Pone 0305245
Pone 0305245
Pone 0305245
RESEARCH ARTICLE
1 Fizyo & Osteopathy Physical Therapy and Healthy Life Center, Nicosia, Cyprus, 2 Faculty of Physical
Therapy and Rehabilitation, University of Hacettepe, Ankara, Turkey, 3 Faculty of Health Sciences, Physical
Therapy and Rehabilitation Department, Eastern Mediterranean University, Famagusta, Cyprus
Funding: The author(s) received no specific In adolescent football players, overuse injuries occur at a rate of 10–40%. The majority (60–
funding for this work. 90%) of injuries are observed in the lower extremity, including the ankle and thigh. The most
Competing interests: The authors have declared common types of injuries are strains, sprains, and contusions [3,4]. Approximately 40%–60%
that no competing interests exist. of injuries occur due to contact with another player or object during the game [5]. Conse-
quently, adolescents have an increased risk of injury from repetitive mechanical stress [6].
The core muscle group is defined as a muscle corset consisting of the abdominals in the
front, the erector spinae and gluteals in the back, the diaphragm as the roof, and the pelvic
floor and hip girdle muscles at the bottom [7]. These muscles collectively support the spine
and trunk during upper and lower extremity movements such as jumping, throwing, running,
and kicking the ball [8]. Kibler [9] explains core stability based on the principle of ‘‘proximal
stability for distal mobility.” According to this principle, optimal transfer and control of power
and movement transmitted to the distal segments during sports activities are achievable
through the ability to control the position and movement of the trunk on the lower extremities
and pelvis [9]. Brown [7] adds that core stability is achieved through the dynamic restriction
provided by the core muscles and the passive stiffness contributed by the vertebrae, fascia, and
ligaments [11]. Panjabi [10] further notes that, in addition to bone, ligament, and muscle
structures, the central nervous system also plays a role in contributing to core stability by pro-
viding neuromuscular control [10].
Training the core muscles is expected to enhance athletic performance and reduce injuries
[9,11]. Studies indicate that disorders in core muscle strength and endurance, proprioception,
and neuromuscular control of core muscles, which can affect core stability, are important risk
factors in the development of lower extremity injuries [12,13]. The effect of core stability train-
ing (CST) on athletic performance has been and continues to be studied. Previous studies
revealed that a CST program increased some parameters of general performance and sport-
specific performance in badminton, handball, baseball, basketball, football, swimming, tennis,
rhythmic gymnastics, and modern dance [14–23].
Although many studies in the literature investigate the effect of core exercise training on
performance, only a few studies look into the effects of a CST program in adolescent football
players [3,12]. We hypothesized that core stability exercises would improve ball-kicking veloc-
ity, sprint speed, and agility in adolescent male football players.
Methods
Experimental approach to the problem
The minimum number of participants required for a study power of 0.95 and alpha error 0.05
was determined using G Power 3.0.10 G Software for Windows (Heinrich-Heine-Universität
Düsseldorf, Düsseldorf, Germany). The results revealed that 36 players are needed. To evaluate
the effect of CST, 45 adolescent male football players who were on a similar training program,
met the study criteria, and whose legal guardians signed the informed consent form were
divided into the training group (TG) (n = 23) and control group (CG) (n = 22) (Fig 1). The TG
followed the CST program three days a week for 8 weeks in addition to the routine training
program, while the CG followed the routine training program only. The participants’ ball-
kicking velocity, sprint speed, and agility performances were evaluated by the same physiother-
apist before training and eight weeks after training. Measurements data were collected at the
beginning of the study and after the completion of the 8 weeks CST program. October 1, 2021
pre-study measurements were completed. CST program was implemented between the dates
October 2, 2021- November 27, 2021. November 29, 2021 post-study measurements were
repeated.
Subjects
The protocol of this study was approved by the Eastern Mediterranean University Health Eth-
ics Subcommittee Presidency prior to the conduct of the study. The study population consisted
of male adolescent football players aged between 12–14, playing football at the youth setup of a
football academy. The study inclusion criteria were determined as not having any pain com-
plaints involving the lower extremities and spine, should had no surgery before of the study,
not having a pathological condition, and participating regularly in training. On the other
hand, the study exclusion criteria were determined as having taken a break from sports, not
having participated in training more than three times, and having difficulty following exercise
programs.
