Background: Individuals with pes planus tend to overuse the extrinsic foot muscles, such as the tibialis anterior (TA) and peroneus longus (PL), to compensate for the weakened intrinsic foot muscles, such as the abductor hallucis (AbdH). Furthermore, differences in weight-bearing can affect the activity of muscles in both the intrinsic and extrinsic foot muscles. To date, no study has compared the effects of the short foot exercise (SFE) and toe spread-out exercise (TSO) on intrinsic and extrinsic foot muscle activity and the corresponding ratios in different weight-bearing positions. Objects: To compare the effects of the SFE and TSO on AbdH, TA, and PL activity and the AbdH/TA and AbdH/PL activity ratios in the sitting and standing positions in individuals with pes planus. Methods: Twenty participants with pes planus were recruited. Surface electromyography was used to assess the amplitudes of AbdH, TA, and PL activity. Participants performed both exercises while adopting both the sitting and standing positions. Results: No significant interaction between exercise and position was found regarding the activity of any muscle or ratio of the activity, except for PL activity. We observed a significant increase in AbdH activity during the TSO compared to the SFE, and no significant difference in TA and PL activity between the two exercises. AbdH, TA, and PL activity were significantly higher in the standing position than in the sitting position. Furthermore, the AbdH/PL activity ratio significantly increased in the sitting position, although there was a significant increase in AbdH activity in the standing position. Conclusion: In individuals with pes planus, we recommend performing the TSO in the sitting position, which may increase the activity of the AbdH while concurrently decreasing the activity of the TA and PL, thus strengthening the AbdH.

Background: Chronic back pain not only causes physical discomfort and decreased functionality but also affects emotional well-being, resulting in feelings of anxiety, depression, and other psychological issues. Studies have indicated that cognitive functional therapy and motor control exercises can alleviate chronic low back pain and associated psychological issues. Objectives: To investigated the effect of chronic low back pain on the cognitive functional therapy (CFT) and motor control exercises (MCE). Design: Quaxi-experimental study. Methods: Forty patients with chronic low back pain were randomly assigned and divided into 20 cognitive functional therapy group with motor control exercises group (CFTMG) and 20 patients in motor control exercises group (MCEG). After applying CFT with motor control exercises and motor control exercises for 8 weeks, changes in numeric pain rating scale (NPRS), Oswestry disability index (ODI) and Fear-avoidance beliefs questionnaire (FABQ) were observed. Results: In the CFTMG, statistically significant changes were observed in NPRS, ODI, and FABQ before and after the intervention. In the MCEG, statistically significant changes were observed in VAS and ODI before and after the intervention. Conclusion: The application of CFTM and MCE in patients suffering from chronic low back pain has demonstrated effectiveness in alleviating pain, enhancing back function, and reducing kinesiophobia associated with the condition.

Background: The Nordic hamstring exercise is a closed-chain exercise that effectively activates all lower extremity muscles, but there is a lack of consideration of ankle joint which affects exercise effectiveness. One of the major advantages of the Nordic exercise have been known as strengthening lower extremity extensors. This manifests the exercise increases activities of the ankle plantar flexors as well as hip extensors. Objectives: To investigated the impacts of changes in ankle position on the lower extremity musculature and subjective difficulties during the Nordic hip extension exercise. Design: Cross-sectional study. Methods: Twenty the healthy male participants participated in this study. Participants perform three variations of the Nordic exercises including three ankle positions. Each Nordic exercise was defined as ankle position (neutral, dorsiflexion and plantar flexion). During the Nordic exercise, erector spine (ES), gluteus maximus (GM), biceps femoris (BF), gastrocnemius (GCM) activities and subjective difficulties (Borg RPE score) were measured. Results: Muscular activities of the biceps femoris and gastrocnemius were significantly different among the three ankle conditions, which showed controversial results (P<.05). The biceps femoris activity was significantly higher with the dorsiflexion condition, compared to the others (P<.05). On the other hand, activity of the gastrocnemius was significantly higher with the plantarflexion position compared to the others (P<.05). Conclusion: Present study suggests the ankle positional changes could affect lower muscular activities during the Nordic exercise. Although it is difficult to affirm the causes due to limited data, selective activation of the biceps femoris might accomplish with ankle dorsi flexion and that of the gastrocnemius might accomplish with the ankle plantarflexion during the Nordic exercises.

