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LE is typically diagnosed by the presence of pain over the lateral humeral epicondyle that may radiate distally.

The aim of this study was to compare different studies and diagnostic and treatment options in lateral epicondylalgia (LE). While many treatments for LE have been researched, many have small effects that occur in the short term.

Exercise has shown to be one of the most effective treatment options. However, it is important to clarify the role of exercise in managing LE, such as optimal dosage and type of exercise for people with mild, moderate of severe LE. Manual therapy and Mobilization with movement are also treatment options that can be considered, Although there is moderate evidence supporting these treatment options.

When LE is a chronic condition, the approach should be more in line with management or persistent or chronic pain, such as pain education, referral for medication and sometimes involvement with pain clinic specialists.

This is the first review identifying the risk factors of recurrent shoulder instability in a non-operative, skeletally immature population.

Studies examining recurrent shoulder instability following a first-time anterior shoulder dislocation do not differentiate between children and adults. The aim of this systematic review was to identify risk factors associated with recurrent shoulder instability following first-time traumatic anterior shoulder dislocation in children aged 18 years and under. A recurrent shoulder instability event was defined as either a subluxation or dislocation.

The mechanisms of injury for first-time traumatic anterior shoulder dislocation are often divided into two groups: sporting and non-sporting related. Children experiencing injury during sporting activity were 2.85 times more likely to experience recurrence, compared to non-sporting activity.

Children aged 14–18 years are 24.14 times more likely to experience recurrent instability compared with those aged 13 years and under.

Male children were 3.44 times more likely to experience recurrent instability compared to female children.

61.1% of participants with an open proximal humeral physis at the time of the initial dislocation had a recurrent episode of shoulder instability compared with 94.1% of participants with a radiographically confirmed closed proximal humeral physis.

83.3% of participants whose initial dislocation was on their dominant shoulder experienced recurrent instability, compared with 50% on their non-dominant side.

There is an indication people aged under 18 years with Hill-Sachs lesions were 17.18 times more likely to experience recurrent instability.

This study analysed the long-term effects of physiotherapy, sham and no treatment after an uncomplicated lumbar disc surgery with a follow-up of 12 years.

111 patients after an uncomplicated lumbar disc surgery participated in this study and were allocated to three groups. 74 patients received 20 sessions of physiotherapy over a period of 12 weeks. 22 patients received a 20 sessions “sham” neck massage of 30 minutes duration and 23 patients were asked to “wait and see” and received no treatment.

After 12 years lumbar back pain was reduced in all three groups. Especially patients who received a comprehensive physiotherapeutic treatment, as well as patients who received a sham treatment showed better outcomes. However, both groups failed to reach significant differences in comparison to the non-treatment group. 21% of patients who had received physiotherapy, 73% of those receiving sham treatment and 52% of those without any treatment reported on prevalent back and/ or leg pain. However, also these results did not reach the level of significance.

The Effect of Body Mass on Eccentric Knee Flexor Strength Assessed With an Instrumented Nordic Hamstring Device (Nordbord) in Football Players

This high quality RCT examines the preventative effect of the Nordic hamstring exercises on primary and recurrent hamstring injuries in soccer

This high quality RCT recruited 579 amateur soccer players into either a control group that performed 'normal training' or a intervention group that performed 13 weeks of nordic hamstring strengthening. The intervention group suffered 2/3 less (p=0.005) hamstring injuries than the control group over the season.

Note: I am currently in the process of writing an updated article on the prevention, rehab, and return to play management of hamstring injuries in footballers. Keep an eye out for it in a journal near you

Image by: willlevy

Tags: hamstrings, Eccentric exercise, eccentric strength training, Hamstrings strain injury, Muscle tears

#hamstrings #eccentric exercise #eccentric strength training #Hamstrings strain injury #muscle tears

In whiplash, high baseline disability, longer predicted recovery time, psychological distress, passive coping and greater number of symptoms were associated with chronic disability. One risk factor resulted in 3.5 times the risk of chronic disability but this risk increased to 16 times in those with four or five risk factors.

Here's a simple exercise to target the small but important Tibialis Posterior muscle of the lower leg. Often a problematic area in runners and triathletes.

A Twitter follower of mine just asked me for a simple exercise to target the small but important Tibialis Posterior muscle of the lower leg.

While I’ve already uploaded a video showing my favourite Tibialis Posterior Stretch, it’s important to also build strength in this often weak, and sometimes dysfunctional muscle.

Try this… all you need is a step!:

For more Tibialis Posterior strengthening exercises, check out these videos.

Unresisted Movement Through Range

Depending on your injury, in the initial stages of your treatment and rehabilitation, your Physio may well prescribe non-weight bearing, unresisted range of motion exercises, such as that in the video below. These help to develop strength and pain free range of motion into inversion and eversion in particular.

Resisted Movement Through Range

As your treatment progresses, resistance exercises further help to build strength and stimulate the healing process of the Tib.Post. tendon. Using a resistance band as per the video below particularly helps to build crucial eccentric strength.

