Reduced Short- and Long-Latency Afferent Inhibition Following Acute Muscle Pa...Antonio Martinez
Corticomotor output is reduced in re-
sponse to acute muscle pain, yet the mechanisms
that underpin this effect remain unclear. Here the au-
thors investigate the effect of acute muscle pain on
short-latency afferent inhibition, long-latency afferent
inhibition, and long-interval intra-cortical inhibition to
determine whether these mechanisms could plausibly
contribute to reduced motor output in pain.
Reduced Short- and Long-Latency Afferent Inhibition Following Acute Muscle Pa...Antonio Martinez
Corticomotor output is reduced in re-
sponse to acute muscle pain, yet the mechanisms
that underpin this effect remain unclear. Here the au-
thors investigate the effect of acute muscle pain on
short-latency afferent inhibition, long-latency afferent
inhibition, and long-interval intra-cortical inhibition to
determine whether these mechanisms could plausibly
contribute to reduced motor output in pain.
Transcranial Magnetic Stimulation ( TMS) for Chronic PainDr. Rafael Higashi
Aula sobre avanço no tratamento da dor crônica com o uso de Estimulação Magnética Transcraniana (EMT) ministrada por Dr. Rafael Higashi, médico neurologista, no departamento de tratamento da dor do Centro Médico da Universidade de Nova York, NYU, EUA.
www.estimulacaoneurologica.com.br
How to use Electrical Stimulation for Faster Hand Recovery After Stroke? by M...Techcare Innovation
Electrical Stimulation (ES) has been proven to help in upper limb recovery after stroke. Its benefits include strengthening weak muscles, increasing range of motion, reducing spasticity, and etc.
However, its benefits are limited in actual application due to lack of knowledge and experience in many patients.
In this sharing session, Ms. Yvonne will share practical recommendations with the clinical support evidence that can help to translate into actual practice and application for hand recovery of stroke patients. It is suitable for stroke patients, caregivers, physiotherapists, occupational therapists, doctors, nurses, and etc.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Transcranial Magnetic Stimulation ( TMS) for Chronic PainDr. Rafael Higashi
Aula sobre avanço no tratamento da dor crônica com o uso de Estimulação Magnética Transcraniana (EMT) ministrada por Dr. Rafael Higashi, médico neurologista, no departamento de tratamento da dor do Centro Médico da Universidade de Nova York, NYU, EUA.
www.estimulacaoneurologica.com.br
How to use Electrical Stimulation for Faster Hand Recovery After Stroke? by M...Techcare Innovation
Electrical Stimulation (ES) has been proven to help in upper limb recovery after stroke. Its benefits include strengthening weak muscles, increasing range of motion, reducing spasticity, and etc.
However, its benefits are limited in actual application due to lack of knowledge and experience in many patients.
In this sharing session, Ms. Yvonne will share practical recommendations with the clinical support evidence that can help to translate into actual practice and application for hand recovery of stroke patients. It is suitable for stroke patients, caregivers, physiotherapists, occupational therapists, doctors, nurses, and etc.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
4. What Are Trigger Points and What
Causes Them?
A myofascial trigger point is an irritable spot within a
taught band of skeletal muscle, ligament or fascia (thin
connective tissue that surrounds muscles and organs).
Trigger points often exhibit referred pain. This is pain that
is felt in a separate area from the site that is believed to
cause the pain.
For example, a trigger point in your shoulder might refer
pain down into the rest of your arm.
4
INTRODUCTION
5. 5
What’s the difference between an active and latent trigger point?
Research has identified two different types of
trigger points:
1. ACTIVE
2. LATENT
Active trigger points produce pain constantly or
during movement and can reduce the flexibility
of muscles.
latent trigger points are only painful when
they’re compressed.
6. 6
What causes trigger points?
There are a few theories about what causes
trigger points:
One theory suggests that active trigger points
develop through…
1. Overuse of the affected tissue.
2. Putting more athletic populations at risk.
&
Latent trigger points
• Are suggested to develop in underused tissue,
making them more likely to occur in people who
are sedentary.
7. 7
MYO = Muscle
Fascia = a band or sheet of connective
tissue
Release = the relaxation and / or
stretching of tight structures
What is Myofascial Release ?
8. 8
What is Myofascial Release ?
Myofascial Release is a specialised physical and
manual therapy used for the effective treatment and
rehabilitation of soft tissue and fascial tension and
restrictions.
Safe and effective hands-on technique that works on
the fascia to release restrictions.
Applied with prolonged pressure to restricted tissue.
Aims to release tension and stretch out restricted
parts of the fascia .
10. 10
Electrotherapy a powerful tool used by
many physiotherapists, electrotherapy
treats chronic pain, musculoskeletal
injuries, muscle wasting, and nerve pain
by using targeted and controlled
electrical stimulation.
Electrotherapy
13. • Myofascial Release can decrease
Pain : Endorphin release / increased
temperature / pain gate theory
• Myofascial Release promotes
healing Increased blood flow and
cell nutrition.