Background/Objectives: 본 연구의 목적은 복부 브레이싱 운동과 복부 할로잉 운동을 결 합한 요부 안정화 운동프로그램이 20대 정상성인의 폐기능에 미치는 영향과 흡연자와 비흡 연자를 비교하여 그 차이를 알아보고자 하는 데 있다. Methods/Statistical analysis: 이를 위해 20대 정상성인을 대상으로 흡연집단(n=16)과 비 흡연집단(n=16) 두 그룹으로 모집하여 동일한 중재를 실시하였다. Findings: 흡연집단은 집단 내 기간 지남에 따라 폐기능 요인 중 FVC과 FEV1/FVC를 제 외한 FEV1과 PEF가 운동 전보다 유의하게 증가하였다(p<.05). 비흡연집단에서 기간 지남에 따라 폐기능 요인 중 FVC과 PEF를 제외한 FEV1, FEV1/FVC가 운동 전보다 유의하게 증가하 였다(p<.05). Improvements/Applications: 본 연구 결과, 복부 브레이싱 운동과 복부 할로잉 운동을 결 합한 요부 안정화 운동프로그램은 흡연집단과 비흡연집단 두 그룹의 폐기능 향상에 효과가 나타난 것을 알 수 있었다.

Background: Pilates exercises are used for body shape correction because they can achieve correct posture alignment through spinal stabilization. Objects: This study aimed to determine whether the use of reformers increases the effectiveness of Pilates core exercises on body alignment in standing. Methods: The study included 30 women without known diagnoses of musculoskeletal and neurological disorders or cancer. Those who had taken more than 10 Pilates lessons were excluded. The participants were randomly assigned to either the reformer exercise group or the mat exercise group, and interventional Pilates exercises were performed for 60 minutes a day, three times a week, for a total of 8 weeks. Ten movements of the reformer and mat Pilates core exercise programs were included. Exbody® 9100 MOMI musculoskeletal analysis equipment (Exbody Inc.) was used to assess the alignment of the standing posture in the frontal plane. Results: As a result of comparing the differences within and between the groups before and after the intervention using the two-way mixed analysis of variance test, height differences in the head, pelvis, left and right, shoulders, scapulas, knees, and ankles in the frontal plane after the intervention were found in both groups. For example, the left-right symmetry of the body alignment in the standing posture was significantly improved within each group (p < 0.05). However, no significant difference was found between the groups (p > 0.05). Conclusion: Both the reformer and mat Pilates core exercises were effective for standing posture alignment, which has clinical significance. If an exercise program is developed based on the analysis of movements necessary for posture improvement and the target muscles to be strengthened, the same effect can be achieved only with mat exercise without using the reformer equipment at the beginner stage.

Background: Scoliosis can be caused by postural changes. The effects of Schroth exercises and Kinesio taping for scoliosis have been reported independently, but there are few studies on the effects of combining both methods. Objectives: To investigated the effects of Schroth exercises and kinesio taping on the Cobb angle and dynamic balance ability in patients with scoliosis. Design: Quaxi-experimental study. Methods: Participants were divided into the taping (n=3) and non-taping (n=3) groups. Pre-tests for the Cobb angle and dynamic balance were performed prior to the first intervention, and post-tests were performed after the intervention was completed. The non-taping group performed Schroth exercises for a total of 12 35-minute sessions thrice a week for 6 weeks. Meanwhile, in the taping group, Kinesio tape was attached before performing the same exercises and was maintained for 24 hours after the exercises were finished. Results: In the taping group, there was no significant change in the Cobb angle and dynamic balance ability pre- and post-intervention (P>.05). Similarly, there was no significant change in the Cobb angle and dynamic balance ability pre- and post-intervention (P>.05) in the non-taping group. Furthermore, there was no significant difference upon comparing the two groups (P>.05). Conclusion: Kinesio taping combined with Schroth exercises did not give additional benefits in terms of the Cobb angle and dynamic balance ability than that in the application of Schorth exercises alone.

Background: Shoulder impingement syndrome, a major cause of shoulder pain, involves weakness of the scapular retractor muscles. The major scapular retractor muscles are the middle trapezius and rhomboid major muscles; however, the latter is excluded in most studies. Objects: We aimed to measure the thickness of the middle trapezius and rhomboid major muscles using an ultrasonic diagnostic imaging system while performing four different shoulder retraction exercises and comparing the thicknesses and ratio of the thicknesses of these muscles. Methods: The thickness of the middle trapezius and rhomboid major muscles was measured in 24 healthy adults using ultrasound. Muscle thickness was measured three times in the Reference posture and four times while performing four different exercises that involved scapular retraction. The averages and standard deviations of the measured muscle thicknesses were obtained and compared. The ratio of muscle thickness and rate of changes in muscle thickness between the reference posture and the four exercises were compared. Results: For both, male (n = 10) and female (n = 14), there was a significant difference in the thickness of the middle trapezius muscle between the reference posture and the four exercises (p < 0.05) and in the thickness of the middle trapezius and rhomboid major muscles between male and female (p < 0.05); however, there was no significant difference in the ratio of the thicknesses of these muscles. Although a significant difference in the rate of change in muscle thickness during the four exercises was noted, there was no significant difference in the ratio of change in muscle thickness. Conclusion: This study demonstrates the ratio of the thicknesses of the middle trapezius and rhomboid major muscles and the rate of change in their thickness during exercises involving scapular retraction in healthy people in their 20s–30s.

