What Type of Clinic in NJ Do You Choose for Neck Pain?

 

Have you have ever woken up after a long night’s sleep and your neck hurt when you turned it to one side? Have you then attributed that pain to “sleeping on it wrong”? You know that the pain will eventually subside once your neck untightens, but in the meantime it may be very uncomfortable or even painful to turn your neck to one side or the other. Depending on the circumstances and pain level, you may need to consider a medical professional to help you get neck pain relief and return to your normal daily activities.

 

How to Choose a Neck Pain Clinic in NJ

Most people take advantage of the fact that they can live their lives free of pain resulting from a neck injury or neck soreness. For those who have symptoms such as headaches, numbness or tingling in the fingers, hand, or forearms, stiffness, compromised range of motion, pain spreading down the arms or to the upper back, and/or muscle weakness, pain and these symptoms may be a part of everyday life. At Monmouth Pain & Rehabilitation, the experts at our neck pain clinic NJ can help. 

We care about the wellness of your whole body, and our treatment strategies encompass your physical, emotional, and social needs. Living with pain can be extremely difficult, and it is very tempting to simply take a pain medication to ease your suffering. However, this is not a long-term solution. If you have decided to seek professional, medical assistance there are some qualification to search for and some questions to ask of your potential clinic.

Qualifications to Consider

When looking for the best clinic for neck pain relief, there are some qualifications to consider. Here are a few to help you narrow does candidates for your neck pain treatment center:

  • The center takes a holistic approach to treatment rather than a very narrow micro view.
  • The underlying cause of the pain is considered.
  • Minimally invasive approaches are considered before extreme ones like surgery to prevent further pain and complications.
  • There are a number of neck pain treatment options to mix and match to suit your specific needs
  • A proven track record

Questions You Should Ask

  • How many neck pain treatment options do you offer?
  • What kind of specialists do you have on staff?
  • How do you compare with other neck pain clinics in NJ?
  • What non-invasive treatments can provide me neck pain relief?
  • Will my treatment plan be tailored to my specific needs?

Call Our Neck Pain Specialists at Monmouth

At Monmouth Pain & Rehabilitation, we specialize in a variety of options designed for neck pain relief, a return to balance in your life, and being as non-invasive as possible. From massage therapy to acupuncture, chiropractic care to rehabilitative treatments, we focus on getting you back to a pain-free life with an emphasis on the holistic approach. Body and mind work together to identify and treat the underlying cause of your pain. Contact us today to make an appointment for a free consultation to assess your symptoms and find the neck pain treatment that is right for you.

Consider Hip Pain Treatment with a Chiropractor

 

Although not as common or evenly dispersed among the population as other types of pain such as neck pain or one of the varieties of arthritis, hip pain can cause a lack of mobility and a serious reduction in a patient’s quality of life. This is why recognizing the symptoms of a serious hop condition is important so that a medical professional can diagnose your pain and begin treatment as soon as possible.

 

 

What Can Cause Hip Pain?

For patients over the age of 50, hip pain is commonly caused by osteoarthritis, a degenerative joint disease. When the cartilage between the femur and acetabulum is greatly reduced, the twp bones rub together resulting in friction and inflammation which causes hip pain. Rheumatoid arthritis is also a common cause of hip (and many other joints) pain.

In addition to osteoarthritis and rheumatoid arthritis, hip fractures (or other injuries/falls), bursitis, tendinitis, muscle/tendon strain, a hip labral tear, certain cancers, and avascular necrosis. Many of these causes are also made worse with strenuous activity and result in reduced range of motion.

How Do Chiropractors Treat Hip Pain?

Because everyone’s circumstances are different, the treatment for their conditions is never exactly the same. When it comes to hip pain treatment in NJ, the chiropractors at Monmouth Pain & Rehabilitation focus on realigning the body for pain relief and mobility restoration. There are numerous types of chiropractic adjustment techniques which could be employed at the discretion of your chiropractor. 

For the “pop” kind of treatment (where you feel like your back got cracked), our experienced chiropractor can use the high-velocity, low-amplitude thrust for a sudden, controlled force to the hip joint. The low-force, gentle chiropractic care is better for patients who are nervous for the “pop” or whose conditions would suffer from it. This method simply used a continual low force until you get the effect you want.

