stroke also involves balance and coordination exercises to help patients minimize the risk of falls. Functional retraining guides patients to practice essential daily activities, facilitating their return to normal life based on their lifestyle needs and recovery goals. 

How Physical Activities for Stroke Patients Accelerate Recovery

Chartered Society of Physiotherapy found that high-intensity stroke recovery exercises begun within 24 hours after a stroke can improve outcomes, helping patients regain mobility, strength, and independence. 

Physical activities for stroke patients promote neuroplasticity by stimulating the brain to form new neural pathways and facilitate functional recovery. These treatments also help manage spasticity (muscle tightness) and improve muscle tone to minimize discomfort while aiding movement. 

Physio for stroke patients goes beyond improving physical functions. Experiencing progress and achieving milestones boosts patient confidence while reducing anxiety and post-stroke depression, enhancing emotional well-being. As they regain functional independence, patients can also reintegrate into daily life and reengage with social activities. 

3 Stroke Recovery Exercises for Rehabilitation 

stroke-rehab-railingHere are the top stroke recovery exercises that aid the stroke recovery process: 

  1. Range-of-motion (ROM) exercises help maintain and improve joint flexibility and mobility while preventing contractures. They also increase blood flow to affected areas to facilitate recovery.
  2. Balance and coordination exercises help patients compensate for functional deficits or physical impairments. Patients exercise, move, and use limbs on the affected side to retrain the brain to coordinate them properly.
  3. Strength exercises stimulate muscle growth and help patients rebuild muscle strength for better control and coordination, allowing them to regain independence in their daily activities.  

In addition to these tried-and-true stroke rehabilitation techniques, reputable rehab facilities provide access to the latest technologies to promote stroke recovery. Let’s review the latest advances and how they may help.

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Chapter 4: Techniques and Advances in Stroke Recovery

Types of Stroke Rehabilitation

Breakthroughs in new stroke therapy help significantly improve stroke patients' quality of life and health outcomes. Here are the most pivotal advances in stroke recovery: 

The Latest Advances in Stroke Recovery and Rehabilitation 

These advances in stroke recovery augment conventional stroke rehabilitation techniques to facilitate the rehabilitation journey: 

Thrombectomy 

This surgical procedure, performed up to 24 hours after a stroke, removes a blood clot from a blood vessel. It reduces the severity of stroke side effects for many patients and improves the likelihood that the patient will recover functional independence. 

Vagus Nerve Stimulation 

This treatment may facilitate stroke recovery for patients with impaired upper limbs. It involves implanting a medical device that delivers electrical impulses to the Vagus nerve, a long nerve that controls heart rate, peristalsis, sweating, and several muscle movements, to release neurotransmitters into the brain to strengthen synaptic connections. 

Repetitive Transcranial Magnetic Stimulation (rTMS) 

This non-invasive procedure involves holding an electrode near a patient's head to send impulses through the brain. The high-frequency rTMS promotes functional recovery by inducing the brain's endogenous repair and recovery mechanisms. 

Umbilical Cord Infusions 

Research published in the Journal of Stem Cells Translational Medicine found that a single infusion of umbilical cord blood was safe and helpful in treating ischemic strokes. Researchers theorized that umbilical cord blood might stimulate the development of new neuronal activity in stroke patients. 

Other New Technology for Stroke Patients 

Reputable stroke rehab facilities often incorporate these technologies into personalized treatment plans to facilitate stroke recovery: 

  • Functional Electrical Stimulation (FES) uses low-energy electrical pulses to stimulate brain regions involved in motor and cognitive functions. It helps muscles move, restoring their function while aiding neuroplasticity development.
  • Telemedicine and virtual reality (VR) enable patients to access therapy from home during the long recovery journey. VR platforms provide immersive environments for practicing motor and cognitive exercises, while telemedicine allows patients to receive real-time feedback from their therapists.
  • Treatment plan personalization uses AI and machine learning applications to analyze each patient’s progress and data. Therapists and physicians can use the insights to build tailored rehab plans for faster stroke recovery.
  • Intensive therapy support uses robotic-assisted therapy devices (e.g., robotic arms or exoskeletons) to guide patients through prescribed movements while providing support and resistance when appropriate to help them engage in consistent therapy at higher intensities.
  • Wearable sensors and Internet of Things (IoT) devices provide real-time progress tracking to help therapists monitor progress, make evidence-based adjustments, and set realistic goals. 

