Here is some of the information I recently shared in the November newsletter. Each newsletter has a specific focus.  This newsletter is focused on PTSD and trauma. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Trauma treatment through Art Therapy
  2. Trauma-induced heme release increases susceptibility to bacterial infection
  3. Epigenetics: long term sequelae of childhood trauma
  4. Diet quality and exercise in older veterans with PTSD
  5. Association between Irritable Bowel Syndrome and PTSD
  6. Potential neuromarkers for differentiating PTSD subgroups
  7. PTSD increases the efficiency of memory of trauma-related information
  8. The prevalence of PTSD among dementia caregivers
  9. Hair cortisol concentrations in trauma not related to PTSD
  10. Tai Chi and Qigong for trauma-exposed populations

 

  1. New book titled Working with Complexity in PTSD
  2. A Framework to Combat PTSD

STUDIES and ARTICLES

1. A research paper, titled Trauma Treatment through Art Therapy (TT-AT): A “women and trauma” group in Tanzania, published in International Journal of Art Therapy in Aug 2021. Six different art therapy workshops developed to address: Emotion regulation, relationships, self-identity, gradual exposure to trauma, integration of trauma & personal resources. Conclusion:  Short-term art therapy interventions was useful with women in low-income countries.

2.  A study titled Trauma-induced heme release increases susceptibility to bacterial infection published in JCI Insight in Oct 2021 concludes:  Infection is a common complication of major trauma that causes significantly increased morbidity and mortality. ..tissue trauma both impaired bacterial clearance and was associated with significant elevations in plasma heme levels. While neutrophil (PMN) recruitment to the lung in response to Staphylococcus aureus was unchanged after trauma, PMN cleared bacteria poorly.

3. A study titled Epigenetics of childhood trauma: Long term sequelae and potential for treatment, published in Neuroscience & Biobehavioral Reviews in Jan 2022 highlights:
⁃    Childhood trauma is a major risk factor for neuropsychiatric disorders, including depression, post-traumatic stress disorder, bipolar, anxiety disorders, psychosis, and schizophrenia
⁃    Long-term epigenetic changes occur in the brain of adults with a history of childhood trauma

4. An intriguing study titled Diet quality and exercise in older veterans with PTSD: a pilot study, published in TBM (Society of Behavioral Medicine) in 2021 concludes:  Supervised exercise intervention was not associated with changes in diet quality. Results revealed that the diet quality of older veterans with PTSD is poor, and while the exercise intervention improved health through exercise, it did not make veterans any more likely to adopt a more healthful diet.

5. A research article titled Associations between Irritable Bowel Syndrome and post-traumatic stress disorder among veteran populations, published in OpenBU in 2021 concludes: PTSD in combat-exposed veterans did not incur a risk for association with IBS but did so for GERD.  Specifically, PTSD in combat-exposed veterans incurred a risk for the association GERD without esophagitis and was positively correlated to the severity of PTSD symptoms. Also, the re-experiencing symptom subtype of PTSD was associated with a higher rate of IBS

6. A study titled Brain Responses to a Self-compassion Induction in Trauma Survivors with and without Post-traumatic Stress Disorder, published in Open Research Exeterin Mar 2022 concludes: ... findings provide evidence for potential neural biomarkers for quantitatively differentiating PTSD subgroups (full PTSD, no PTSD, subsyndromal PTSD).

7.  A study titled Posttraumatic Stress Symptoms Increase the Efficiency of Memory Functioning for Trauma-Related Information, published in Cambridge University Press in Feb 2022 concludes: contrary to expectations, the findings suggest that the encoding of trauma-related information in PTSD is relatively independent from the availability of cognitive resources. Thus, rather than reflecting an increased allocation of cognitive resources to the processing of threatening information, memory biases in PTSD  appeared to be supported by an enhanced efficiency of their processing.

8. A study titled The Prevalence of PTSD among Dementia Caregivers, published in ScholarWorks University of Montana in 2022 concludes: Almost one out of four dementia caregivers might be experiencing acute stress disorder/PTSD. This prevalence rate is greater than the general US population, nurses, emergency medical responders, and veterans.

