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Alabau-Dasi R, Nieto-Gil P, Ortega-Avila AB, Gijon-Nogueron G. Variations in the Thickness of the Plantar Fascia After Training Based in Training Race. A Pilot Study. J Foot Ankle Surg 2022; 61:1230-1234. [PMID: 35370051 DOI: 10.1053/j.jfas.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 08/11/2021] [Accepted: 02/14/2022] [Indexed: 02/03/2023]
Abstract
Plantar fascia (PF) is a connective tissue made up of mostly type 1 collagen that is subjected to constant loads. This study evaluated the effect of continuous running on tissue stress in the PF by measuring changes in the thickness of the PF using ultrasound scans. It was a cross-sectional study involving 24 runners from the University of Valencia, recruited as volunteers between December 2018 and February 2019. A variety of data was recorded: (age, body mass index, type of footwear, number of workouts per week, KM run per week, sports injuries in the last year, pre and postrace ultrasound PF measurements). There were significant differences in the 3 postrace measurements of the left foot (<0.001). PF thicknesses were measured before and after running, with a minimal average difference of 0.4 mm in the medial and central fascicles, and 0.3 mm in the lateral fascicle. We observed PF thicknesses above 4mm in asymptomatic patients with no signs of vascularisation, proving that increased PF thickness is not the only criterion for diagnosis of plantar fasciitis.
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Affiliation(s)
| | - Pilar Nieto-Gil
- Department of Nursing and Podiatry, University of Valencia, Valencia, Spain
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Faculty of Health Sciences. University of Malaga, Spain; Biomedical Research Institute (IBIMA), Malaga, Spain.
| | - Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Faculty of Health Sciences. University of Malaga, Spain; Biomedical Research Institute (IBIMA), Malaga, Spain
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Raja AE, Shustorovich A, Robinson DM, Alfonso K, Meyer R, Roemmich RT, Eng C, Wisniewski SJ, Cabahug P. Musculoskeletal Ultrasound as a Motivator for Selecting a Physical Medicine and Rehabilitation Residency Program in the United States: A Multicenter Survey Study. Am J Phys Med Rehabil 2022; 101:97-103. [PMID: 33605576 PMCID: PMC8371081 DOI: 10.1097/phm.0000000000001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT This study aimed to determine the influence of musculoskeletal ultrasound (MSKUS) curriculum on applicants during the residency-selection process. A survey of 666 applicants for the Johns Hopkins University, Mayo Clinic, and Harvard/Spaulding Rehabilitation Physical Medicine and Rehabilitation programs was conducted in June 2020. A total of 180 respondents scored the influence of a MSKUS curriculum on their decision making for residency selection. In addition, applicants were asked to rank specific areas of physical medicine and rehabilitation that influenced their decision making. Participants most commonly included MSKUS in their top three areas of interest when constructing their rank order list. When asked whether MSKUS presence within a program had an effect during the interview-selection process, 71% responded with "very important" or "absolutely essential" (P < 0.001). For 74% of applicants, exposure to MSKUS in residency was an important factor when creating their rank order list (P < 0.001). More than 92% of applicants stated that they are "likely" or "very likely" to use MSKUS in their future practice and 83% would recommend a program with MSKUS to future candidates (P < 0.001). Based on these results, a large percentage of physical medicine and rehabilitation applicants intend on using MSKUS in their future practice. Therefore, MSKUS may be an important factor for residency selection.
