CN205434166U - A rehabilitation pillow that is used for good limb position of hemiplegia patient fixed - Google Patents
A rehabilitation pillow that is used for good limb position of hemiplegia patient fixed Download PDFInfo
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Abstract
本实用新型公开了一种用于偏瘫患者良肢位固定的康复枕,该康复枕由用于固定偏瘫患者上肢良肢位的上肢枕、用于固定偏瘫患者肩关节良肢位的肩枕、用于固定偏瘫患者髋关节或下肢良肢位的髋枕和用于固定偏瘫患者下肢良肢位的下肢枕组成,上肢枕、肩枕、髋枕和下肢枕均包括枕芯,枕芯内填装有颗粒状的硬性填充物。该康复枕根据人体的解剖特点,为保持肢体良好功能位而设计,具有易吸汗、透气性好、流动性好等特点,受压后不易变形变硬,对维持良肢位起到良好的支撑固定作用;对肢体具有一定的按摩作用,可减轻肢体疲乏和酸痛;可依个体舒适度自由调节康复枕的厚度和重量,适应性强;能有效预防压疮、肩下垂、肩内收、髋关节外旋、足外翻等继发障碍。
The utility model discloses a rehabilitation pillow for fixing the good limb position of hemiplegic patients. It consists of a hip pillow for fixing the good position of the hip joint or lower limbs of hemiplegic patients and a lower limb pillow for fixing the good position of the lower limbs of hemiplegic patients. The upper limb pillow, shoulder pillow, hip pillow and lower limb pillow all include pillow cores, and the pillow cores are filled Contains granular hard filler. According to the anatomical characteristics of the human body, the rehabilitation pillow is designed to maintain a good limb position. It has the characteristics of easy sweat absorption, good air permeability, and good fluidity. Fixation effect; it has a certain massage effect on the limbs, which can relieve limb fatigue and soreness; the thickness and weight of the rehabilitation pillow can be freely adjusted according to the individual comfort level, and has strong adaptability; it can effectively prevent pressure sores, shoulder sagging, shoulder adduction, hip Joint external rotation, foot valgus and other secondary obstacles.
Description
技术领域technical field
本实用新型涉及一种医疗康复设备,具体涉及一种用于偏瘫患者良肢位固定的康复枕。The utility model relates to a medical rehabilitation device, in particular to a rehabilitation pillow for fixing the good limb position of a hemiplegic patient.
背景技术Background technique
脑卒中患者生存质量的高低取决于瘫痪或偏瘫肢体功能恢复的程度,而瘫痪或偏瘫肢体功能的恢复则取决于患病早期良肢位的摆放,其干预的时机和方法的正确与否对患者的后续康复治疗及临床结局具有重要意义。The quality of life of stroke patients depends on the degree of recovery of paralyzed or hemiplegic limb function, while the recovery of paralyzed or hemiplegic limb function depends on the placement of good limbs in the early stage of the disease, and the timing and method of intervention are correct. The follow-up rehabilitation treatment and clinical outcome of patients are of great significance.
良肢位是为了保持肢体的良好功能而将其摆放在一种体位或姿势,是从治疗护理的角度出发而设计的一种临时性体位。良肢位是早期抗痉挛的重要措施之一,这种良肢位(又称抗痉挛体位)能够使偏瘫后的关节相对稳固,可以有效预防上肢屈肌、下肢伸肌的典型痉挛模式,同时也是预防以后出现病理性运动模式的方法之一。The good limb position is to place it in a position or posture in order to maintain the good function of the limb, and it is a temporary position designed from the perspective of treatment and nursing. Good limb position is one of the important measures for early anti-spasticity. This kind of good limb position (also known as anti-spasticity position) can make the joints after hemiplegia relatively stable, and can effectively prevent the typical spasm pattern of upper limb flexors and lower limb extensors. It is also one of the ways to prevent pathological movement patterns in the future.