How Video Games for Stroke Patients Shorten Recovery Time 

Using video games for stroke recovery is one of the new trends that helps patients regain full use of their limbs. Like other effective stroke rehabilitation techniques, video games for stroke patients help improve neuroplasticity. Such “rewiring,” supported by consistent exercise, helps patients recover lost functionalities.  

Video games promote neuroplasticity by leveraging repetitive, engaging, and goal-oriented activities to stimulate the brain and facilitate healing. They also make it easier for patients to commit to performing repetitive movements through engaging tasks.  

Video games for stroke patients, supported by virtual reality (VR) technology, offer multisensory stimulation (e.g., visual, audio, and tactile feedback). They help improve hand-eye coordination while activating multiple brain regions simultaneously to encourage the creation of new neural pathways.  

Moreover, many video games require players to use both hands or coordinate actions between hands and feet, promoting communication between the brain's hemispheres. The cross-lateral stimulations help restore balance and function between the affected and unaffected sides of the body.  

Video gamesSome video games for stroke patients also involve problem-solving, memory, and decision-making skills to support cognitive flexibility and strengthen neural networks. They also stimulate the release of dopamine — a neurotransmitter that strengthens synaptic connections and keeps patients motivated.  

Today, reputable rehab facilities combine cutting-edge gaming technologies with traditional stroke rehabilitation techniques to maximize the benefits of video games for stroke patients. 

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Chapter 5: A New Beginning With Effective Stroke Recovery

Advances in Stroke Rehabilitation

Stroke recovery is a long journey. Life after stroke requires a lot of adjustments. The good news is that many patients can take their lives back through effective therapy supported by hard work, determination, and patience. 

Life After Stroke: Rehab, Recovery, and New Beginnings 

Therapy is an essential part of life after stroke to help you recover from the event and lower the risk of having another one. Your rehabilitation team will help you regain strength, relearn lost abilities, and work around disabilities or weaknesses. They will also help you manage the emotional side effects, such as post-stroke depression and anxiety.  

Here are a few pointers to navigating life after stroke: 

Choose Between Inpatient vs. Outpatient Rehab 

Inpatient stroke rehab involves checking into a specialized rehabilitation facility for intensive therapy and care. Outpatient rehabilitation therapy may consist of appointments at a rehabilitation clinic daily or several times per week or having therapists provide services in your home. 

Your doctor can help you make the best decision for your care. However, during the first few weeks after stroke, many patients — especially those who experience significant impairments — benefit most from round-the-clock professional attention and intensive rehabilitation programs in dedicated, inpatient rehab centers.  

Start Stroke Recovery as Soon as Possible 

Stroke survivors who begin rehabilitation therapy as soon as they're medically stabilized and get permission from their doctors accomplish the most progress. They recover more skills, abilities, and strength than those who delay rehab or fail to continue therapy. 

Manage Modifiable Risk Factors for Stroke 

About 185,000 strokes per year, nearly one in four, happen in people who have had a previous stroke. Managing modifiable risk factors for stroke through dietary and lifestyle changes can help lower your risk for another stroke and improve your overall health. 

Modifiable risk factors for stroke include high blood pressure, diabetes, smoking, high cholesterol, a sedentary lifestyle, being overweight, poor diet, excessive alcohol consumption, heart disease, arteriosclerosis, and chronic stress. 

Here are some tips to manage modifiable risk factors for stroke: 

  • Mitigate hypertension by lowering salt intake, eating a heart-healthy diet, and taking prescribed antihypertensive medications.
  • Control diabetes with a diet low on sugar and refined carbohydrates. Manage blood glucose levels with medications or insulin as needed.
  • Quit smoking through nicotine replacement therapies, medications, or counseling.
  • Lower cholesterol by reducing the intake of saturated and trans fats and adding fiber and omega-3-rich foods to your diet.
  • Control body weight with a diet and exercise program.
  • Address heart conditions and manage them with prescribed medications or surgical interventions.
  • Manage stress with relaxation techniques and adopt healthy coping mechanisms to avoid destructive behaviors like smoking, drinking, and overeating. 