Chiropractic Benefits

In addition to the overall increase in mobilization and functionality, chiropractic hip pain treatment in NJ can relieve more discomfort than medication. It is also non-invasive, so there are few to no side effects from the treatment. At Monmouth Pain & Rehabilitation, we create a treatment plan that is designed specifically for your needs, and we work to find the underlying cause of your hip pain.

Schedule Your Hip Pain Treatment with NJ Specialists

If you have hip pain and want to use chiropractic care as a means to treat it, contact the hip pain treatment NJ specialists at Monmouth Pain & Rehabilitation. We will diagnose your specific condition and take a holistic approach to your overall treatment. Our chiropractors want to treat your body and mind. Contact us today to set up an appointment for your hip pain consultation today!

Get to Know Your Practitioner: Dr. Riddhi Patel, PT, DPT

Monmouth Pain & Rehabilitation is proud to host 8th Grade interns from the Red Bank Charter School. One of our interns, Viridiana Cielo, interviewed one of our Shrewsbury physical therapists Riddhi Patel to find out more about Riddhi and what it’s like being a physical therapist!

Where are you from?

I’m from North Jersey

How long have you been a Physical Therapist?

I’ve been a Physical Therapist for 8 years.

What college did you attend?

I attended to the University of the Sciences in Philadelphia.

How many years of school did you complete to become a PT?

I took 6 years of college.

Did you always want to be a Physical Therapist?

I definitely always wanted to be in the health field.

What inspired you to be a Physical Therapist?

I like the idea of helping people move around, be active, and do sports.

What kind of things do you need to know in order to be a Physical Therapist?

I have to know anatomy, communication, and neurology.

What is one of the biggest challenge you had to face while learning Physical Therapy?

One of the biggest challenges I faced was putting together all the information I was learning and make sense out of it.

What type of things do you do on a daily basis?

I help people ease their pain and injuries. We deal with a lot of knee, back, and shoulder pain.

What are some things you have to be really careful about with Physical Therapy?

I have to be careful that I’m not causing pain or soreness for the patient.

What are some challenges you face being a Physical Therapist?

Some challenges I face are insurance limitations and patients’ time constraints when treating.

Get to Know Your Practitioner: Acupuncturist Hugh Kim, L.Ac

Monmouth Pain & Rehabilitation is proud to host 8th Grade interns from the Red Bank Charter School. One of our interns, Mei-Ling Downey, interviewed our Shrewsbury/Freehold acupuncturist Hugh Kim to find out more about why Hugh became an acupuncturist, his inspiration, and more!

Where are you from?

I was born and raised in Korea.

What college did you attend, and for how many years?

I went to Binghamton University for 4 years of undergrad.

What degrees did you need to become an acupuncturist?

You can attend programs after college, but I have a Masters in Oriental Science; you can get that or a masters in acupuncture.

How long did it take you to learn about acupuncture?

I completed 4 years of Masters, but I am always learning as there are so much to learn about.

What kind of things did you need to learn about to become an acupuncturist?

I had to study western forms of medicine and oriental medicine, and the many different pressure points on the body. There is a lot to learn, like the history of oriental science, which goes very far back into history.

What was the hardest thing to learn about acupuncture?

It was hard to master timing, when to put the needle in and the pulses . Also the history of oriental science is always been hard as there is so much to learn.

Did you always want to be an acupuncturist?

I never was definite on being an acupuncturist, but my grandfather was an acupuncturist, and that encouraged me to become one. In college I found out you can go to acupuncture school so I decided to attend.

As a kid what did you want to be when you grew up?

I wanted to be a scientist, or in the scientific field.

If you weren’t an acupuncturist what would you be?

I think I’d be a dentist.

Are there different needle sizes in acupuncture?

There are few, like long ones to hit the pressure points that are farther down into the body and prickers for the points that are closer.

Do you ever do acupuncture yourself?

Yes I sometimes do acupuncture for myself if I need it.

Were you ever afraid of needles?

I wasn’t very comfortable with them before I became an acupuncturist but over time I just got used to them.

If you would be interested in trying acupuncture for yourself, you can schedule an appointment with Hugh or any of the acupuncturists in our other locations by calling 732-345-1377.