良肢位的摆放除了对护理人员的专业性有要求以外,一个功能性好的体位摆放支撑垫枕起着非常重要的作用。然而传统的良肢位摆放一般都是采用由患者从家中自带的普通枕头或靠垫,这些普通的枕头或靠垫一般都是采用海绵或棉絮填充,这种填充材料在受压后容易塌陷,且长期受压后较难复原,因此难以起到支撑、固定良肢位的作用。目前医院提供的枕头或靠垫也都是采用海绵或棉絮填充的,同样存在类似问题。In addition to the requirements for the professionalism of nursing staff, the placement of good limb positions plays a very important role in the placement of support cushions in a functional good position. However, traditional good limb placement generally uses ordinary pillows or cushions brought by patients from home. These ordinary pillows or cushions are generally filled with sponge or cotton wool. This filling material is easy to collapse after being pressed. And it is difficult to recover after long-term compression, so it is difficult to support and fix the good limb position. Pillows or back cushions provided by hospitals are also filled with sponge or cotton wool at present, and there are similar problems.
实用新型内容Utility model content
本实用新型提供了一种用于偏瘫患者良肢位固定的康复枕,该康复枕对中风偏瘫患者良肢位具有良好的固定和支撑作用。The utility model provides a rehabilitation pillow for fixing the good limbs of hemiplegia patients. The rehabilitation pillow has good fixing and supporting functions for the good limbs of stroke hemiplegia patients.
一种用于偏瘫患者良肢位固定的康复枕,由用于固定偏瘫患者上肢良肢位的上肢枕、用于固定偏瘫患者肩关节良肢位的肩枕、用于固定偏瘫患者髋关节良肢位或下肢良肢位的髋枕和用于固定偏瘫患者下肢良肢位的下肢枕组成,所述上肢枕、肩枕、髋枕和下肢枕均包括枕芯,枕芯内填装有颗粒状的硬性填充物。A rehabilitation pillow for fixing the good limb position of the hemiplegic patient, comprising an upper limb pillow for fixing the good limb position of the upper limb of the hemiplegic patient, a shoulder pillow for fixing the good limb position of the shoulder joint of the hemiplegic patient, and a shoulder pillow for fixing the good limb position of the hemiplegic patient's hip joint It consists of a hip pillow for limbs or lower limbs and a lower limb pillow for fixing the lower limbs of hemiplegia patients. The upper limb pillow, shoulder pillow, hip pillow and lower limb pillow all include pillow cores filled with particles shaped hard fillers.
本实用新型的康复枕不再采用海绵或棉絮作为填充物,而是采用颗粒状的硬性填充物,硬性填充物的抗变形性能强,受压后较难变形,不会变硬,能够对偏瘫患者良肢位起到良好的固定和支撑作用;硬性填充物呈颗粒状,流动性好,对患者肢体具有一定的按摩作用,可减轻肢体疲乏及酸痛。采用本实用新型的康复枕对脑卒中等偏瘫患者进行早期静态、被动的体位护理,具有良好的临床疗效。The rehabilitation pillow of the utility model no longer uses sponge or cotton wool as filler, but uses granular hard filler, which has strong anti-deformation performance, is difficult to deform after being pressed, will not harden, and can treat hemiplegia The patient's good limb position plays a good role in fixing and supporting; the hard filler is granular and has good fluidity, which has a certain massage effect on the patient's limbs and can relieve limb fatigue and soreness. Adopting the rehabilitation pillow of the utility model to perform early static and passive posture nursing on hemiplegia patients such as cerebral apoplexy has good clinical curative effect.
枕芯外可以根据需要设置枕套。Pillowcases can be set outside the pillow core as required.
作为优选,所述硬性填充物的填装体积占枕芯总容积的80~95%。若填装过少,硬性填充物易在枕芯内滑移,不利于患者良肢位的支撑固定;若填装过多,枕芯过于饱满,不仅会降低患者舒适性,对良肢位的固定作用也会有所减弱。Preferably, the filling volume of the hard filler accounts for 80-95% of the total volume of the pillow core. If the filling is too little, the hard filler will easily slip in the pillow core, which is not conducive to the support and fixation of the patient's good limb position; if the filling is too much, the pillow core will be too full, which will not only reduce the patient's comfort, but also affect the good limb position. The immobilization effect will also be reduced.
如未作特殊说明,本实用新型所述的“枕芯总容积”是指枕芯的最大容积。Unless otherwise specified, the "total volume of the pillow core" mentioned in the utility model refers to the maximum volume of the pillow core.
