Term
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Definition
| process or components of walking. Basic: balancing on one leg while other leg moves fwd. analyze gait: what joint motions occur. Then decide which muscle(s) groups are acting p339 |
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Term
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Definition
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Term
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Definition
| Distance traveled during gait cycle |
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Term
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Definition
| – basically one-half of a stride 2 steps = a stride or gait cycle |
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Term
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Definition
| is that distrance between the heel strike of one foot & heel strike of other foot |
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Definition
| walking speed. Number of steps taken per minute. Slow may be 70 spm, fast 130 spm. Gait is same regardless of speed. All parts occur in proper place at proper time p 340 |
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Term
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Definition
activity that occurs when foot is in contact w/the ground begins w/heel strike of one foot and ends when that foot leaves the ground. Accounts for about 60% of the gait cycle.
= The weight bearing phase of gait |
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Term
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Definition
Heel strike – initial contact
Foot flat - loading
Mid-stance
Heel off – terminal stance
Push off/toe off – “preswing” |
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Term
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Definition
foot is not in contact w/floor. Begins as foot leaves the floor and ends when heel of same foot touches floor again. Swing phase makes up approx 40% of gait cycle >non weight-bearing phase of gait
>>Initial – acceleration
>>mid phase – mid swing non-wt bearing leg is directly under the body
>>Terminal swing – deceleration |
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Term
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Definition
| A voluntary position or attitude of the body, the relative arrangement of body parts for a specific activity, or a characteristic manner of bearing one’s body. Which can become habit and is influenced by culture, fatigue, emotions, structure (stand/sit,thin/obese). It can be static (sitting, standing, lying) or it can be dynamic as body moves f one position to another |
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Term
| how do emotions, fatigue & structure affect posture? |
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Definition
emotions – faster for happy or angry; skip when exhilarated; slow for sad
fatigue – shuffle for tired
structure - speed, stride length |
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Term
| Habitual postures without positional changes result in |
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Definition
| pain, deformity, contracture, and injury |
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Term
| Comatose patients & posture |
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Definition
| possibility of joint contractures (ankle plantarflexion, wrist and finger flexion, knee flexion, etc.) due to prolonged poor posture |
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Term
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Definition
| increase muscle tone may lead to wrist and finger flexion contractures, ankle plantarflexion contractures |
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Term
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Definition
| scarring over a joint may restrict movement and lead to contracture and deformity |
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Term
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Definition
| lateral curvature of the spine which may be idiopathic or related to injury |
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Term
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Definition
| protecting a joint because of pain may lead to contracture and deformity due to lack of movement |
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Term
| Pressure ulcerations and posture |
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Definition
| lack of movement with prolonged poor positioning can lead to skin breakdown (calcaneal, sacral ulcers) |
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Term
| Compensation from injury and posture |
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Definition
| protecting a joint that has been injured can lead to lack of movement and the development of contracture and deformity |
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Term
| What is the affect of prolonged abnormal posture On Circulation |
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Definition
-Decreased nutrition -Decreased vascularization
-Skin breakdown with pressure |
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Term
| What is the affect of prolonged abnormal posture On Muscle |
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Definition
=Muscular imbalances
=Atrophy
=Loss of elasticity |
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Term
| What is the affect of prolonged abnormal posture On Joints |
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Definition
| >Decreased elasticity of ligaments >Decreased synovial fluid |
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Term
| What is the normal alignment of body segments in normal posture |
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Definition
ANTERIOR p 333
>Head is in midline
>Shoulders are level
>Level iliac crests and ASIS
>Knees are level
>Medial malleoli are opposing one another |
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Term
| What is the normal alignment of body segments in normal posture Posterior? |
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Definition
POSTERIOR
-Head is in midline
-Shoulders are level
-Spines of the scapulae and inferior angles are in alignment with one another
-Iliac crests , PSISs, and inferior gluteal folds are in alignment
-Popliteal fossae are aligned
-Medial malleoli are aligned |
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Term