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Affiliation(s)
- Altamash E Raja
- From the Department of Physical Medicine & Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland (AER, AS, RM, RTR, PC); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts (DMR, CE); Department of Physical Medicine & Rehabilitation, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota (KA, SJW); and Center for Movement Studies (RTR) and International Center for Spinal Cord Injury (PC), Kennedy Krieger Institute, Baltimore, Maryland
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Osterwalder J, Tamborrini G. [CME Sonography 100: Emergency Ultrasound of the Soft Tissues and the Musculoskeletal System]. PRAXIS 2021; 110:488-507. [PMID: 34231384 DOI: 10.1024/1661-8157/a003712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CME Sonography 100: Emergency Ultrasound of the Soft Tissues and the Musculoskeletal System Abstract. The term "emergency sonography" refers to a focused sonography in emergency situations, also called emergency "Point of Care Ultrasound (POCUS)". The attending physician applies it specifically and directly to the patient. As an indispensable part of the physical examination, emergency ultrasound helps to answer simple clinical questions. The corresponding answers provide essential elements for diagnostic and therapeutic decision-making. Furthermore, the emergency ultrasound increases the safety and efficiency of interventions on the musculoskeletal system and soft tissues. In this article we will discuss common clinical emergency situations in a focused way, but we will not address the regional anesthesiologic and analgesia-related applications that are also important in this context.
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Affiliation(s)
| | - Giorgio Tamborrini
- UZR® - Schweizer Ultraschallzentrum und Institut für Rheumatologie, Basel
- Klinik für Rheumatologie, Universitätsspital Basel, Basel
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da Silva Junior EM, Mesquita-Ferrari RA, França CM, Andreo L, Bussadori SK, Fernandes KPS. Modulating effect of low intensity pulsed ultrasound on the phenotype of inflammatory cells. Biomed Pharmacother 2017; 96:1147-1153. [DOI: 10.1016/j.biopha.2017.11.108] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/27/2017] [Accepted: 11/20/2017] [Indexed: 12/21/2022] Open
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Greene J, Louis J, Korostynska O, Mason A. State-of-the-Art Methods for Skeletal Muscle Glycogen Analysis in Athletes-The Need for Novel Non-Invasive Techniques. BIOSENSORS-BASEL 2017; 7:bios7010011. [PMID: 28241495 PMCID: PMC5371784 DOI: 10.3390/bios7010011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/16/2017] [Accepted: 02/19/2017] [Indexed: 11/16/2022]
Abstract
Muscle glycogen levels have a profound impact on an athlete’s sporting performance, thus measurement is vital. Carbohydrate manipulation is a fundamental component in an athlete’s lifestyle and is a critical part of elite performance, since it can provide necessary training adaptations. This paper provides a critical review of the current invasive and non-invasive methods for measuring skeletal muscle glycogen levels. These include the gold standard muscle biopsy, histochemical analysis, magnetic resonance spectroscopy, and musculoskeletal high frequency ultrasound, as well as pursuing future application of electromagnetic sensors in the pursuit of portable non-invasive quantification of muscle glycogen. This paper will be of interest to researchers who wish to understand the current and most appropriate techniques in measuring skeletal muscle glycogen. This will have applications both in the lab and in the field by improving the accuracy of research protocols and following the physiological adaptations to exercise.
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Affiliation(s)
- Jacob Greene
- Department of Built Environment, Faculty of Engineering and Technology, BEST Research Institute, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Julien Louis
- Faculty of Science, School of Sports and Exercise Science, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Olga Korostynska
- Department of Civil Engineering, Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Alex Mason
- Animalia, Norwegian Meat and Poultry Research Centre, Økern 0513, Oslo, Norway.
- Department of Built Environment, Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK.