作为优选,所述硬性填充物为麦粒或谷粒。麦粒或谷粒不仅取材方便,价格低廉,制作简单,而且透气性能和吸湿性能均较为良好,便于保持患者的护理舒适性。Preferably, the hard filler is wheat or grain. Wheat grains or grains are not only easy to obtain, low in price, and easy to make, but also have relatively good air permeability and moisture absorption performance, which is convenient for maintaining patient care comfort.
作为进一步优选,所述硬性填充物为荞麦。荞麦的食用性较其他麦种和谷物较差,另作他用更为妥当;而且荞麦的外形较为有棱角,对偏瘫患者肢体的按摩作用较其他麦类或谷物要强。As a further preference, the hard filler is buckwheat. The edible property of buckwheat is poorer than that of other wheat species and grains, so it is more appropriate to use it for other purposes; moreover, the shape of buckwheat is more angular, and its massage effect on the limbs of hemiplegic patients is stronger than that of other wheats or grains.
作为优选,所述上肢枕的规格为:长55~65cm,宽25~35cm,高1.5~2.5cm,重1.5~2.5kg。更优选为:长60cm,宽30cm,高2cm,重1.8~2.2kg(2±0.2kg)。Preferably, the specifications of the upper limb pillow are: 55-65 cm in length, 25-35 cm in width, 1.5-2.5 cm in height, and 1.5-2.5 kg in weight. More preferably: length 60cm, width 30cm, height 2cm, weight 1.8-2.2kg (2±0.2kg).
作为优选,所述肩枕的规格为:长40~50cm,宽20~30cm,高1.5~2.5cm,重0.8~1.5kg。更优选为:长45cm,宽25cm,高2cm,重0.9~1.1kg(1±0.1kg)。Preferably, the specifications of the shoulder pillow are: 40-50 cm in length, 20-30 cm in width, 1.5-2.5 cm in height, and 0.8-1.5 kg in weight. More preferably: length 45cm, width 25cm, height 2cm, weight 0.9-1.1kg (1±0.1kg).
作为优选,所述髋枕的规格为:长35~45cm,宽35~45cm,高1~2.5cm,重1.2~2kg。更优选为:长40cm,宽40cm,高2cm,重1.35~1.65kg(1.5±0.15kg)。Preferably, the specifications of the hip pillow are: 35-45cm in length, 35-45cm in width, 1-2.5cm in height, and 1.2-2kg in weight. More preferably: length 40cm, width 40cm, height 2cm, weight 1.35-1.65kg (1.5±0.15kg).
作为优选,所述下肢枕的规格为:长25~35cm,宽8~12cm,高1.5~2.5cm,重0.8~1.5kg。更优选为:长30cm,宽10cm,高2cm,重0.9~1.1kg(1±0.1kg)。Preferably, the specifications of the lower limb pillow are: 25-35 cm in length, 8-12 cm in width, 1.5-2.5 cm in height, and 0.8-1.5 kg in weight. More preferably: the length is 30 cm, the width is 10 cm, the height is 2 cm, and the weight is 0.9-1.1 kg (1±0.1 kg).
具有以上长宽高的康复枕是市面上较为常见的,易于获取。并且,在以上规格和重量下,硬性填充物在枕芯内的填充比例适中,能对良肢位起到最佳的固定支撑作用。Rehabilitation pillows with the above length, width and height are relatively common in the market and are easy to obtain. Moreover, under the above specifications and weight, the filling ratio of the hard filling in the pillow core is moderate, which can play an optimal role in fixing and supporting the good limbs.
以上规格和重量的康复枕对于一般体格(身高、体重)的人群都适用,对于身高和体重与常人有较大差异的人群,可以对各康复枕的规格和重量作适应性调整。The rehabilitation pillows of the above specifications and weights are suitable for people with general physique (height and weight). For people whose height and weight are quite different from ordinary people, the specifications and weight of each rehabilitation pillow can be adjusted adaptively.
作为优选,所述腔体的开口位于枕芯的侧边,腔体的开口处设有拉链。拉链的设置便于腔体的随时开闭,便于患者根据个体舒适度自由调整硬性填充物的填装量,为保证康复枕发挥作用,调整幅度宜在上述写明的±10%范围内。Preferably, the opening of the cavity is located at the side of the pillow core, and a zipper is provided at the opening of the cavity. The setting of the zipper is convenient for the opening and closing of the cavity at any time, and it is convenient for the patient to freely adjust the filling amount of the hard filler according to the individual comfort. In order to ensure the function of the rehabilitation pillow, the adjustment range should be within the range of ±10% stated above.