9. A study titled Trauma-related but not PTSD-related increases in hair cortisol concentrations in military personnel published in Journal of Psychiatric Research in Jun 2022 concludes:
⁃    Hair cortisol was higher in trauma-exposed compared to non-exposed service members
⁃    Hair cortisol did not differ between PTSD patients and trauma-exposed controls
⁃    Within PTSD patients, hair cortisol did not correlate with symptom severity
⁃    Enhanced cumulative cortisol output indicates trauma exposure there than PTSD.

10. A study titled Tai Chi and Qigong for trauma-exposed populations: A systematic review published in Mental Health and Physical Activity in Mar 2022 concludes:
⁃    Tai Chi and/or Qigong appears to be safe, feasible, and acceptable for individuals post trauma
⁃    Tai Chi and/or Qigong may improve well-being and functioning and reduce post-trauma symptoms.

 

TIDBITS

Here is some of the information I recently shared in the October newsletter. Each newsletter has a specific focus.  This newsletter is focused on foot and ankle conditions. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Effects of Toe-grasping on balance ability
  2. Comparison of effectiveness of minimally invasive treatments for plantar fasciitis
  3. Impact of asthma on plantar pressures
  4. Evaluation of plantar fasciitis improvement after shock wave therapy
  5. Myofascial treatment techniques on the plantar surface effects on functional performance
  6. Calcaneal taping techniques in plantar fasciitis
  7. Dry needling and stretching vs stretching on plantar fasciitis
  8. Effective of Graston Technique on pain
  9. Effectiveness of two types of night splints in plantar fasciitis
  10. Dry needling for the management of plantar heel pain

 

  1. Kinematics and Kinetics of ankle and foot complex

STUDIES and ARTICLES

1. A study titled The Effect of Toe-grasping Exercises on Balance Ability in Home-based Rehabilitation: A Randomized Controlled Trial by Block randomization, published in Phys Ther Res in Oct 2021 concludes: Toe-Grasping exercises could improve the balance ability of home-based rehabilitation users. This suggests the clinical significance of toe function in rehabilitation programs.

2.  A study titled Comparative Effectiveness of Minimally Invasive Nonsurgical Treatments for Plantar Fasciitis: A Network Meta-analysis of 30 Randomized Controlled Trials, published in Pain Physician in Nov 2021 concludes: The miniscalpel-needle treatment should be recommended as the best therapy, followed by Botulinum toxin A in the gastrocnemius. Corticosteroid and platelet-rich plasma are common medications that remain valuable in clinical practice.  Peppering technique can be performed after the injection of medication.

3. A study titled Impact of Asthma on Plantar Pressures in a Sample of Adult Patients; A Case-Control Study published in Journal of Personalized Medicine in Nov 2021 concludes: …alterations in static plantar pressures in asthmatic patients compared to healthy individuals. Specifically, the subjects with asthma showed less maximum pressure in the right forefoot and less weight on the left heel, which appear to be associated with the asthma disease.

4. A study titled Evaluation of plantar fasciitis improvement after shock wave therapy in calcaneal spur patients by musculoskeletal ultrasonography published in Egyptian Rheumatology and Rehabilitation in Nov 2021 concludes: Plantar fascia thickness increases significantly in calcaneal spur patients and responds to treatment. Extracorporeal shock wave therapy decreases the thickness of the plantar fascia and improves pain and function significantly

5. A study titled Myofascial Treatment Techniques on the Plantar Surface Influence Functional Performance in the Dorsal Kinetic Chain, published in Journal of Sport Science and Medicine  in 2022 concludes:  The combination of self- and therapeutic massage techniques on the plantar surface applied in our study might reduce performance in terms of force generation along the  superficial fascial back line. Our hypotheses is supported by the fact that the plantar fascia itself was not loaded during the functional performance test and that the opposite effect was observed on the control side. As we applied a combination of different self and therapeutic massage techniques, it should be considered that some techniques, like foam rolling, might have no effect, while others, like stretching, had a negative effect.