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Kerkhof DL, Gleason CN, Basilico FC, Corrado GD. Is There a Role for Limited Echocardiography During the Preparticipation Physical Examination? PM R 2016; 8:S36-44. [DOI: 10.1016/j.pmrj.2016.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 12/24/2015] [Accepted: 01/01/2016] [Indexed: 01/29/2023]
Affiliation(s)
| | - Courtney N. Gleason
- Brown University Warren Alpert Medical School, Departments of Orthopedics and Pediatrics, Rhode Island Hospital, Providence, RI
| | | | - Gianmichel D. Corrado
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Ave, Boston, MA 02115; Harvard Medical School, Boston, MA; Northeastern University, Boston, MA; The Micheli Center for Sports Injury Prevention, Waltham, MA
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Marshall NE, Keller RA, Van Holsbeeck M, Moutzouros V. Ulnar Collateral Ligament and Elbow Adaptations in High School Baseball Pitchers. Sports Health 2015; 7:484-8. [PMID: 26502440 PMCID: PMC4622378 DOI: 10.1177/1941738115604577] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Baseball pitchers have adaptive changes in the soft tissues of the throwing elbow. HYPOTHESIS High school baseball pitchers would show adaptive changes in the ulnar collateral ligament (UCL), such as calcifications and hypoechoic foci, thickening, and increased ulnohumeral joint laxity, on dynamic ultrasound (DUS). STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Twenty-two asymptomatic high school pitchers, designated as their primary position by their coach, underwent DUS and physical examination of the throwing and nonthrowing elbows prior to the start of the season. UCL substance consistency and thickness, ulnohumeral joint space widening, and soft tissue elbow structures were evaluated. RESULTS The mean age of the cohort was 16.9 years. Calcifications of the UCL were similar, being present in 7 of 22 (32%) throwing elbows versus 8 of 22 (36%) nonthrowing elbows (P = 0.11). UCL hypoechoic foci also were similar between elbows: 2 of 22 (9%) throwing elbows versus 0 of 22 nonthrowing elbows (P = 0.11). UCL thickness was also found to be similar in both elbows (throwing arm, 6.54 mm vs nonthrowing, 6.71 mm; P = 0.48). Ulnohumeral joint laxity unloaded (throwing arm, 3.13 mm vs nonthrowing, 3.17 mm; P = 0.835) and loaded (throwing arm, 3.87 mm vs nonthrowing arm, 4.11 mm; P = 0.30) was similar between elbows. Throwing elbows showed posteromedial olecranon spurring in 36%, effusions in 27%, and synovitis in 9%. CONCLUSION High school pitchers show limited adaptive changes in the elbow, including UCL calcifications, hypoechoic foci, posteromedial olecranon spurring, and effusions. However, these changes are similar to those seen in the nonthrowing elbow, and these younger athletes lack findings seen in professional and collegiate pitchers such as UCL thickening and increased ulnohumeral joint space laxity. CLINICAL RELEVANCE Preseason ultrasound examination of the high school pitching elbow lacks the adaptive changes to the elbow as seen in professional pitchers. These changes likely occur later in a pitcher's career.
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Affiliation(s)
| | - Robert A Keller
- Department of Orthopedics, Henry Ford Hospital, Detroit, Michigan
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Abstract
Occupational therapy practice is grounded in the delivery of occupation-centered, patient-driven treatments that engage clients in the process of doing to improve health. As emerging technologies, such as medical imaging, find their way into rehabilitation practice, it is imperative that occupational therapy practitioners assess whether and how these tools can be incorporated into treatment regimens that are dually responsive to the medical model of health care and to the profession's foundation in occupation. Most medical imaging modalities have a discrete place in occupation-based intervention as outcome measures or for patient education; however, sonographic imaging has the potential to blend multiple occupational therapy practice forms to document treatment outcomes, inform clinical reasoning, and facilitate improved functional performance when used as an accessory tool in direct intervention. Use of medical imaging is discussed as it relates to occupational foundations and the professional role within the context of providing efficient, effective patient-centered rehabilitative care.