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

Background: Low back and neck pain are two of the most common medical problems in the adult population. It is estimated that between 70% and 80% adults experience an episode of low back pain at least once during their lifetime. Objects: This study aimed to compare the effects of various stretching exercises and muscle energy techniques used for treatment of iliopsoas, quadratus lumborum, and hamstrings of patients with low back pain. Methods: A total of 52 subjects were randomly assigned to the control group (n = 17), the muscle energy technology group (METG, n = 19), and the stretching exercise group (SEG, n = 16). Interventions were performed twice a week for 4 weeks. Outcomes were measured before and after 4 weeks of treatment in the three groups, using the Korean version of the Oswestry Disability Index, the Visual Analogue Scale (VAS), the Fear Avoidance Belief Questionnaire (FABQ), the Finger to Floor test (FTF), the Modified-Modified Schober Test (MMS), and the Trunk Flexion Range of Motion test. Results: This study showed significant reduction in the pre-test and post-test KODI, VAS, and FABQ scores in all the three groups (p < 0.05). The KODI, VAS, FABQ and FTF assessed in this study showed interactions between the groups and the measurement time point (p < 0.01). After intervention, the KODI, VAS, FABQ and FTF in the SEG and METG were significantly higher (p < 0.05), and there was no difference between the METG and SEG. MMS and HFROM test showed no difference between the three groups (p > 0.05). Conclusion: KODI, VAS, FABQ and FTF showed significant improvement after basic physical therapy, muscle energy technique, and stretching exercise intervention. And there was no significant difference in the intervention effect between the muscle energy group and the stretching exercise group.

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

Background: Since chronic ankle instability (CAI) can adversely affect postural control, core stability exercises have been investigated to improve postural control. However, only a few studies have focused on kinetic chain exercises. Objectives: To investigate the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) core stability exercises on static and dynamic balance abilities and vertical jump height in CAI patients. Design: Randomized controlled trial. Methods: The 18 participants enrolled in this study were randomly divided into the OKC group (n=9) and CKC group (n=9). Static and dynamic balance abilities and vertical jump height were measured before and after the intervention. The intervention program comprising OKC or CKC core stability exercises depending on the groups was conducted for 30 min twice a week for 6 weeks in 12 sessions. Results: In the OKC group, static measured with the eyes open or closed and dynamic balance abilities were significantly improved after the intervention (P<.05). In the CKC group, dynamic balance ability was significantly increased (P<.05). A significant difference was observed in static balance ability measured with the eyes open between the two groups (P<.05). Vertical jump height was significantly increased after the intervention in both groups (P<.05). Conclusion: OKC and CKC core stability exercises improve static and dynamic balance abilities and vertical jump height in CAI patients. Specifically, the OKC core stability exercise was more effective in enhancing static balance ability than the CKC core stability exercise.

Background: Lunge exercises are lower extremity rehabilitation and strengthening exercises for patients and athletes. Most studies have shown the effectiveness of the forward and backward lunge exercises for treating patellofemoral pain and anterior cruciate ligament injuries (by increasing lower extremity muscle activity) and improving kinematics. Objects: However, it is not known how the two different lunge movements affect trunk muscle activities in healthy individuals. The purpose of this study was to investigate the electromyographic activity of the rectus abdominis and erector spinae muscles during forward and backward lunge exercises in healthy participants. Methods: Twelve healthy participants were recruited. Electromyographic activity of the rectus abdominis and erector spinae was recorded using surface electrodes during forward and backward lunges, and subsequently normalized to the respective reference voluntary isometric contractions of each muscle. Results: Activity of the erector spinae was significantly higher than that of the rectus abdominis during all stages of the backward lunge (p < 0.05). The activity of the erector spinae was significantly greater during the backward than forward lunge at all stages (p < 0.05). Conclusion: Backward lunging is better able to enhance trunk motor control and activate the erector spinae muscles.