| What is the normal alignment of body segments in normal posture Lateral view? |
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Definition
LATERAL
-Plumb line falls through the ear and the center of the shoulder (acromion process)
-Line falls through the hip joint or slightly posterior (greater trochanter)
-Line falls anterior to the knee and the ankle
-knee joint passively extended in standing |
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Term
| Increased thoracic kyphosis |
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Definition
| head extended, cervical spine hyperextended, hips FLX, anterior tilt pelvis, thoracic spine = kyphosis or incr flexion; lumbar spine – hypertext or lordosis |
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Term
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Definition
| everything extended, head forward, thoracic slight FLX, cervical spine slightly EXT |
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Term
| What are key elements of proper sitting? |
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Definition
-Disc pressure is nearly twice as great as standing due to shift of weight to the front part of the vertebrae
-Best to maintain lumbar curve in sitting with chairs that provide good lumbar support
-Slouching causes increased stress on the thoracic and cervical regions
-Properly position work at eye level
-Position and support to relieve stress on neck and shoulders |
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Term
| What are the key elements of proper standing? |
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Definition
-Relatively little energy expenditure to remain in standing
-Slow twitch muscle contractions – especially hamstrings and soleus
-Rely on ligamentous support to maintain standing
-Shift weight from one foot to the other to allow muscles to rest
-Lack of muscle pump and fainting
>pooling of venous blood |
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Term
| 5 Components of Stance are: |
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Definition
| 1.Heel strike 2. Foot flat 3. Midstance 4. Heel-off 5. Toe-off |
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Term
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Definition
ankle = 0-5 degrees of DF’d to neutral
knee = 0 degrees
hip = 20-30 degrees of hip flexion depending on the stride length
+ pelvis rotated forward |
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Term
| Heel Strike muscle action? |
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Definition
--eccentric contractions of the tibialis anterior and the quadriceps mechanism
--erector spinae contract for shock absorption |
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Term
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Definition
ankle = 10-20 degrees of PF
knee = 5 degrees of flexion partially flexed absorbing shock
hip = 10 degrees of flexion hip moving into extension |
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Term
Flat Foot
Muscle action = body catching up w/leg? |
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Definition
| continued eccentric work of tibialis anterior and the quadriceps mechanism |
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Term
| Weakness at heel strike & foot flat leads to the what gait deviations? |
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Definition
| foot slap, knee buckling, genu recurvatum, decreased stance time on the same side with deceased step length on the opposite side |
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Term
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Definition
Opposite LE is in mid-swing
ankle = neutral to 10 degrees of DF ankle slightly DF’d
knee = 0 degrees
knee & hip continue extending
hip = neutral pelvis in neutral |
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Term
| What muscle action occuring during Midstance? |
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Definition
| gluteus maximus and medius |
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Term
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Definition
ankle = 5-10 degrees of PF
ankle slightly DF then begins PF
knee = 0 degrees
knee ext then beginning slight FLX
hip = 5-10 degrees of extension hip hyperextending |
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Term
| Muscle action during Heel Off? |
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Definition
-triceps surae -controls the anterior motion of the tibia on the talus
-erector spinae at opposite heel strike |
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Term
| If weaknesses at Heel off, what gait deviations may occur? |
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Definition
| poor push off, decreased stride length |
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Term
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Definition
-ankle = 20-30 degrees of PF
-knee = 20-30 degrees of FLX
-hip = 10 of EXT
lateral pelvic tilt on right side |
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Term
| What muscle actions at toe/push off? |
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Definition
-triceps surae
-hamstrings |
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Term
| What gait deviations can occur at toe\push-off from muscle weakness? |
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Definition
| poor push off, toe drag, increased hip/knee flexion |
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Term
| What are three parts of Swing Phase? |
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Definition
| Acceleration, Midwing and Deceleration |
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Term
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Definition
| Initial swing – leg is behind body, moving forward to catch up. Begins w/foot leaving floor, ends w/swinging foot opposite stance foot. Non-weight bering phase begins. Single leg support beings on contralateral side |
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Term
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Definition
ankle neutral beginning to DF
knee = 30-40 FLX
knee & hip continue FLX
hip = 5 FLX pelvis beg’g to rotate fwd |
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Term
| Muscles acting during acceleration |
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Definition
-tibialis anterior
-hamstrings |