Measurements
Ball-kicking velocity test. Kicking velocity was measured using a Bushnell velocity radar
gun (Bushnell Performance Optics, Overland Park, KS, US) [24]. To this end, the ball was
placed at a distance of 15 m from the goal. The tripod support of the velocity radar gun was set
at a height of 1.22 m from the ground and kept 1 m behind the goal. The participants were
asked to run from a distance of 5 m and kick the ball with maximum force. A test kick was
made, followed by three kicks. The average of these three kicks was recorded in km/h. In
accordance with the International Federation of Association Football (FIFA) standards, 12-to-
13-year-olds made the kicks with a number 4 soccer ball, and 14-year-olds made the kicks with
a number 5 soccer ball [25,26]. Radar guns are a common tool both in practical use and scien-
tific research due to their high accuracy (ICC> 0.94) [27,28].
Sprint speed test. Sprint speed was measured via the 20 m sprint test. To this end, the par-
ticipants were asked to start the sprint run 50 cm behind the starting line, and the time to com-
plete 20 m was recorded in seconds. Sprint test was conducted using a stopwatch. The
reliability of 20 m sprint test among U12 (ICC = 0.73), U13 (ICC = 0.90) and U14 (ICC = 0.83)
has been demonstrated [29].
Agility test. Agility performance was measured with the 505 agility test developed by
Draper and Lancaster in 1985. To this end, the participants were first asked to complete a 10 m
approach run, followed by moving back a distance of 5 m, making a 180˚ turn, and returning.
The time it took for the participants to cover the said 5 m distance back and forth was recorded
in seconds. Agility test was conducted using a stopwatch. The reliability of 505 agility test
among U12 (ICC = 0.57), U13 (ICC = 0.91) and U14 (ICC = 0.89) has been demonstrated [29].
Training program
Following the completion of performance assessment measurements, an exercise diary was
created to track participants’ attendance in the study. Subsequently, the TG followed the CST
program in addition to the routine training program during the season for eight weeks, three
days a week, under the supervision of the same physiotherapist. The program was imple-
mented in three phases. Accordingly, phases 1, 2 and 3 were implemented between 1st–3rd,
3rd–5th, and 5th–8th weeks, respectively. Before the initiation of the program, transversus abdo-
minis muscle and multifidus muscle contraction were explained and checked by palpation to
enhance motor control, endurance, and kinesthetic awareness. This was followed by four ses-
sions of individual training, including instructions on maintaining a neutral spine position,
abdominal hallowing, and abdominal bracing techniques, utilizing a pressure biofeedback
device. Ankle weights, dumbbells, resistance bands, and physio balls were incorporated into
the program. The exercise equipments’ used by participants were determined by verbally ask-
ing them about the weights they could lift ten times in a row without difficulty. Exercise inten-
sity progressively increased every phases. From week 1–3 exercises were repeated 15 times, 1
set. From week 3–5 exercises were repeated 12 times, 2 sets. From week 5–8 exercises were
repeated 10 times, 3 sets. The rest period between sets was one minute in all training phases.
The exercise program content was changed every phases; thus, duration of the sessions was ini-
tially 40 minutes and increased to 60 minutes in the following weeks. Warm-up exercises were
performed for 10 minutes before each session, and a 10-minute cool-down program was
applied at the end of each session. The details of the CST program are outlined in Table 1.
Statistical analysis
The descriptive statistics obtained from the collected data were tabulated as mean ± standard
deviation or median with minimum and maximum values, depending on the normal distribu-
tion characteristics of continuous (numerical) variables. Categorical variables were presented
as numbers and percentages. Normal distribution characteristics of numerical variables were
assessed using the Shapiro-Wilk, Kolmogorov-Smirnov, and Anderson-Darling tests. In com-
parisons of two independent groups, the independent samples t-test or Mann-Whitney U test
was used for normally and non-normally distributed numerical variables, respectively. For
comparisons of two dependent groups, the paired samples t-test was applied. Statistical analy-
ses were conducted using Jamovi project 2.2.5.0 (Jamovi, version 2.2.5.0, 2022, retrieved from
https://www.jamovi.org) and JASP 0.16.1 (Jeffreys’ Amazing Statistics Program, version 0.16.1,
2022, retrieved from https://jasp-stats.org) software packages. A probability (p) value of � 0.05
was deemed to indicate statistical significance.