• Myofascial release can reduce
tension Stretching / elongation of
fascia / Increased heat in tissues.
vs
• Electrotherapy includes a range of
treatments using electricity to…
• reduce pain,
• improve circulation,
• repair tissues,
• strengthen muscles,
• And promote bone growth,
leading to improvements in
physical functioning.
13
SIGNIFICANCE
This study will give awareness to physiotherapy community on the
effectiveness of myofascial release vs electrotherapy on trigger points.
14. Research Design
14
Methodology
The purpose of research design is to know about the
effectiveness of electrotherapy v/s myofascial release on
trigger point. Research design for this research was
quantitative. A 5-member group work on this study. Each
one must read at least 5 research article on their
respective topics, whole group total (25) articles to find
out which one is more effective.
15. Some studies showed that TENS was found to be one of the best
effective electro-modality in reducing pain among all
electrotherapies.
Some studies reported a significant effect of high power ultrasound
along with some analgesics to be effective in reducing pain.
15
CROSS SECTIONAL STUDIES HAVE DONE FROM WHICH FOLLOWING
FINDINGS THROUGH SYSTEMATIC REVIEW CAME WHICH ARE AS FOLLOWS.
Result / Findings
An adequate amount of higher quality studies proposed that MFR is
one of the best therapy used to treat or resolve trigger points.
Hence, follow results would came if long term follow-up was
done under the supervision of physiotherapist.
16. 16
Result / Findings
There is significant evidence for the short-term effectiveness of laser therapy on pain
intensity and the immediate benefits of TENS. There are insufficient data to determine
the long-term effectiveness of TENS. The evidence for the effectiveness of frequency
modulated electrical muscle stimulation, electrical muscle stimulation, high voltage
galvanic stimulation and interferential current is limited. Preliminary evidence
indicates that magnet therapy may be effective. Ultrasound is no more effective than
placebo. The evidence for physical and manual therapies is high level.
17. 17
“
“
Guys what about
both on trigger
points..?
SAMEER
HOOR & RAMEEN
HADISA & MARIA
DISCUSSION
Myofascial release is
best on trigger
points?
No!!!
Electrotherapy is the
paracetamol in
physiotherapy.
18. DISCUSSION
• Myofascial trigger points (MTrps) are present in most of the musculoskeletal
conditions due to sustained activity in incorrect posture . This study is
intended to compare the effectiveness of ELECTROTHERAPY V/S
MYOFASCIAL RELEASE in MTrps in different muscles.
• Hong CZ (2002) said that the pathogenesis of myofascial trigger points
appears to be related to the integration in the spinal cord in response to the
disturbance of the nerve endings and abnormal contractile mechanism at
multiple dysfunctional endplates. Methods usually applied to treat
myofascial trigger point include stretch, massage, thermotherapy,
electrotherapy, laser therapy, Myofascial trigger point injection, dry needling,
and acupuncture.
• Aguilera MJ et al., (2009) did a study to determine immediate effect of
ischemic compression and ultrasound on MTrps of upper trapezius muscle.
This study was a randomized control trial in which 66 volunteers diagnosed
with latent MTrps of upper trapezius muscle participated. The study
concluded that both treatments were shown to have immediate effect of
pain reduction on latent MTrps.
19. DISCUSSION
• Rickards LD (2006) in a systemic review of 23 randomized control trials on
effectiveness of non- invasive treatment for myofascial trigger point,
concluded that there is significant evidence for short term effectiveness of
laser therapy on pain intensity and immediate benefits of Transcutaneous
Electrical Nerve Stimulation (TENS). But the evidence for effectiveness of
frequency modulated electrical muscle stimulation, high voltage galvanic
stimulation and interferential current is limited. Evidence for physical and
manual therapies is high.
• Rachlin ES (1994) suggested that the most effective technique for electrical
stimulation of myofascial trigger points is to increase the electrical stimulus
to the point of gentle muscular contraction in cyclic mode which is a
passive form of contract relax and recommended duration is 10- 15 minutes
of intermittent current which can be surged type of current.
• Hou et al., (2002) investigated the immediate effects of manual pressure
release on pain reduction, MTrp sensitivity and improvement in cervical
range of motion in 48 women with upper trapezius MTrps. They concluded
that significant change was seen in groups using low pressure for 90 sec,
and high pressure for 30 sec and 60 sec.
20. DISCUSSION
SUMMARY
• The obtained results remain in line with those of a study by Mukkannavar
[15] compared between combination therapy (transcutaneous electric nerve
stimulation and US) and ischemic compression in the treatment of active
myofascial trigger points and showed that combination therapy resolved
acute active trigger points pain and increased ROM more rapidly than the
ischemic compression treatment technique.
• Also, the results of this study agree with those obtained by Namvar et al. [16],
who concluded that myofascial release was one of the effective manual
therapy techniques in reducing pain and disability, as well as improving the
isometric extension strength of neck in patients with non-specific chronic
neck pain.