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Affiliation(s)
- Shawn C Roll
- Shawn C. Roll, PhD, OTR/L, CWCE, RMSK, FAOTA, is Assistant Professor, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
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Nieman DC, Shanely RA, Zwetsloot KA, Meaney MP, Farris GE. Ultrasonic assessment of exercise-induced change in skeletal muscle glycogen content. BMC Sports Sci Med Rehabil 2015; 7:9. [PMID: 25905021 PMCID: PMC4406335 DOI: 10.1186/s13102-015-0003-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/30/2015] [Indexed: 11/10/2022]
Abstract
Background Ultrasound imaging is a valuable tool in exercise and sport science research, and has been used to visualize and track real-time movement of muscles and tendons, estimate hydration status in body tissues, and most recently, quantify skeletal muscle glycogen content. In this validation study, direct glycogen quantification from pre-and post-exercise muscle biopsy samples was compared with glycogen content estimates made through a portable, diagnostic high-frequency ultrasound and cloud-based software system (MuscleSound®, Denver, CO). Methods Well-trained cyclists (N = 20, age 38.4 ± 6.0 y, 351 ± 57.6 wattsmax) participated in a 75-km cycling time trial on their own bicycles using CompuTrainer Pro Model 8001 trainers (RacerMate, Seattle, WA). Muscle biopsy samples and ultrasound measurements were acquired pre- and post-exercise. Specific locations on the vastus lateralis were marked, and a trained technician used a 12 MHz linear transducer and a standard diagnostic high resolution GE LOGIQ-e ultrasound machine (GE Healthcare, Milwaukee, WI) to make three ultrasound measurements. Ultrasound images were pre-processed to isolate the muscle area under analysis, with the mean pixel intensity averaged from the three scans and scaled (0 to 100 scale) to create the glycogen score. Pre- and post-exercise muscle biopsy samples were acquired at the vastus lateralis location (2 cm apart) using the suction-modified percutaneous needle biopsy procedure, and analyzed for glycogen content. Results The 20 cyclists completed the 75-km cycling time trial in 168 ± 26.0 minutes at a power output of 193 ± 57.8 watts (54.2 ± 9.6% wattsmax). Muscle glycogen decreased 77.2 ± 17.4%, with an absolute change of 71.4 ± 23.1 mmol glycogen per kilogram of muscle. The MuscleSound® change score at the vastus lateralis site correlated highly with change in measured muscle glycogen content (R = 0.92, P < 0.001). Conclusions MuscleSound® change scores acquired from an average of three ultrasound scans at the vastus lateralis site correlated significantly with change in vastus lateralis muscle glycogen content. These data support the use of the MuscleSound® system for accurately and non-invasively estimating exercise-induced decreases in vastus lateralis skeletal muscle glycogen content.
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Affiliation(s)
- David C Nieman
- Appalachian State University, Human Performance Lab, North Carolina Research Campus, 600 Laureate Way, Kannapolis, NC 28081 USA
| | - R Andrew Shanely
- Department of Health and Exercise Science, Appalachian State University, Boone, NC USA
| | - Kevin A Zwetsloot
- Department of Health and Exercise Science, Appalachian State University, Boone, NC USA
| | - Mary Pat Meaney
- Appalachian State University, Human Performance Lab, North Carolina Research Campus, 600 Laureate Way, Kannapolis, NC 28081 USA
| | - Gerald E Farris
- Department of Emergency Medicine, Carolinas Medical Center NorthEast, Concord, NC USA
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Aortic root disease in athletes: aortic root dilation, anomalous coronary artery, bicuspid aortic valve, and Marfan's syndrome. Sports Med 2014; 43:721-32. [PMID: 23674060 DOI: 10.1007/s40279-013-0057-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Two professional athletes in the U.S. National Basketball Association required surgery for aortic root dilation in 2012. These cases have attracted attention in sports medicine to the importance of aortic root disease in athletes. In addition to aortic root dilation, other forms of aortic disease include anomalous coronary artery, bicuspid aortic valve, and Marfan's syndrome. In this review, electronic database literature searches were performed using the terms "aortic root" and "athletes." The literature search produced 122 manuscripts. Of these, 22 were on aortic root dilation, 21 on anomalous coronary arteries, 12 on bicuspid aortic valves, and 8 on Marfan's syndrome. Aortic root dilation is a condition involving pathologic dilation of the aortic root, which can lead to life-threatening sequelae. Prevalence of the condition among athletes and higher risk athletes in particular sports needs to be better delineated. Normative parameters for aortic root diameter in the general population are proportionate to