Can Acupuncture Treat the Flu?

 

Through acupuncture you will see benefits not just physically, but emotionally and mentally as well. Acupuncture can be used to treat back/neck pain, headaches, fertility, digestive conditions, allergies, improved immune system, and so much more.
As we head into flu season…YES it is nearly here, let’s take a look at all the ways we can help prevent the flu, and reduce the symptoms and duration.
At the core of Acupuncture is the notion that a type of energy known as Qi (pronounced “chee”), flows through energy pathways in the body. Each pathway corresponds to one organ, or group of organs, that manages particular body functions. Achieving the proper flow of Qi is thought to create health and wellness. It boosts the immune system’s production of natural killer cells for up to 3 days after each treatment.

Tips for Boosting Immunity:
EAT RIGHT – Eat warm foods, soups, stews, roasted veggies. Avoid eating cold foods, yogurt, smoothies, salads.
Dress Warm – Keep your head and neck covered, keep your core warm.
Get Acupuncture – Regular acupuncture treatments help support and strengthen immunity. It can provide immediate relief, and reduce the length of infection.
Get regular chiro adjustments – Did you know that those who have regular chiro adjustments will have a 200% greater immune competence? Fall is not the time to skip your appointments!
Remember, the sooner you treat it the better!

Physical Therapy as the First Point of Care has Been Shown to Reduce Health Care Costs and Opioid Usage

A new study has shown that using physical therapy as the first point of care for patients with low back pain reduces overall health care costs and opioid usage.

According to the National Institutes of Health, 80% of adults experience low back pain at some point in their lifetime being the most common cause of job-related disability and a leading contributor to missed work days1. In addition to being a common ailment, low back pain is among the most common disorders associated with prescribed opioid use in primary care2. According to the new study, when patients turn to physical therapy as the first point of care, they enjoy the benefits of lower health care spending and opioid usage in relation to treating their back pain.

The study, published by Health Services Research, compared the differences in opioid prescription, health care utilization, and costs among patients with low back pain who saw a physical therapist at the first point of care, at any time during the episode, or not at all. The patients were between the ages of 18-64 years old with a new primary diagnosis of low back pain and were observed over a one year period.

The main findings of the report detailed that patients who saw a physical therapist at the first point of care had an 89.4% lower probability of having an opioid prescription, 27.9% lower probability of having any advanced imaging services, and 14.7% lower probability of ER visits, as well as significantly lower out-of-pocket costs compared to patients who saw a physical therapist late or not at all3.

The findings of this study emphasize the world of benefits physical therapy offers patients – most importantly – lasting relief from addressing musculoskeletal issues appropriately. Additionally, patients avoid opioid usage by getting to the root of the problem to provide real relief. Lastly, patients may face lower out-of-pocket costs and avoid undergoing costly diagnostic imaging procedures.

If you are suffering from a new diagnosis of low back pain or have been battling chronic low back pain, now is the time to realize the benefits of a comprehensive physical therapy program. Let Monmouth Pain and Rehabilitation be your first point of care for treating your low back pain. Together, we will help lower your overall health care costs by avoiding opioid prescriptions, advanced imaging services, and ER visits that may arise due to the development low back pain complications.

  1. Ashworth, J., Green, D. J., Dunn, K. M., & Jordan, K. P. (2013). Opioid use among low back pain patients in primary care: Is opioid prescription associated with disability at 6-month follow-up? Pain, 154(7), 1038–1044. http://doi.org/10.1016/j.pain.2013.03.011 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250559/
  2. National Institutes of Health. (2017) Back Pain Fact Sheet. NINDS. NIH Publication No. 1505161. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
  3. Frogner, B. K., Harwood, K., Andilla, C. H. A., Schwartz, M., & Pines, J. (2018) Physical Therapy As the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Services Research https://doi.org/10.1111/1475-6773.12984

Most Common High School Sports Injuries and Steps for Prevention

High school sports play an important role in developing a healthy, active lifestyle for kids while also developing invaluable life skills such as goal setting, time management, leadership, cooperation, and social intelligence.