• In summary, the study demonstrated that a comparison between
multimodal approach of electrotherapy and myofascial release for their
effect on pain, CROM, and functional restriction in the treatment of patients
with chronic mechanical neck pain revealed no significant differences
between them & When treatment efficacy were taken into consideration
for significance, there was no significant difference between both the
groups.
21. This study can be concluded by stating that
both groups have got beneficial effect in
reducing the pain intensity and increasing
the range of motion in patients with
myofascial trigger point in muscles. When
treatment efficacy were taken into
consideration for significance, there was no
significant difference between both the
groups.
21
CONCLUSIONS
22. Kshama. S. Shetty, A. Joseph Oliver Raj (2015). Effect of Surged Faradic Current on Myofascial Trigger Point of Upper
Trapezius Muscle as compared with Manual Pressure Release. International Journal of Science and Research. 2319-
7064 https://www.ijsr.net/archive/v6i3/ART20172020.pdf
Rickards LD (2006). The effectiveness of non-invasive treatments for active myofascial trigger point pain. A systematic
review of the literature. Database of Abstracts of Reviews of Effects (DARE):
https://www.ncbi.nlm.nih.gov/books/NBK72610/
Jibi Paul, Selvabharathi. C. Effect of Myofascial Release and Trigger Point Release among Osteoarthritis Knee Patients.
Research J. Pharm. and Tech. 2019. https://rjptonline.org/HTMLPaper.aspx
Mohammed H. El-Gendy, Yasser R. Lasheen, Wafaa K.S. Rezkalla(2019). Multimodal approach of electrotherapy versus
myofascial release in patients with chronic mechanical neck pain: a randomized controlled trial. Physiotherapy
Quarterly. https://www.researchgate.net/publication/337760966.
Zeng.C, H. Li, T .Zeng (2015). Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network
meta-analysis. Osteoarthritis and Cartilages Volume 92. Science Direct Journal and Books.
https://www.sciencedirect.com/science/article/pii/S1063458414013375
Carol Grace T. Vance, Barbara A. Rakel, Nicole P. Blodgett, Josimari Melo DeSantana, Annunziato Amendola, Miriam
Bridget Zimmerman, Deirdre M. Walsh, Kathleen A. Sluka, Effects of Transcutaneous Electrical Nerve Stimulation on
Pain, Pain Sensitivity, and Function in People With Knee Osteoarthritis: A Randomized Controlled Trial, Physical
Therapy, Volume 92, Issue 7, 1 July 2012, Pages 898–910, https://doi.org/10.2522/ptj.20110183
P. Gurudut, A. Welling, G. Kudchadkar (2019). Combined Effect of Gross and Focused Myofascial Release Technique on
Trigger Points and Mobility in Subjects with Frozen Shoulder. International Journal of Health Sciences & Research.
2249-9571. https://www.ijhsr.org/IJHSR_Vol.9_Issue.4_April2019/10.pdf
Ge, hy., fernández-de-las-peñas, c. & yue, sw. Myofascial trigger points: spontaneous electrical activity and its
consequences for pain induction and propagation. Chin med 6, 13(2011). Https://doi.org/10.1186/1749-8546-6-13.
Sara ahmed, md, christopher haddad, msc, shoba subramaniam, mph, shereen khattab, msc, dinesh kumbhare, md,
msc, frcpc, faapmr, the effect of electric stimulation techniques on pain and tenderness at the myofascial trigger point:
a systematic review, pain medicine volume 20, issue 9, september 2019, pages 1774–1788,
https://doi.org/10.1093/pm/pny278
Donelly J (2018) Myofacial pain and dysfunction. Wolters Kluwer Health 654-800.
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&output=bibtex
Micheal. H (2013) Myofacial release for trigger points using shockwave. Medical Wave 1- 25
https://medicalwaveus.com/2021/09/22/
Blennerhasset DG (2021) Trigger point release explanation. Dr Greame Health Products 1-20
https://www.drgraeme.com/articles/author/dr-graeme-blennerhassett
Alvarez DJ, Rockwell PG (2002) Trigger points: diagnosis and management. Am Fam Physician 65: 653-660
http://www.ncbi.nlm.nih.gov/pubmed/11871683
Majlesi J, Unalan H (2010) Effect of treatment on trigger points. Curr Pain Headache Rep 14: 353-360.
http://www.ncbi.nlm.nih.gov/pubmed/20652653
Han SC, Harrison P (1997) Myofascial pain syndrome and trigger-point management. Reg Anesth 22: 89-101.
http://www.ncbi.nlm.nih.gov/pubmed/9010953
Han SC, Harrison P (1997) Myofascial pain syndrome and trigger-point management. Reg Anesth 22: 89-101.
http://www.ncbi.nlm.nih.gov/pubmed/9010953
Arne N Gam, Susan Warming, Lone Hørdum Larsen, Bente Jensen, Ola Høydalsmo, Ingelise Allon, Bente Andersen, Niels
E Gøtzsche, Marelis Petersen, Birgitte Mathiesen,
Treatment of myofascial trigger-points with ultrasound combined with massage and exercise – a randomised controlled
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