Results
During the study period, four and five participants from the TG and CG groups, respectively,
were excluded from the study. Three players from the TG did not participate regularly in CST
and one player had an orthopedic injury. Five participants from CG did not participate regu-
larly in routine training program. In the end, 19 and 17 participants completed the study in
the TG and CG, respectively (Fig 1). The age, height, weight, body mass index, and sports age
data of the participants showed a homogeneous distribution. The distribution of the partici-
pants’ demographic characteristics by the TG and CG is given in Table 2.
The inter-group comparisons after the completion of the CST program revealed significant
differences between the TG and CG. Accordingly, a significant difference was found between
the TG and CG in ball-kicking velocity after the completion of the program, in favor of the TG
(p = 0.002, d > 1). Similarly, the sprint speed test time was significantly higher in the CG than
in the TG after the completion of the program (p = 0.001, d > -1.2). There was a significant dif-
ference between the TG and CG in the median percent change in sprint speed, in favor of the
CG (p = 0.006). In parallel, the decrease in the time to complete the sprint speed test was signif-
icantly higher in the TG than in the CG (-5.56 [-21.03–4.13] sec. vs. -0.71 [-7.19–17.62] sec.).
The inter-group comparisons in agility performance parameters did not reveal any statistically
significant difference between the groups (p > 0.05). Effect size for time agility was d = -0.51
(CI = [-1.175–0.156]) (Table 3) (Figs 2–4).
The intra-group comparisons revealed significantly higher ball-kicking velocity and signifi-
cantly lower sprint speed and agility test times with large effect sizes in the TG (p = 0.002, d =
-0.83; p < 0.001, d = 0.90; p < 0.001, d = 0.95 respectively) (Table 4) (Figs 2–4).
Descriptive statistics were expressed as mean ± standard deviation and median [minimum-maximum].
Test statistic: The numerical outcome of statistical tests comparing the demographic characteristics between the training and control groups.
CI: Confidence Interval.
p-values*: Results of Independent samples t-test.
p-values **: Results of Mann-Whitney u test.
https://doi.org/10.1371/journal.pone.0305245.t002
Table 3. Comparison of inter group performance tests before and after the core stability exercise program.
Training group Control group Test Cohen’s d [95% CI] p-value
(n = 19) (n = 17) statistic
Ball kicking velocity (km/hour)
Before the Program 71.89 ± 16.21 67.71 ± 13.80 121.500 0.248 [-0.129–0.562] 0.204**
78.00 [35.00–92.00] 68.00 [29.00–88.00]
After the Program 81.05 ± 8.46 69.12 ± 13.04 3.292 1.099 [0.388–1.796] 0.002*†
82.00 [63.00–97.00] 69.00 [32.00–89.00]
Δ% 7.14 [-8.75–87.50] 4.41 [-14.71–19.61] 100.000 0.381 [0.018–0655] 0.051**
Sprint speed (sec)
Before the Program 3.86 ± 0.40 3.96 ± 0.25 -0.897 -0.300 [-0.956–0.361] 0.376*
3.78 [3.28–4.81] 4.00 [3.50–4.31]
After the Program 3.60 ± 0.23 3.95 ± 0.34 -3.706 -1.237 [-1.947 –-0.513] 0.001*†
3.59 [3.09–4.00] 3.94 [3.44–4.94]
Δ% -5.56 [-21.03–4.13] -0.71 [-7.19–17.62] 74.000 -0.542 [-0.757 –-0.220] 0.006***
Agility (sec)
Before the Program 3.03 ± 0.28 3.03 ± 0.20 -0.017 -0.006 [-0.660–0.649] 0.987*
2.94 [2.66–3.60] 2.96 [2.81–3.53]
After the Program 2.80 ± 0.28 2.93 ± 0.20 -1.536 -0.513 [-1.175–0.156] 0.134*
2.75 [2.41–3.58] 2.90 [2.68–3.40]
Δ% -4.82 [-21.94–4.07] -3.68 [-9.37–10.33] 122.000 -0.245 [-0.560–0.133] 0.211**
Descriptive statistics were expressed as mean ± standard deviation and median [minimum-maximum].
Δ%: Percentage difference between two times (positive values indicate increase, negative values indicate decrease).