At the same time, youth athletes are prone to injuries just like their favorite pros. Youth athletes also face an increased risk of injury due to the fact that their bodies are still developing. It is key to find the optimal recovery options so that your kids can be back in action without missing too many games or practices – Monmouth Pain & Rehabilitation can make that possible!

Dr. R. Dawn Comstock conducted the National High School Sports-Related Injury Surveillance Study for the 2015 – 2016 academic year which monitored sports-related injuries among high school athletes, and identified the top five most common high school sports injuries:

  1. Head Injuries
  2. Ankle Strain/Sprain
  3. Knee Strain/Sprain
  4. Hip/Thigh/Upper Leg Strain/Sprain
  5. Hand/Wrist Injuries

Though a large portion of sports-related injuries did not require surgery, recurring injuries accounted for almost 10% of total injuries for the year. It is vital to understand that treating the symptoms of an injury does not always address the underlying cause of the problem. Pain medication can reduce inflammation and mask the pain giving the illusion that the injury has healed. Just because the pain subsided does not mean the injury has fully healed resulting in the increased risk of reinjuring the affected area.

Through effective injury management and preventative care, we can help keep kids active, healthy, and on the field! That is why it is important to understand the benefits that physical therapy, chiropractic, and acupuncture bring to the injury recovery and prevention process.

Benefits of Physical Therapy for High School Athletes

Physical therapy works to maximize movement during the recovery process, and seeks to avoid pain medication and surgery. This is achieved by assessing the extent of the injury, and creating a treatment program specific to the patient’s needs and capabilities. Physical therapy can be utilized not only after an injury has occurred, but at the first signs of tenderness and weakness. For instance, many times an athlete will perform through pain, further increasing their chance of injury. Consulting with a physical therapist at the first sign of pain will help to strengthen the affected area before the pain manifests into a debilitating injury.

Benefits of Chiropractic for High School Athletes

 Chiropractic care plays a key role in sports injury prevention and recovery. Training, practice, and competition take a toll on an athlete’s body, exposing them to increased stress that can result in chronic aches and pains which may lead to injury. Chiropractors correct spinal misalignments, fix asymmetries throughout the body, and increase range of motion by reducing the tension on muscles and tendons, which promotes faster healing and reduces the risk of injury. Chiropractic care is effective in injury prevention and can also benefit an athlete’s performance. Seeing a chiropractor without a preexisting injury is a proactive step in injury prevention.

Benefits of Acupuncture for High School Athletes

 Acupuncture produces improved energy and biochemical balance, which results in stimulating the body’s natural healing abilities and promoting physical and emotional well-being. Acupuncture is a common practice used by many professional athletes around the world. Studies show that acupuncture effectively treats sports injuries, while also improving the athlete’s performance and endurance. The growing popularity of acupuncture treatment raises awareness of how beneficial acupuncture is for injury prevention.

Monmouth Pain and Rehabilitation is Your Home Team!

 If you or your child have experienced a sports injury in the past, are currently facing a sports related injury, or want to take the proactive steps in strengthening and optimizing your body for peak performance, please feel free to take advantage of our free consultation (a $245 value) and contact us directly by calling 732-345-1377 or by emailing us using the Contact Form below. Monmouth Pain and Rehabilitation has three convenient locations in Monmouth and Ocean County: Shrewsbury, Wall, and Forked River. We look forward to helping with all your rehabilitation, physical therapy, and chiropractic needs!

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6 Treadmill Mistakes to Avoid

Most people have probably been on a treadmill at some point in their lives. It’s an incredibly useful exercise machine that is great for people of all fitness levels, whether you’re looking to have a reasonably paced walk, a steep uphill climb, or a more vigorous run or jog.

While using a treadmill can yield a number of health benefits, it is crucial to be sure you’re utilizing the machine safely and correctly. Make sure you don’t make these six mistakes when on the treadmill, to avoid injuries and ensure a beneficial workout.

1. Skipping a warm-up

Warming up gets your muscles ready to exercise, boosts blood flow, and increases oxygen supply, which improves performance. Taking your time before launching into a full-blown run can also help prevent injuries. Start at a comfortable speed to warm-up and gradually increase speed. If you are going to run, be sure to walk for a few minutes before and after running to give your muscles time to warm-up/cool-down.