本实用新型一种用于偏瘫患者良肢位固定的康复枕的使用方法为:A method of using the rehabilitation pillow for fixing the good limb position of the hemiplegia patient of the utility model is as follows:
脑卒中等引起的偏瘫患者在入院时即开始使用本实用新型的康复枕。Hemiplegia patients caused by cerebral apoplexy or the like begin to use the rehabilitation pillow of the present utility model when they are admitted to the hospital.
其中,取仰卧位时,将肩枕垫在患侧肩胛骨下方,将上肢枕垫在患肢肘关节和腕关节下方,使患者上肢呈外旋位,肩关节前屈,肘关节伸直,前臂旋后,腕关节稍背伸,手指取伸直位;将髋枕垫在髋关节下方,防止髋关节外旋,将下肢枕放在患腿脚踝处,使下肢取中立位。Among them, when taking the supine position, put the shoulder pillow under the scapula of the affected side, and put the upper limb pillow under the elbow joint and wrist joint of the affected limb, so that the upper limb of the patient is in an external rotation position, the shoulder joint is flexed forward, the elbow joint is straightened, and the forearm is stretched. After supination, the wrist joint is slightly dorsiflexed, and the fingers are in a straight position; the hip pillow is placed under the hip joint to prevent external rotation of the hip joint, and the lower limb pillow is placed on the ankle of the affected leg so that the lower limb is in a neutral position.
取健侧卧位(即患侧在上)时,将上肢枕置于胸前,放在两上肢之间,且患肢肘关节伸直,前臂外展,腕关节轻度背屈,手指伸直;保持患腿髋关节、膝关节呈90度,置于髋枕或下肢枕。When taking the healthy side lying position (that is, the affected side is on top), place the upper limb pillow in front of the chest and between the two upper limbs, and the elbow joint of the affected limb is straightened, the forearm is abducted, the wrist joint is slightly dorsiflexed, and the fingers are extended. Straight; keep the hip joint and knee joint of the affected leg at 90 degrees, and place it on a hip pillow or a lower limb pillow.
取患侧卧位(即健侧在上)时,将患肢置于上肢枕上,使肘关节伸直,前臂外展,腕关节轻度背屈,手指伸直;使患腿髋关节保持伸展位,膝关节轻度屈曲,踝关节保持轻度背屈位;健腿髋关节、膝关节屈曲放于髋枕或下肢枕上。When taking the affected side lying position (that is, the healthy side is on top), place the affected limb on the upper limb pillow, straighten the elbow joint, abduct the forearm, slightly dorsiflex the wrist joint, and straighten the fingers; keep the hip joint of the affected leg extended position, the knee joint is slightly flexed, and the ankle joint is kept in a slightly dorsiflexed position; the hip joint and knee joint of the healthy leg are flexed and placed on the hip pillow or lower limb pillow.
与现有技术相比,本实用新型的有益效果为:Compared with the prior art, the beneficial effects of the utility model are:
(1)本实用新型的康复枕根据人体的解剖特点,为保持肢体良好功能位而设计,具有易吸汗、透气性好、流动性好等特点,受压后不易变形、变硬,对维持良肢位起到良好的支撑和固定作用;对肢体具有一定的按摩作用,可减轻肢体疲乏和酸痛;(1) According to the anatomical characteristics of the human body, the rehabilitation pillow of the present utility model is designed to maintain good functional positions of the limbs. It has the characteristics of easy sweat absorption, good air permeability, and good fluidity. The limbs play a good role in supporting and fixing; it has a certain massage effect on the limbs, which can relieve fatigue and soreness of the limbs;
(2)本实用新型的康复枕可以根据个体舒适度自由调整硬性填充物的填装量,进而调节康复枕的厚度和重量,适应性强;(2) The rehabilitation pillow of the utility model can freely adjust the filling amount of hard filler according to the individual comfort, and then adjust the thickness and weight of the rehabilitation pillow, and has strong adaptability;
(3)使用本实用新型的康复枕能有效预防压疮、肩下垂、肩内收、髋关节外旋、足外翻等继发障碍;通过早期反复训练,刺激部分脑细胞产生代偿功能,使神经系统尽快建立新的联系,使患者肢体功能早日康复。(3) Using the rehabilitation pillow of the present utility model can effectively prevent secondary obstacles such as pressure sores, shoulder sagging, shoulder adduction, hip joint external rotation, and foot valgus; through early repeated training, some brain cells are stimulated to produce compensatory functions, Make the nervous system establish a new connection as soon as possible, so that the patient's limb function can recover as soon as possible.