Test statistic: The numerical outcome of statistical tests comparing the inter group performance tests before and after the program between the training and control
groups.
CI: Confidence Interval.
p-values
*: Results of Independent samples t-test.
p-values
**: Results of Mann-Whitney u test.
† Significate difference between training group and control group (p < 0.05).
https://doi.org/10.1371/journal.pone.0305245.t003
On the other hand, in the CG, no significant change was detected in the ball-kicking veloc-
ity and sprint speed (p > 0.05, d = -0.24; p > 0.05, d = 0.02 respectively), whereas a significant
improvement was observed in agility performance (p = 0.009, d = 0.71 CI = [0.171–1.242])
(Table 5) (Figs 2–4).
Discussion
This study aimed to investigate the effects of core stability exercises on ball-kicking velocity,
sprint speed, and agility in adolescent male football players. The findings of this study revealed
that the implementation of a CST program, in addition to the routine training program during
the season, is effective in improving ball-kicking velocity and sprint speed. On the other hand,
the CST program did not lead to a significant improvement in agility performance among ado-
lescent male football players. Although these results were generally consistent with previous
studies conducted with athletes from different age groups and genders, as well as healthy indi-
viduals, they also exhibit some differences in terms of certain sport-specific parameters.
Kicking the ball, an action that engages multiple joints, stands out as one of the most crucial
skills in football. The performance of ball-kicking relies on the maximum force and strength
Fig 2. Ball kicking velocity pre- training and post- training values in TG and CG. TG = Training group, CG = Control
group.
https://doi.org/10.1371/journal.pone.0305245.g002
Fig 3. Sprint speed pre- training and post- training values in TG and CG. TG = Training group, CG = Control group.
https://doi.org/10.1371/journal.pone.0305245.g003
Fig 4. Agility pre- training and post- training values in TG and CG. TG = Training group, CG = Control group.
https://doi.org/10.1371/journal.pone.0305245.g004
exerted by the foot responsible for both kicking the ball and providing support. Additionally, it
depends on the coordination between agonist muscles (including vastus lateralis, medialis, rec-
tus femoris, tibialis anterior, iliopsoas) and antagonist muscles (such as gluteus maximus,
biceps femoris, and semitendinosus) [30,31]. Wickstorm explains kicking the ball in four
phases: (1) the swing phase, where the thigh and shank are withdrawn; (2) the support phase,
where hip flexion begins; (3) ball impact, involving knee extension; and (4) the follow-through,
where both the hip and knee undergo flexion [25,32]. A review study, encompassing 96 studies
on the relationship between ball-kicking velocity and muscle strength, unveiled a significant
Table 4. Comparison of performance tests before and after the exercise program in the training group.
Training group Test Cohen’s d [95% CI] p-value
Before the Program After the Program Statistic
Ball kicking velocity (km/hour) 71.89 ± 16.21 81.05 ± 8.46 -3.637 -0.834 [-1.351 –-0.301] 0.002*†
78.00 [35.00–92.00] 82.00 [63.00–97.00]
Sprint speed (sec) 3.86 ± 0.40 3.60 ± 0.23 3.938 0.903 [0.358–1.431] <0.001*†
3.78 [3.28–4.81] 3.59 [3.09–4.00]
Agility (sec) 3.03 ± 0.28 2.80 ± 0.28 4.148 0.952 [0.397–1.488] <0.001*†
2.94 [2.66–3.60] 2.75 [2.41–3.58]
Descriptive statistics were expressed as mean ± standard deviation and median [minimum-maximum].
Test statistic: The numerical outcome of statistical tests comparing the performance tests before and after the exercise program in the training group.
CI: Confidence Interval.
p-values*: Results of paired samples t-test.
† Significant difference between before and after the program (p < 0.05).
https://doi.org/10.1371/journal.pone.0305245.t004
Table 5. Comparison of performance tests before and after the exercise program in the control group.