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Term
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Definition
| Begins w/foot opposite stance foot, ends w/tibia in vertical position. Foot swings under & past body. Leg shortens to clear floor; single leg support continues on contralateral side |
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Term
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Definition
ankle neutral
knee = 70 FLX
Knee at max flex & beg to EXT
hip neutral,10 FLX
hip at max flex; pelvis neutral |
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Term
| Muscle action during Midswing? |
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Definition
=tibialis anterior
-hamstrings
-sartorius, gracilis |
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Term
| Deceleration / Terminal swing defined |
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Definition
| leg slowing down, preparing to touch floor. Begins w/vertical tibia, ends when foot touches floor. Leg advancement task ends. Single support ends. |
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Term
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Definition
ankle 5-10 DF, cont DF
knee = 0, EXT
hip 20-30 FLX
leg ahead of body. Pelvis ROT FWD |
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Term
| Deceleration muscle action |
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Definition
| eccentric contraction of the gluteus maximus and hamstrings to slow down the forward moving LE |
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Term
| Gait deviation in Deceleration |
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Definition
| terminal knee extension – uncontrolled extension of the tibia as the knee slaps into extension |
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Term
| What is Double contact/support? |
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Definition
| at normal speeds there is a period when both feet are in contact with the ground. |
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Term
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Definition
| Single support occurs when only one foot is in contact with the ground |
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Term
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Definition
| the distance between heel contact of one foot to the subsequent heel contact of the same foot |
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Term
| What happens when speed of gait increased? |
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Definition
stride length increases and the time of double contact decreases
when running - there are periods when neither foot is contact with the ground called “nonsupport”
Cadence increases with increased gait speed |
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Term
| Why can individual is able to walk for long periods of time without fatiguing? |
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Definition
muscles have a burst of activity followed by a period of rest
--accounts for lack of fatigue. In normal gait, the individual has a wide latitude of safe, comfortable gait speeds avail. |
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Term
| What walking speed indicates decline in physical function? |
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Definition
| less than 0.6 meters/second (1.3 mph) |
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Term
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Definition
1.Trendelenburg (pelvis drops on the affected leg during stance) w/foot drag on the opp side
2.Lateral trunk FLX twd the stance leg to clear swinging leg on opp side
3. Decr step length on the swing side
4. Decr stance time on the stance side |
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Term
| Early & Midswing deviations |
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Definition
1 Foot/toe drag – failure to clear the toes during swing
2 Circumduction – LE swings forward in a circular pattern using a combination of hip ab, add & ROT
3 Lat trunk FLX twd stance phase LE – leaning over strong leg helps to provide clearance for swing of the weak leg |
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Term
| More Early & Swing Deviations |
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Definition
4 Hip hiking – use quadratus lumborum to elevate pelvis,clear the affected leg for swing
5 Trunk extension–throwing trunk into EXT during swing helps the affected to move forward. |
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Term
| Two more Early & Mid Swing Deviations |
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Definition
6. Vaulting – strong plantarflexion on strong leg during midstance helps the opp swinging leg to be advanced
7. Excessive hip/knee FLX–using strong hip flexors to compensate for weak hamstrings or dorsiflexors. Also known as “steppage gait.” |
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Term
| ENERGY CONSUMPTION – NORMAL GAIT |
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Definition
| The greater the stride length and the faster the gait cadence, the greater the energy consumption |
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Term
| More energy consumption at normal gait |
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Definition
-Energy cost (O2 consumption per unit of time) is relatively constant until stride lengths exceed 90cm
-Calorie cost incr w/incr speed and inclination |
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Term
| ENERGY COST IN SPECIAL POPULATIONS |
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Definition
-The lower the amputation the lower the energy cost
-Ambulating w/prosthesis has a lower energy cost than amb w/crutches
-use of orthotic devices in hemiplegic patients may decr energy costs |
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Term
| Energy cost considerations |
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Definition
=Braces may incr or decr energy consumption
-Weight bearing status may affect energy use |
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Term
| Conditions that may cause a deterioration in normal gait function include but are not limited to: |
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Definition
Muscle weakness
Neurological deficits
Joint dysfunction
Painful muscles and joints
Habit patterns
Disease processes |
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