The good news is that you don’t have to embark on your stroke recovery journey alone. The right stroke rehab facility can provide the appropriate support to help you navigate the process to achieve the best outcomes. 

How Inpatient Rehab Facilities Help With Your Post-Stroke Care Plan 

The American Academy of Physical Medicine and Rehabilitation estimates that 55% of stroke patients require inpatient care after their initial hospitalization to help them recover. 

Inpatient rehab facilities like Rehab Select use evidence-based approaches to design personalized treatment plans for stroke patients to meet individual needs while providing patients with round-the-clock, multi-disciplinary, specialized stroke care.  

The intensive nature of this approach ensures patients stay on track with their treatments to shorten the stroke recovery timeline. All the specialists and caretakers communicate regularly to stay on the same page and support each other’s therapy regimens.  

Moreover, staff members in inpatient rehab facilities are knowledgeable about community programs and other resources patients may need when they return home, such as medical specialists, in-home help, and support groups, to support their long-term stroke recovery. 

How to Choose the Right Stroke Rehab Facility

Stroke recovery may take place in several types of rehab settings after a patient is discharged from the hospital: 

  • An inpatient stroke rehab facility offers the most intensive form of post-stroke rehabilitation. Typically, patients remain in an inpatient program for two to three weeks to receive 24-hour medical supervision and participate in a customized program.
  • A skilled nursing facility supports patients who don’t need full-time, intensive rehab but still require medical care and supervision and are not ready to return home.
  • A nursing home offers long-term nursing care for patients unable to care for themselves after a stroke.
  • Outpatient rehab services are suitable for patients not too severely affected by a stroke or who can arrange for at-home care. Patients may travel to a rehab center in a hospital or medical facility or receive rehabilitative therapy at home. 

Questions to Ask When Choosing a Stroke Rehab Facility  

Choosing the best stroke rehab facility for your needs can be overwhelming. Here are some questions to ask when selecting one for you or your loved one:   

Questions for your insurance provider:  

  • What rehabilitation services are covered by the patient’s medical policy?
  • What is the maximum amount of rehab the patient can receive?
  • What rehab facilities are in your insurance network?
  • Are there any additional financial resources available?
  • Who will cover unexpected additional medical costs? 

Questions for the stroke rehab facility: 

  • Do they offer a specialist stroke rehab program?
  • Are they certified to treat stroke patients?
  • How many patients are currently receiving stroke rehab care?
  • How will progress be evaluated?
  • How do they measure functional recovery?
  • What treatments are available?
  • Where will rehab take place?
  • How do they ensure the quality of care for each patient?
  • What percentage of short-term stroke rehab patients are discharged home?
  • What support do they offer family members and caregivers?
  • What psychological support is offered to stroke patients?
  • How do they prevent falls?
  • Person celebratingHow do they prevent reoccurring strokes?
  • Do the nurses, therapists, and support staff have specialist training?
  • Which professionals will be involved in patient care?
  • How frequently will the patient see a physician?
  • Do they offer 24-hour medical supervision?
  • What will the patient schedule look like? 

Besides asking these questions, seek a stroke rehab facility that aims to get patients home as quickly as possible. They should prioritize each patient’s quality of life and help restore their self-confidence and autonomy. They should build their rehab programs to support real-life needs and help you plan the discharge process diligently to make returning home as easy and stress-free as possible.

State-of-the-Art Inpatient Stroke Rehab Facility in Alabama

The American Stroke Association recommends that patients who have suffered a serious stroke participate in intensive inpatient rehab for as long as possible.  

Rehab Select’s five state-of-the-art facilities across Alabama are here to help. We provide access to a team of specialists who facilitate stroke recovery with a personalized treatment plan, various therapeutic modalities, and new technology for stroke patients —helping patients shorten their stroke recovery timeline. 

Learn more and schedule a tour of our facilities in Alabaster, Talladega, Montgomery, Albertville, or Guntersville.

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