anthropomorphic variables, but this has not been validated for athletes at the extremes of anthropomorphic indices. Although echocardiography is the favored screening modality, computed tomography (CT) and cardiac magnetic resonance imaging (MRI) are also used for diagnosis and surgical planning. Medical management has utilized beta-blockers, with more recent use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and statins. Indications for surgery are based on comorbidities, degree of dilation, and rate of progression. Management decisions for aortic root dilation in athletes are nuanced and will benefit from the development of evidence-based guidelines. Anomalous coronary artery is another form of aortic disease with relevance in athletes. Diagnosis has traditionally been through cardiac catheterization, but more recently has included evaluation with echocardiography, multislice CT, and MRI. Athletes with this condition should be restricted from participation in competitive sports, but can be cleared for participation 6 months after surgical repair. Bicuspid aortic valve is another form of aortic root disease with significance in athletes. Although echocardiography has traditionally been used for diagnosis, CT and MRI have proven more sensitive and specific. Management of bicuspid aortic valve consists of surveillance through echocardiography, medical therapy with beta-blockers and ARBs, and surgery. Guidelines for sports participation are based on the presence of aortic stenosis, aortic regurgitation, and aortic root dilation. Marfan's syndrome is a genetic disorder with a number of cardiac manifestations including aortic root dilation, aneurysm, and dissection. Medical management involves beta-blockers and ARBs. Thresholds for surgical management differ from the general population. With regard to sports participation, the most important consideration is early detection. Athletes with the stigmata of Marfan's syndrome or with family history should be tested. Further research should determine whether more aggressive screening is warranted in sports with taller athletes. Athletes with Marfan's syndrome should be restricted from activities involving collision and heavy contact, avoid isometric exercise, and only participate in activities with low intensity, low dynamic, and low static components. In summary, many forms of aortic root disease afflict athletes and need to be appreciated by sports medicine practitioners because of their potential to lead to tragic but preventable deaths in an otherwise healthy population.
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Talbott NR, Witt DW. Ultrasonographic measurements of lower trapezius muscle thickness at rest and during isometric contraction: a reliability study. Physiother Theory Pract 2014; 30:360-6. [DOI: 10.3109/09593985.2013.876693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McCreesh K, Lewis J. Continuum model of tendon pathology - where are we now? Int J Exp Pathol 2013; 94:242-7. [PMID: 23837792 DOI: 10.1111/iep.12029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 04/16/2013] [Indexed: 12/01/2022] Open
Abstract
Chronic tendon pathology is a common and often disabling condition, the causes of which remain poorly understood. The continuum model of tendon pathology was proposed to provide a model for the staging of tendon pathology and to assist clinicians in managing this often complex condition (Br. J. Sports Med., 43, 2009, 409). The model presents clinical, histological and imaging evidence for the progression of tendon pathology as a three-stage continuum: reactive tendinopathy, tendon disrepair and degenerative tendinopathy. It also provides clinical information to assist in identifying the stage of pathology, in addition to proposed treatment approaches for each stage. The usefulness of such a model is determined by its ability to incorporate and inform new and emerging research. This review examines the degree to which recent research supports or refutes the continuum model and proposes future directions for clinical and research application of the model.
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Affiliation(s)
- Karen McCreesh
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
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Fredericson M. On the horizon: defining the future of sports medicine and the role of the physiatrist. PM R 2013; 4:707-10. [PMID: 23093214 DOI: 10.1016/j.pmrj.2012.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Michael Fredericson
- Division of Physical Medicine & Rehabilitation, Stanford University, Stanford, CA, USA.
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Musculoskeletal Ultrasound in Physical Medicine and Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2013. [DOI: 10.1007/s40141-012-0003-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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