附图说明Description of drawings
图1为本实用新型一种用于偏瘫患者良肢位固定的康复枕的结构示意图;Fig. 1 is a structural schematic diagram of a rehabilitation pillow for hemiplegic patients with good limb position fixation according to the utility model;
图2为图1中上肢枕的结构示意图;Fig. 2 is a schematic structural view of the upper limb pillow in Fig. 1;
图3为偏瘫患者取仰卧位时本实用新型一种用于偏瘫患者良肢位固定的康复枕的使用状态图;Fig. 3 is the use state figure of a kind of rehabilitation pillow of the utility model for hemiplegic patient's good limb position fixation when the hemiplegic patient takes the supine position;
图4为偏瘫患者取健侧卧位时本实用新型一种用于偏瘫患者良肢位固定的康复枕的使用状态图;Fig. 4 is the use state diagram of a kind of rehabilitation pillow of the utility model that is used for fixing the good limb position of the hemiplegic patient when the hemiplegic patient takes the healthy side lying position;
图5为偏瘫患者取患侧卧位时本实用新型一种用于偏瘫患者良肢位固定的康复枕的使用状态图。Fig. 5 is a diagram of the use state of a rehabilitation pillow of the utility model for fixing the good limb position of the hemiplegic patient when the hemiplegic patient takes the affected side lying position.
具体实施方式detailed description
下面结合附图和具体实施方式对本实用新型的技术方案作进一步的详细说明。The technical solution of the utility model will be further described in detail below in conjunction with the accompanying drawings and specific embodiments.
如图1所示,本实施例一种用于偏瘫患者良肢位固定的康复枕,由用于固定偏瘫患者上肢良肢位的上肢枕1、用于固定偏瘫患者肩关节良肢位的肩枕2、用于固定偏瘫患者髋关节良肢位的髋枕3和用于固定偏瘫患者下肢良肢位的下肢枕4组成。As shown in Figure 1, the present embodiment is a kind of rehabilitation pillow that is used for fixing the good limb position of the hemiplegic patient. Pillow 2, the hip pillow 3 for fixing the good position of the hip joint of the hemiplegic patient and the lower limb pillow 4 for fixing the good position of the lower limb of the hemiplegic patient are composed.
由图2可见,上肢枕1包括枕芯11,枕芯11内设有一腔体,腔体内填装有颗粒状的硬性填充物;并且腔体的开口位于枕芯11的侧边,腔体的开口处设有拉链12。It can be seen from Fig. 2 that the upper limb pillow 1 includes a pillow core 11, and a cavity is provided in the pillow core 11, and a granular hard filler is filled in the cavity; The opening is provided with a slide fastener 12.
除规格尺寸不同外,肩枕2、髋枕3和下肢枕4的构成均与上肢枕1相同,也是包括枕芯,枕芯内填装有颗粒状硬性填充物。Except that the specifications and sizes are different, the shoulder pillow 2, the hip pillow 3 and the lower limb pillow 4 have the same configuration as the upper limb pillow 1, and also include pillow cores filled with granular hard fillers.
本实施例中,颗粒状的硬性填充物选用的是荞麦。In this embodiment, buckwheat is selected as the granular hard filler.
上肢枕1、肩枕2、髋枕3和下肢枕4的枕芯外,可以根据需要设置布套。Outside the pillow core of upper limb pillow 1, shoulder pillow 2, hip pillow 3 and lower limb pillow 4, cloth cover can be set as required.
本实施例中,上肢枕1的规格为:长(L1)60cm,宽(W1)30cm,高(H1)2cm,重2kg;肩枕2的规格为:长(L2)45cm,宽(W1)25cm,高2cm,重1kg;髋枕3的规格为:长(L3)40cm,宽(W3)40cm,高2cm,重1.5kg;下肢枕4的规格为:长(L4)30cm,宽(W4)10cm,高2cm,重1kg。In the present embodiment, the specification of upper limb pillow 1 is: long (L1) 60cm, wide (W1) 30cm, high (H1) 2cm, heavy 2kg; The specification of shoulder pillow 2 is: long (L2) 45cm, wide (W1) 25cm, height 2cm, weight 1kg; the specification of hip pillow 3 is: length (L3) 40cm, width (W3) 40cm, height 2cm, weight 1.5kg; specification of lower limb pillow 4 is: length (L4) 30cm, width (W4 ) 10cm, height 2cm, weight 1kg.