2. Holding onto the bar

It may seem like a safe idea to hold onto the bar at the front of the treadmill when walking or running to avoid falling off the back of the machine. We will admit that it is helpful to hold on as you start the machine until you are comfortable enough to let go. Then, be sure to let your arms swing. Arm swing is a natural part of our gait and holding on while walking/running can inhibit this natural pattern.

3. Looking down

If you’re not quite comfortable on the treadmill, you may get the urge to look down at your feet, but try to avoid doing that. Posture is incredibly important when exercising, and looking down may actually cause you to lose balance. Try to remain as upright as you can, look forward, and don’t hunch over.

4. Staying at the front of the treadmill

Some people place themselves as close to the front of the treadmill as they can to prevent themselves from falling off the back. However, it’s important to center yourself and utilize the entire belt. This allows for a full stride and free upper body movement.

5. Not hydrating enough

Be sure to drink plenty of water before, during, and after your workout, especially if you’ll be running. Drink 16 oz 2 hours before your run, 5 oz every 15-20 minutes during, and another 16 oz after.

6. Sticking with the same old thing

Muscle repetition and overuse are major causes of injuries and machines like the treadmill are a huge factor in this. Running in one straight line, at the same incline and same pace through every run will likely lead to overuse and therefore injuries. The wisest choice would be to run outside to mix it up with turns and natural inclines. If you’ll be sticking with the treadmill, just change up your speed and use that incline function. It will give you a more complete and effective workout, and confuse your muscles in a good way.

If you’re interested in learning more about proper workouts, or you have experienced an injury from running, sports, or your daily activities, please give us a call at 732-345-1377. The team at Monmouth Pain & Rehabilitation is skilled in treating a wide range of injuries, as well as educating in injury prevention.

10 Things You Didn’t Know Chiropractic Can Treat

Written by: Dr. Nicole Yarbenet, D.C.

Often times, people perceive chiropractic care as a series of “back cracks”. But it’s so much more than that. Chiropractic allows for optimal health throughout the body, for all ages. Our Wall NJ chiropractors and Shrewsbury NJ chiropractors can treat a wide variety of health issues. Pediatric chiropractic is also something worth exploring for your children.

Chiropractic for Pregnancy Pain

During pregnancy, there are several physiological and hormonal changes that occur in preparation for creating the environment for the developing baby. Chiropractic for pregnancy pain can help in maintaining a healthier pregnancy, reducing the time of labor and delivery, relieving back, neck or joint pain, and preventing a potential cesarean delivery.

Anxiety & Chiropractic

People suffering from anxiety have an overly active sympathetic nervous system which controls our fight or flight mechanism. The thoracic vertebrae are highly innervated by the sympathetic nervous system, therefore, any irritation of that area will cause symptoms of anxiety. Adjusting the thoracic spine will calm down this response and relieve anxiety.

Headache Relief

Headaches are a common problem. A majority of headaches originate in the neck. When you have a headache it is important to see your chiropractor. Your chiropractor can perform a spinal adjustment to improve spinal function and alleviate the stress on your system. They can also provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins. Your chiropractor can also offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Attention-deficit/hyperactivity disorder (ADHD) 

Chiropractic cannot necessarily treat ADHD but it can help decrease the symptomatology. ADHD is a central nervous system disorder that causes tension on the nervous system. A chiropractic adjustment can help calm down the nervous system by releasing nerve tension.

Pediatric Chiropractic for Colic  

Comfortless crying and periodic fussiness can be very upsetting to a new parent and even more upsetting for baby. This condition can last for hours or days. Colic is characterized by a loud piercing cry, tensed abdominal muscles, flexed legs, and clenched fingers.  Any type of vertebral subluxation can adversely affect the child’s nervous system resulting in colic symptoms. A chiropractic adjustment helps to restore normal function in a child’s nervous system, bringing it back to full normal potential. The result is a happy and content baby.

Gastrointestinal Issues  

The nervous system controls the digestive system in many ways. The vagus nerve which comes from the brain and travels around the first cervical bone innervates all the major organs of digestion and functions to stimulate the digestive process. Other major areas controlling digestion include the sympathetic nerves coming out of the thoracic and lumbar regions of the spine. Spinal misalignment in any of these regions can lead to neurological compromise and altered digestive function. Regular chiropractic adjustments can help alleviate digestive problems.