Control group Test Cohen’s d [95% CI] p-value
Before the Program After the Program statistic
Ball kicking velocity (km/hour) 67.71 ± 13.80 69.12 ± 13.04 -0.995 -0.241 [-0.720–0.245] 0.335*
68.00 [29.00–88.00] 69.00 [32.00–89.00]
Sprint speed (sec) 3.96 ± 0.25 3.95 ± 0.34 0.212 0.027 [-0.449–0.502] 0.913*
4.00 [3.50–4.31] 3.94 [3.44–4.94]
Agility (sec) 3.03 ± 0.20 2.93 ± 0.20 2.949 0.715 [0.171–1.242] 0.009*†
2.96 [2.81–3.53] 2.90 [2.68–3.40]
Descriptive statistics were expressed as mean ± standard deviation and median [minimum-maximum].
Test statistic: The numerical outcome of statistical tests comparing the performance tests before and after the exercise program in the control group.
CI: Confidence Interval.
p-values*: Results of paired samples t-test.
† Significant difference between before and after the program (p <0.05).
https://doi.org/10.1371/journal.pone.0305245.t005
correlation between maximal isokinetic force and ball-kicking velocity in young football play-
ers. Conversely, the analysis of the results from explosive power tests and ball-kicking velocity
in young football players did not reveal any significant relationship between maximal strength,
explosive strength, and ball-kicking performance. They also found no significant relationship
between the results of the 10 m sprint test and ball-kicking velocity. The aforementioned
review study concluded that, despite the controversy surrounding the relationship between
strength and ball-kicking velocity, incorporating plyometric and explosive strength exercises
into the training routine may enhance maximum ball-kicking velocity [33]. Sporis et al. [26]
investigated the relationship between ball-kicking velocity and sprint speed with 27 football
players with an average age of 15±2.9. They measured ball-kicking speed using a velocity speed
gun and running speed through 5, 10, 20, and 30 m sprint tests. In the mentioned study, in
contrast to Lorenzo et al.’s [33] study, ball-kicking velocity was found to be significantly related
to running speed [26]. In a study examining the relationship between ball-kicking speed and
muscle strength, the dominant lower extremity strength of amateur football players was mea-
sured with an isokinetic dynamometer at 90˚ and 240˚ angular velocities. Consequently, it was
demonstrated that participants with greater knee extension concentric strength had signifi-
cantly higher ball-kicking speeds [34].
In our study, both intra- and inter-group analyses of ball-kicking velocity measurements,
conducted with a velocity radar gun, revealed that the CST program significantly improved
ball-kicking velocity. The noteworthy improvement in ball-kicking velocity within the TG
compared to the CG may be attributed to the increase in muscle strength and postural control
ability fostered by the CST program. Similarly, in a randomized controlled study examining
the effect of in-season integrative neuromuscular strength training on performance develop-
ment in early adolescent football players who followed a neuromuscular training program
three times a week for eight weeks in addition to the routine training program, in comparison
with a CG who only followed the routine training program, Panagoulis et al. [23] found signifi-
cant improvements in all parameters. These included ball-kicking velocity, 10–20 m sprint
speed, jumping performance, and lower extremity muscle strength in the study group [23].
In a review study encompassing 21 studies related to sports where postural stability is essen-
tial, including team sports such as football, basketball, and hockey, as well as individual sports
such as tennis, running, and cycling, Zemkova et al. [35] investigated whether core stability
exercises contribute to improving sport-specific performance. They found that the CST
strength, linear running speed, and direction change/agility performance in young people and
adults if applied for more than 18 sessions but less than or equal to 30 minutes. However, to
achieve sport-specific performance improvement, this training should be applied for more
>30 minutes twice a week. They also stated that there is a need to investigate the effects of dif-
ferent CST programs on sport-specific parameters and physical performance [41].
Doğanay et al. [42] investigated the effects of core exercise training, administered for 35
minutes thrice a week over eight weeks, on running speed, quickness, and agility in U19 male
football players. These parameters were measured using the 40 m sprint test, hexagon test, and
agility t-test, respectively. Consequently, they observed significant differences between the TG
and CG in agility and quickness, but not in sprint speed [42]. In contrast, our study detected
significant improvements in ball-kicking velocity and sprint speed, while agility did not show
a significant enhancement in adolescent football players. Some studies have speculated that an
increase in power, strength, speed, and overall performance may be achieved primarily
through participation in football training during the adolescent and preadolescent period
[43,44]. In one study in the literature, arguing the opposite perspective, Schilling et al. [45]
applied a core strength and endurance training program on 10 college students who did not
participate in sports activities. The program was conducted twice a week for six weeks. Signifi-
cant changes were observed in back extensor endurance, flexor endurance, and lateral muscu-
lature endurance values after the completion of the training program. However, no significant
improvements were found in sprint speed, agility, and vertical jump performances. As a result,
the researchers concluded that standalone strength training does not enhance performance
parameters [45]. Similarly, Nesser and Lee [46] asserted that core strengthening does not lead
to improvements in sports performance parameters such as agility and running [46].