6. A study, titled A study to Analyze the effect of Calcaneal Taping Techniques in Plantar fasciitis published in Research Journal of Pharmacy and Technology in 2021 concludes: Ultrasound therapy along with plantar fascia stretching and calcaneal taping technique was found more effective than ultrasound therapy and plantar fascia stretching alone at reducing pain in the heel and increasing functional ability of the foot.

7.  A study titled Effects of dry needling and stretching exercise versus stretching exercise only on pain intensity, unction, and sonographic characteristics of plantar fascia in the subjects with plantar fasciitis: a parallel single-blinded randomized controlled trial published in Physiotherapy Theory and Practice in Jan 2022 concludes:   There were considerable differences tween the two groups and the experimental group experienced more improvements in the primary outcomes (first step pain) compared to the control group. For secondary outcomes, plantar fascia thickness at insertion significantly decreased, and the echogenicity in the two regions significantly increased in the experiments group.

8. A study titled Effectiveness of the Graston Technique on Pain and General Foot Health in Patients with Chronic Plantar Fasciitis; A Randomized Clinical Trial published in Alternative Therapies in Health and Medicine in Feb 2022 concludes: in the case of general foot health, there was no significant difference between the groups at the end of the fourth week. The use of the Graston technique combined with conventional physical therapy shows significant results compared with conventional physical therapy alone; i.e., Graston therapy speeds up the recovery from heel pain and foot function in patients with chronic plantar fasciitis.

9. A study titled The Effectiveness of Two Types of Night Splints on the Range of Motion of the Ankle Joint, Pain Intensity, and Quality of Life in Patients with Plantar Fasciitis: A Pilot Study with Parallel Groups, published in Rehabilitation Journal 2022 concludes:  All three orthoses (tension calf splint, tension plantar fascia splint, heel pad) used in this study significantly reduced pain in people with plantar fasciitis. The results also suggest that a tension calf splint has greater effectiveness in improving pain severity and soft tissue flexibility than a tension fascia splint.

10. A study titled Is Dry Needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis published in Pain Medicine in Mar 2021 concluded: moderate to low evidence suggests a positive effect of TrP dry needling for improving pain intensity and pain-related disability in patients with plantar heel pain of musculoskeletal origin at short- and long-term, respectively.

 

TIDBITS

An article titled Kinematics and Kinetics of Ankle and Foot Complex, published in Conceptual Biomechanics and Kinesiology in Nov 2021 reviews the bones, joints, muscles, tendons, and ligaments of the foot and ankle and summarizes some information about the joints.

Here is some of the information I recently shared in the September newsletter. Each newsletter has a specific focus.  This newsletter is focused on the lymphatic system and lymphatic drainage. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Effects of Pneumatic Compression with Kinesiotape
  2. Mesenteric lymphatic dysfunction in insulin resistance
  3. Pneumatic compression therapy increases compliance
  4. Physical therapy in women with early-stage lipedema
  5. Lymphatic drainage and muscle energy techniques post third molar surgery
  6. Pedal pump lymphatic technique vs passive recovery
  7. Comparison of low-level laser, kinesio-taping and manual lymphatic drainage

STUDIES and ARTICLES

1. A study titled Effect of Intermittent Pneumatic Compression in Combination with Kinesiotape on Post Mastectomy Lymphedema, published in The Egyptian Journal of Hospital Medicine in Oct 2021 concludes: Intermittent Pneumatic Compression in combination with Kinesiotaping was an effective method in post-mastectomy lymphedema more than Complete Decongestive Therapy only.

2.  A study, titled Mesenteric lymphatic dysfunction promotes insulin resistance and represents a potential treatment target in obesity published in Nature Metabolism in Oct 2021 concludes:  …lymph from mice and humans consuming a high-fat diet stimulates lymphatic vessel growth, leading to the formation of highly branched mesenteric lymphatic vessels that “leak” high-fat-diet lymph into visceral adipose tissue and, thereby, promote insulin resistance.