根据患者个体舒适度,可以调整枕芯内荞麦的填装量,使上肢枕1、肩枕2、髋枕3和下肢枕4的重量在±10%范围内浮动;在较佳的情况下,应保证荞麦的填装体积占枕芯总容积的80~95%。According to the patient's individual comfort, the filling amount of buckwheat in the pillow can be adjusted so that the weights of upper limb pillow 1, shoulder pillow 2, hip pillow 3 and lower limb pillow 4 can fluctuate within ±10%; in a better situation, It should be ensured that the filling volume of buckwheat accounts for 80-95% of the total volume of the pillow core.
脑卒中等引起的偏瘫患者在入院时即开始使用本实用新型的康复枕。Hemiplegia patients caused by cerebral apoplexy or the like begin to use the rehabilitation pillow of the present utility model when they are admitted to the hospital.
如图3所示,取仰卧位时,将肩枕2垫在患侧肩胛骨下方,将上肢枕1垫在患肢5肘关节和腕关节下方,使患者上肢呈外旋位,肩关节前屈,肘关节伸直,前臂旋后,腕关节稍背伸,手指取伸直位;将髋枕3垫在髋关节下方,防止髋关节外旋,将下肢枕4放在患腿6脚踝处,使下肢取中立位。As shown in Figure 3, when the supine position is taken, the shoulder pillow 2 is placed under the scapula of the affected side, and the upper limb pillow 1 is placed under the elbow joint and wrist joint of the affected limb 5, so that the patient's upper limbs are externally rotated and the shoulder joints are flexed forward. , the elbow joint is straightened, the forearm is supinated, the wrist joint is slightly dorsiflexed, and the fingers are straightened; the hip pillow 3 is placed under the hip joint to prevent external rotation of the hip joint, and the lower limb pillow 4 is placed on the ankle of the affected leg 6. Keep the lower limbs in a neutral position.
如图4所示,取健侧卧位(即患侧在上)时,将上肢枕1置于胸前,放在两上肢之间,且患肢5肘关节伸直,前臂外展,腕关节轻度背屈,手指伸直;保持患腿6髋关节、膝关节呈90度,置于髋枕3或下肢枕4上(图4中显示了髋枕3,实际应用中同样可以采用下肢枕4)。As shown in Figure 4, when taking the healthy side lying position (that is, the affected side is on top), place the upper limb pillow 1 in front of the chest, between the two upper limbs, and the elbow joint of the affected limb 5 is straightened, the forearm is abducted, the wrist The joints are slightly dorsiflexed, and the fingers are straightened; keep the hip joint and knee joint of the affected leg 6 at 90 degrees, and place it on the hip pillow 3 or the lower limb pillow 4 (the hip pillow 3 is shown in Figure 4, and the lower limb pillow can also be used in practical applications. Pillow 4).
如图5所示,取患侧卧位(即健侧在上)时,将患肢5垫在上肢枕1上,使肘关节伸直,前臂外展,腕关节轻度背屈,手指伸直;使患腿6髋关节保持伸展位,膝关节轻度屈曲,踝关节保持轻度背屈位;健腿7髋关节、膝关节屈曲放于髋枕3或下肢枕4上(图5中显示了髋枕3,实际应用中同样可以采用下肢枕4)。As shown in Figure 5, when the affected side is lying (that is, the healthy side is on top), the affected limb 5 is placed on the upper limb pillow 1, the elbow joint is straightened, the forearm is abducted, the wrist joint is slightly dorsiflexed, and the fingers are extended. Keep the hip joint of the affected leg 6 in extended position, the knee joint slightly bent, and the ankle joint slightly dorsiflexed; the healthy leg 7 hip joint and knee joint should be flexed and placed on the hip pillow 3 or lower limb pillow 4 (Fig. 5 A hip pillow 3 is shown, but a lower limb pillow 4 can also be used in practice.
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