Agility is defined as the ability to move the body between two points and change direction
as easily, quickly, fluently, and controlled as possible, with balance, speed, strength, and nerve-
muscle coordination [47]. We measured physical component of agility performance using the
505 agility test. While intra-group evaluations revealed significant changes in agility in both
the TG and CG, inter-group comparisons showed no significant differences between the
groups. We attribute the increase in agility in both the TG and CG to the fact that the study
was carried out during the season, and both groups followed routine training. Additionally, we
believe that the reason the study group did not show superiority to the control group in agility
performance is related to the absence of agility training specific to football in the CST
program.
As a matter of fact, studies conducted in other sports have yielded varied results regarding
the impact of core exercises on sport-specific parameters. In one such study examining the
effects of core strengthening training on physical and athletic performance in elite handball
players, significant improvements were observed in physical components, but not in handball-
specific athletic performance [14]. Similarly, a study investigating the effects of core exercises
on functional movement patterns in adult tennis players reported significant changes in all
functional movement screen test results [48]. Lust et al. [49] also found that a six-week training
program, combining open and closed kinetic chain plyometric exercises with core stability
exercises, improved core endurance in baseball athletes [49]. Özmen et al. [22] investigated the
effect of CST program applied twice a week for six weeks on dynamic balance and agility in
adolescent badminton players with a mean age of 10±0.3 years. They measured dynamic bal-
ance using the Star Excursion Balance test and agility with the Illinois agility test. Conse-
quently, they observed a significant improvement in dynamic balance in the TG compared to
the CG, which followed routine training. On the other hand, they found that agility increased
in both groups, but there was no significant difference between the groups [22]. Athletes gen-
erally participate in high-intensity training programs along with a core stability program.
Therefore, it is challenging to investigate the effect of a core stability exercise program on per-
formance independently from other training.
Studies conducted in various sports on the effect of CST on sports performance have
yielded inconsistent results. The findings of this study indicated that an eight-week core stabil-
ity exercise program, in addition to routine training, led to improvements in ball-kicking
velocity and sprint speed in adolescent male soccer players. However, as no significant differ-
ence was observed between the TG and CG in agility performance, we recommend incorporat-
ing agility-style exercises into the CST program and extending the program duration for more
substantial benefits.
Limitations
There are several limitations to our study. Firstly, only performance-oriented tests were used
for evaluation. The results could have been interpreted more effectively if core strength tests
were applied in conjunction with the performance tests. Secondly, adding a new training to
the routine program may have increased the load in CST group. Thirdly, the study was con-
ducted during a period when the participants were receiving distance education due to the
coronavirus 2019 (COVID-19) measures and were leaving their homes almost exclusively for
football training. Control and focus, which are essential for exercise efficiency, are employed
during the performance of core exercises. Throughout the study period, it was noted that par-
ticipants encountered challenges in adaptation attributed to psychosocial factors. Conse-
quently, the application of the study during a period when participants were subjected to
pandemic-related restrictions may have influenced the results.
In future research, our intention is to explore the effects of core exercises on injury inci-
dence among adolescent football players and their recovery performance during the rehabilita-
tion period following an injury.
Practical applications
The study’s findings suggest that an 8-week CST program enhanced ball-kicking velocity,
sprint speed, and agility performance in adolescent male soccer players. Due to its practicality
in the field, affordability of associated equipment costs, and adaptability to routine training
programs, we recommend the CST program to football coaches and individuals professionally
engaged in football to enhance their performance.
Supporting information
S1 Data.
(XLSX)
Acknowledgments
The authors gratefully acknowledge the contribution of the participants in this study.
Author Contributions
Conceptualization: Ceyda Sofuoğlu, Volga Bayrakcı Tunay.
Data curation: Ceyda Sofuoğlu.
Formal analysis: Ceyda Sofuoğlu.
Investigation: Ceyda Sofuoğlu, Volga Bayrakcı Tunay.
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