3. A study, Adding Pneumatic Compression therapy in Lower Extremity Lymphedema increases compliance of treatment while decreasing the infection rate, published in Lymphatic Research and Biology in Jun 2022 concludes:  Pneumatic Compression therapy leads to a decrease in infection rate, hospital admissions, and physical therapy visits in clinically significant lower extremity lymphedema.

4. A study titled Physical Therapy in Women with Early Stage Lipedema: Potential Impact of Multimodal Manual Therapy, Compression, Exercise, and Education Interventions, published in Lymphatic Research and Biology in 2022 concludes:  persons with lipedema can benefit from physical therapy to manage characteristic symptoms of leg pain and improve Quality of Life. Objective MRI measurement of reduced tissue sodium in the skin and subcutaneous adipose tissue regions indicates reduced inflammation in the treated limbs.

5. A study, Manual lymphatic drainage and muscle energy techniques after third molar surgery: A randomized split-mouth clinical trial, published in Repositório Aberto da Universidade do Porto in 2021 concludes: …physical therapy is a good, noninvasive, alternative for the control of pain and limitation of mouth opening in the postoperative period of third molars surgery.

6. A study titled The effect of pedal pump lymphatic technique versus passive recovery following maximal exercise: A randomized cross-over trial, published in Sports Medicine in 2022 concludes: the pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20.

7.  A study The randomized controlled study of low-level laser therapy, kinesio-taping and manual lymphatic drainage in patients with stage II breast cancer-related lymphedema, published at ResearchSquare in Apr 2022, concludes:  kinesio-taping led to better results than manual lymphatic drainage and similarly effective with low-level laser in stage II breast cancer-related lymphedema at 12th weeks follow-up.

Here is some of the information I recently shared in the August newsletter. Each newsletter has a specific focus.  This newsletter is focused on cupping. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Dry needling vs Trigger Point Compression vs cupping
  2. Dry needling vs dry cupping at Upper Trapezius muscle
  3. Stretching vs static and dynamic cupping on lumbar ROM
  4. Dry cupping in female with chronic plantar fasciitis
  5. Ear acupuncture plus dry cupping for chronic back pain
  6. Aerobic exercise vs cupping on cardiovascular disease factors

STUDIES and ARTICLES

1. An oral presentation titled Comparing the Effectiveness of Different Modalities for Myofascial Pain Relief: A  systematic review, published in ScholarWorks University of Montana in 2022, concludes: Dry Needling and Trigger Point Compression were both shown to decrease pain in short-term periods. However…Dry Needling was the only examined modality able to provide pain relief in both short-term and long-term periods. There is a lack of literature supporting cupping.

2.  A study titled Comparison of the effectiveness of dry needling with dry cupping at upper Trapezius muscle in patients with myofascial trigger points, published in International Journal of Endorsing Health Science Research in May 2021 concludes:  Both treatment methods effectively treat myofascial trigger points. There was no significant difference between the two groups.

3. A study titled The effects of stretching versus static and dynamic cupping on lumbar range of motion: a randomized control trial, published in Orthopedic Physical Therapy Practice in Jan 2022 concludes:  Static and dynamic cupping to the lumbar paraspinal muscles was not more effective than stretching at increasing lumbar ROM.

4. A study titled Effects of dry cupping therapy on pain, dynamic balance and functional performance in young female with recreational runners chronic plantar fasciitis, published in Sport Orthopaedics and Traumatology in Jun 2022 concludes: Findings suggested a significant improvement in parameters of pain, dynamic balance, and functional performance. However, these improvements were found to be significantly greater with the addition of dry cupping therapy to the conventional treatment.

5. A study titled Effects of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain; a randomized trial, published in Journal Acupuncture Meridian Studies in Apr 2022 concludes:  Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

6. A study titled Comparison of aerobic exercise and cupping methods on serum levels of fibrinogen, LDL and HDL as cardiovascular disease factors in postmenopausal women, published in Yafteh Lorestan University of Medical Sciences in 2022 concludes: cupping therapy and aerobic physical activity are effective factors in reducing the levels of fibrinogen and LDL and increasing HDL in postmenopausal women. Exercise may have better effects on decreasing fibrinogen and blood lipids, compared to cupping therapy.