Background: Although recent studies using virtual reality have been actively conducted, studies on exercise therapy interventions and changes in muscle characteristics in patients with scoliosis are limited. Objectives: To investigate the effects of trunk and pelvic exercises program using virtual reality on the characteristics of paraspinal muscles in patients with scoliosis. Design: A randomized controlled trial. Methods: Thirty college students with scoliosis were randomly assigned to the trunk and pelvic exercise program using virtual reality group (VRG; n=15) and the general stretching exercise group (SG; n=15). The intervention was conducted three times a week for 8 weeks for 30 min per session. The recorded variables were muscle tone (F), muscle stiffness (S), and muscle elasticity (D). The collected data were analyzed after statistical processing. Results: In the cervical vertebrae, F showed significant differences in the amount of inter-group variation in the VRG compared that in the SG on the right side. The VRG showed significant increases in intra-group variation on both the right and left sides. S showed significant differences in the amount of inter-group variation in the VRG compared to that in the SG on the right side. With regard to the intra-group variation of F in the thoracic vertebrae, the right muscle in the VRG demonstrated significantly increased after the experiment, while D significantly increased in the left muscle in the VRG. Conclusion: Pelvic and trunk exercises program using virtual reality may be applied a better therapeutic intervention for patients with scoliosis.

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

This study examines learner perceptions into the use of Classwide Peer Tutoring (CPT) as an approach to conduct a mechanical exercise (ME). This research analyzed learner preferences between CPT and other methods of conducting MEs (i.e., oral MEs and written MEs), examined learner perceptions of CPT’s learning effectiveness, and also inquired into student perceptions of CPT’s peer corrective feedback (CF) approach. Forty-six Korean university students participated in this study by completing a survey after experiencing CPT, oral MEs, and written MEs over the course of nine lessons. The data were analyzed through chi-squared, goodness-of-fit tests and descriptive statistics. The results indicated the participants preferred CPT and perceived CPT as more interesting and motivating than the other ME methods. The results also indicated the participants perceived CPT to be more effective than alternative ME approaches. Lastly, the participants had positive perceptions of CPT’s peer CF approach and believed CPT’s peer CF approach was more effective than the CF approach in oral MEs.

Background: Patients with low back pain (LBP) experience misalignments in the center of pressure (COP) and muscle imbalances due to frequent onesided posture adjustments to avoid pain. Objectives: To identify the effects of Squat Exercises with Vertical Whole-Body Vibration on the Center of Pressure and Trunk Muscle Activity. Design: Randomized controlled trial. Methods: Thirty LBP patients with an imbalance in the COP were sampled and randomly assigned to an experimental group of 15 patients who under went an intervention involving squat exercises with vertical WBV and a control group of 15 patients who were treated via a walking intervention. As pretests before the interventions, the subjects’ COP was identified by measuring their stability index (ST), and erector spinae, rectus abdominis, transverse abdominis, gluteus medius muscle activity was analyzed by determining the % reference voluntary contraction (%RVC) value using surface electromyography while sit to stand. After four weeks, a post test was conducted to remeasure the same variables using the same methods. Results: Statistically significant differences were found in the ST (P<.01) and trunk muscle (P<.05, P<.001) in the experimental group before and after the intervention. In terms of the differences between the left- and right-side (RL) muscle activity, only the transverse abdominis (TrA) and gluteus medius (GM) exhibited statistically significant increase (P<.05). A comparison of the groups showed statistically significant differences in the TrA with respect to muscle activity (P<.05) and in the RLTrA and RLGM in terms ofthe difference between left- and right-side muscle activity (P<.01). Conclusion: Squat exercises with vertical WBV produced effective changes in the COP of patients with LBP by reducing muscle imbalances through the delivery of a uniform force. In particular, strengthening the TrA and reducing an imbalance in the GM were determined to be important factors in improving the COP.

Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGⅠ, n=10), closed kinetic chain exercise experimental group (EGⅡ, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

Background: Unstable surface-based core training can significantly enhance core strength, but no studies have compared the effects of balance pad- and sling-assisted exercises. Objects: To study the effects of unstable surface-based balance pad- and sling-assisted core strength exercises on muscle activity. Methods: Twenty male students aged 20–25 years participated in this study. The effects of three types of core strength exercises, performed with a sling or balance pad, on the activities of three muscles, i.e., the right musculus obliquus externus abdominis (EO), right erector spinae (ES), and right gluteus maximus (GM), were examined. Results: 1) In the glute bridge exercise, the percentage of maximum voluntary contraction of the EO, ES, and GM were significantly different between the balance pad- and sling-assisted exercises. The relative contribution of the ES and GM activities to all muscle activity were not significantly different between the two training types, whereas that for EO showed a significant difference. 2) There was no significant difference in the percentage value of maximum voluntary contraction (%MVC) among the EO, ES, and GM during the “leg-lifting with flat support”exercise, and there were no significant difference in the relative contributions between the two training types. 3) In the “side bridge leg separation exercise”, the %MVC of the ES, EO, and GM were significantly different between the two training types. Conclusion: Sling training for core muscles was generally better than balance pad assist training. The majority of physiotherapy patients require core training. Our results could guide physiotherapists in the choice of targeted exercises for these patients.

Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.