Sinus Infections and Chiropractic

Your sinuses consist of hollow spaces in the bones of the forehead, cheeks and temples. Healthy, open sinuses are lined with sticky mucus to ensure that air going into the lungs is moist, warm and free from dust, dirt, and pollutants. Your Chiropractor is specially trained to help properly drain the sinuses with specific cranial and upper cervical adjustments. Chiropractic care is also proven to help boost the immune system. There is a direct relationship between the immune system and the central nervous system.  If we support the nervous system through proper spinal function and alignment, then we will ultimately support and strengthen the immune system.

Bed-wetting (Enuresis)

Bed-wetting (enuresis) is another of the many reasons why parents bring their children to see the chiropractor. Emptying of the urinary bladder is controlled by the detrusor and trigone muscles. The nerve supply to these muscles is via the sacral parasympathetic nerves from S2 to S4. Adjustment of the sacral segments in children will relieve any nerve interference that contributes to bed-wetting.

Difficulty breast feeding 

It is very frustrating when a newborn has a difficult time latching on to breastfeed. This can be upsetting for mom and baby. The birth process is very traumatic to an infant’s upper cervical spine. Correcting the misalignment with a gentle adjustment will help the baby latch on without difficulty.

Chiropractic for Stress

Chiropractic care can help manage your stress levels.  When you experience stress, your body releases stress hormones into your bloodstream, including cortisol and adrenaline.  These stress hormones cause a whole series of physiological changes in your body, such as increasing your heart rate and blood pressure, shutting down your digestive system, and altering your immune system. One of the effects of chronic stress is muscle tension and contraction, which can lead to uneven pressure on the spine, which in turn leads to subluxations. Adjustments help ease muscle tension, which will diminish the stress on certain parts of the skeleton leading to stress reduction.

If you or anyone you know is suffering from any of these conditions, please contact Monmouth Pain & Rehabilitation for a FREE consultation ($245 value).  To schedule a consultation fill out the form below or give us a call at 732-345-1377. Our Shrewsbury & Wall NJ chiropractors provide expert service, and can combine adjustments with a number of our other modalities, for an all-encompassing, effective treatment.

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Chiropractic: The Natural, Effective Remedy & Prevention for Ear Infections

MPR Chiropractor Dr. Nicole Yarbenet explains in the above video that ear infections are one of the most common childhood illnesses, most often occurring in children up to age 6. Without treatment, the condition can persist into adulthood.

Symptoms can include:

  • Soreness, pain, and discomfort in the area surrounding the ear
  • Fever
  • Fluid drainage
  • Trouble sleeping
  • Loss of appetite
  • Grumpy behavior
  • Popping and ringing in the ears
  • Pressure buildup

Some children may be too young to communicate these symptoms, so parents can usually tell if their child is pulling at their ear, they are having difficulty hearing, or experiencing balance problems and dizziness.

Research has shown that antibiotics are not effective in treating ear infections in the long term. This is where chiropractic comes in, getting to the root of the problem.

Chiropractic adjustments are known to boost the immune system and promote overall wellness, but on top of that, proper alignment of the spine allows the muscles around the infected ears to relax. The Eustachian Tube is responsible for draining fluid from the ear. The nerves coming out of the upper cervical spine (the neck) influence the muscles surrounding the Eustachian Tube, and if any of the upper cervical bones are out of place, the muscles become tight and put pressure on that tube. This pressure makes it difficult for fluid to drain from the tube, which may cause an infection. Upper cervical adjustments are key in preventing the pressure buildup and subsequent ear infections, plus releases any pressure to relieve infections that may already be present.

No child is too young or too small to be adjusted by a chiropractor. Chiropractic is a safe and healthy approach for all ages, from newborns to children and adolescents, all the way through adulthood. Chiropractors alter their force depending on the age and size of their patient, and the chiropractic team at MPR is gentle enough to ensure your child has a comfortable and calm experience.

If you would like to make an appointment for your child to get adjusted at Monmouth Pain & Rehabilitation, to relieve or prevent ear infections, to help with another condition, or just to promote improved health and a strong immune system, please call 732-345-1377.

 

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