Here is some of the information I recently shared in the July newsletter. Each newsletter has a specific focus.  This newsletter is focused on chronic pain conditions. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Aerobic exercise for pain intensity
  2. Effect of Curcumin on Neuroinflammation
  3. Melatonin moderates chronic pain, sleep architecture and immunometabolism
  4. Ketamine for treatment of chronic pain
  5. Effectiveness of MFR on pain, sleep and quality of life
  6. Effects of Vitamin D on pain severity
  7. Reflexology for Fibromyalgia
  8. Effect of acupuncture for fibromyalgia
  9. Effectiveness of reformer pilates for fibromyalgia
  10.  Infrared radiation for chronic pain

STUDIES and ARTICLES

1. An article titled Aerobic Physical Exercise for Pain Intensity, Aerobic Capacity, and Quality of Life in Patients with Chronic Pain: A Systematic Review and Meta-Analysis published in Journal of Physical Activity and Health in Aug 2021 concludes: Aerobic exercise is a nonpharmacological therapeutic option for treatment (of chronic pain). Also, aerobic capacity and endurance improved when this type of exercise was prescribed, thus resulting in a substantial improvement in the quality of life of people suffering from chronic pain.

2.  An article titled Mechanistic Insight into the Effects of Curcumin on Neuroinflammation-Driven Chronic Pain, published in Pharmaceuticals  in August 2021, reviews and details the role of curcumin in microglia and astrocytes both in vitro and in vivo and how it improved pain.

3. An article titled Melatonin Moderates the Triangle of Chronic Pain, Sleep Architecture and Immunometabolic Traffic, published in Biomedicines in Aug 2021, details and reviews current literature relevant for the shared pathways of sleep, pain, and immunometabolism and elaborates the impact of melatonin on the crossroad of sleep, chronic pain, and immunometabolism.

4. A review titled Ketamine for the Treatment of Chronic Pain: A Comprehensive Review published in Health Psychology Research in 2021 highlights the use of ketamine for: neuropathic pain, fibromyalgia, complex regional pain syndrome, phantom limb pain, cancer pain, and post-thoracotomy pain syndrome.

5. A study titled Effectiveness of myofascial release on pain, sleep, and quality of life in patients with fibromyalgia syndrome: A systematic review published in Complementary Therapies in Clinical Practice in November 2021 concludes: moderate evidence for the effect of therapist-administered and self-myofascial release in improving pain, sleep subscales, and quality of life against sam and no treatment, respectively, in fibromyalgia syndrome patients

6. A study, titled  Effects of Vitamin D on Pain severity, Quality of Life, Depression and Sleep in Patients with Fibromyalgia published in Medicine International Istanbul Hastanesi in 2021 concludes: Vitamin D deficiency may be a factor associated with symptom severity, sleep and wakefulness problems, and physical function in FMS. Therefore, serum 25OHD status should be evaluated in patients with FMS and its importance in treatment management should not be ignored.

7. A study titled The effect of Reflexology in patients with Fibromyalgia, published in Signa Vitae (Anesthesiology Department, Pain and Palliative Care Center Aretaeion Hospital, University of Athens, Athens Greece) in Feb 2020 concludes:  Reflexology may be beneficial as add-on treatment in patients with Fibromyalgia who are unable to receive the recommended dosages of their medication (pregabalin).

8. A study titled The effects of acupuncture in fibromyalgia: integrative review published in April 2020 in BrJP Sao Paulo concludes: studies suggest that acupuncture is effective for the treatment of pain in patients with fibromyalgia, with improved quality of life and positive interference in sleep.

9.  A study titled Investigation of effectiveness of reformer pilates in individuals with fibromyalgia: a randomized controlled trial published in Reumatlogía Clínical in Feb 2022 concludes: reformer pilates exercises had positive effects on clinical status and muscle strength while home mat pilates exercises had positive effects on the number of painful regions, clinical status, biopsychosocial status and physical component quality of life.

10.  An article titled Infrared Radiation in the Management of Musculoskeletal Conditions and Chronic Pain: A Systematic Review published in European Journal of Investigation Health, Psychology and Education in Mar 2022 concludes: based on findings of our review, we noted a decrease in pain levels, decrease in Fibromyalgia Impact Questionnaire scores.

 

Here is some of the information I recently shared in the February newsletter. Each newsletter has a specific focus.  This newsletter is focused on cupping. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.

TABLE OF CONTENTS

  1. Cupping for post-herpetic neuralgia
  2. Active movement decompression vs Static decompression
  3. Pressure ranges of Fire cupping method
  4. Cupping as an anti-inflammation therapy and immunomodulator in cancer patients
  5. Dry cupping for runners with plantar fasciitis
  6. Efficacy of wet cupping for sciatic pain
  7. Brief Dry Cupping for muscle soreness
  8. Safety of cupping on stroke survivors
  9. Effect of dry cupping for non-specific low back pain

STUDIES and ARTICLES

1. A study, titled Acupuncture and moxibustion combined with cupping for the treatment of post-herpetic neuralgia, published in Medicine Aug 2021, concluded: The effect of acupuncture and moxibustion combined with cupping in the treatment of PHN is significantly higher than that of conventional western medicine and it can significantly prevent the occurrence of PHN.

2.  A study titled The effects of Active Movement Myofascial Decompression Therapy and Static Myofascial Decompression Therapy on Range of Motion, Muscle strength, Functional Movement in Young Adults, published in Journal of The Korean Society of Integrative Medicine in Sept 2021 concludes: As a result of this experiment, both active movement myofascial decompression and static myofascial decompression had a positive effect on dependent variable. Therefore the study is meaningful in that it is easier and simpler to see the effect on flexibility, muscle strength, and functional movement just by implementing movement myofascial decompression.

3. A study titled An Experimental Study on the Pressure Range of Fire Cupping Method, published in Journal of Acupuncture Research in May 2021 concludes: Large glass cups which are widely used in clinical practice, when used in the fire cupping method exerted pressure ranging from -381.947 mmHG to -391.973 mm HG

4. A study titled Cupping Therapy as an Anti-inflammation Therapy and Immunomodulator in Cancer Patients, published in Journal of Gastrointestinal Cancer in 2021, concludes: Similar to anti-inflammatory drugs, cupping therapy may be seen as an adjuvant therapeutic strategy to modulate host microenvironment by reducing inflammation and modulating immune system, all actions the could be useful in biological treatments, in cancer patients

5. A study titled Effectiveness of dry cupping on pain, dynamic balance and functional performance in recreational runners with chronic plantar fasciitis, published in Indian Journal of Health Sciences and Care in Aug 2021, found: Significant improvement were observed in both the groups (Dry cupping or conventional therapy). However, the dry cupping group showed significantly greater improvements as compared to control group. Significant group differences were illustrated for pain, dynamic balance, and functional performance.

6. A study titled Efficacy of Himajah bil-shart (Wet Cupping) on Irq Al-Nasa (Sciatic Pain): A Randomized Controlled Clinical Trial, published in International Journal of Research Publication and Reviews in Oct 2021 concluded: Hijamah Bil-Shart (Wet Cupping) could be an effective therapy for the management of pain in patients of Irq al-Nasa (Sciatic pain) without any adverse effects.

7. A study titled Effects of Brief Dry Cupping on Muscle Soreness in the Gastrocnemius Muscle and Flexibility of the Ankle, published in Asian Journal of Kinesiology in 2021, concludes: Ninety seconds of dry cupping on the calf may reduce 24-hr muscle soreness after performing heel drops to exhaustion, but had no effect on ROM.

8. A study titled The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials, published in DBpia in 2021 concludes: …the potential of CT to be beneficial in managing a variety of complications in stroke survivors.

9.  A study titled Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial, published in Journal of Acupuncture and Meridian Studies in 2021, concludes: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham

 

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