Weight Bearing Proprioception

The next progression adds the important weight bearing and proprioceptive elements. Perform this exercise barefoot. The video demonstrates well how Tib.Post. has to constantly work dynamically to maintain medial arch height as the body moves above the foot.

Dynamic Weight Bearing Proprioception

As a progression to the above exercise, we now add more dynamic movement from the upperbody, while still in single limb stance. This challenges Tib.Post. further to maintain the medial arch.

Heel Raise with Inversion

Here’s another weight bearing exercise to build strength in Tibialis Posterior.

Low Level Plyometrics

Here’s another weight bearing exercise to build strength in Tibialis Posterior.

N.B. Begin With A Few 10sec Efforts – See How Your Tib.Post. Reacts!

Ballistic Heel Raise Off Step

Here’s a ballistic weight bearing exercise, working trough full range to build strength in Tibialis Posterior.

N.B. Start Gently – Build Up To The Intensity Of The Exercise In The Video!

About The Author James Dunne

James has an academic background in Sport Rehabilitation and a special interest in Applied Biomechanics. He currently coaches a large number of Runners and Triathletes across all levels of ability and performance. He's grown a strong reputation for enabling athletes to improve their running performance and overcome running injuries through improving their Running Technique and developing Running Specific Strength.

In this short video, James demonstrates a simple tweak to the classic Soleus stretch that changes it into a targeted Tibialis Posterior stretch...

Hitting That Hard To Reach Spot…

‘Shin Splints’ is one of those annoying generic terms commonly used to describe a handful of similar (but very different) issues affecting a particular part of the lower leg – particularly the medial border of the tibia – the inner aspect of the shin bone.

Collectively we can refer to these issues as Medial Tibial Stress Syndrome (MTSS). One such issue is characterised by irritation of the outer surface (periosteum) of the inside of the shin bone at the point where the Tibialis Posterior and Soleus muscles attach. This is particularly common in, but certainly not exclusive to runners who have recently changed to midfoot/forefoot strike pattern, and increase training milage too quickly.

For those runners who do suffer with tightness through Tibialis Posterior, and the dull medial shin pain that comes with it, finding a stretch to effectively target the specific muscle can be really difficult. In the video below, I demonstrate a simple tweak to the classic Soleus stretch that changes it into a targeted Tibialis Posterior stretch…

About The Author James Dunne

EVANGELIDIS, PAVLOS E.; MASSEY, GARRY J.; PAIN, MATTHEW T. G.; FOLLAND, JONATHAN P.

ABSTRACT

Purpose: A disproportionately small biceps femoris long head (BFlh) proximal aponeurosis has been suggested as a risk factor for hamstring strain injury by concentrating mechanical strain on the surrounding muscle tissue. However, the size of the BFlh aponeurosis relative to BFlh muscle size, or overall knee flexor strength, has not been investigated. This study aimed to examine the relationship of BFlh proximal aponeurosis area with muscle size (maximal anatomical cross-sectional area (ACSAmax)) and knee flexor strength (isometric and eccentric).

Methods: Magnetic resonance images of the dominant thigh of 30 healthy young males were analyzed to measure BFlh proximal aponeurosis area and muscle ACSAmax. Participants performed maximum voluntary contractions to assess knee flexion maximal isometric and eccentric torque (at 50° s-1 and 350° s-1).

Results: BFlh proximal aponeurosis area varied considerably between participants (more than fourfold, range = 7.5–33.5 cm2, mean = 20.4 ± 5.4 cm2, coefficient of variation = 26.6%) and was not related to BFlh ACSAmax (r = 0.04, P = 0.83). Consequently, the aponeurosis/muscle area ratio (defined as BFlh proximal aponeurosis area divided by BFlh ACSAmax) exhibited sixfold variability, being 83% smaller in one individual than another (0.53 to 3.09, coefficient of variation = 32.5%). Moreover, aponeurosis size was not related to isometric (r = 0.28, P = 0.13) or eccentric knee flexion strength (r = 0.24, P >= 0.20).

Conclusion: BFlh proximal aponeurosis size exhibits high variability between healthy young men, and it was not related to BFlh muscle size or knee flexor strength. Individuals with a relatively small aponeurosis may be at increased risk of hamstring strain injury.

Trainees tend to spend most their training what they can see in the mirror. Hence, pecs and biceps get plenty of attention. That works for a while, until shou

Trainees tend to spend most their training what they can see in the mirror.

Hence, pecs and biceps get plenty of attention.

That works for a while, until shoulder pain sets in because of improper muscle balance between the agonist and antagonists.

Since I shot this video on face pulls, I have been asked to expand on it:

I became aware of this exercise in the late seventies, through the writings of John Parillo, who to the best of my knowledge, is the one who promoted it the most. I immediately incorporated it in the training of my athletes, from swimmers to football players, with obvious dividends in health and performance.

It highly benefits the scapulae retractors, which in turn keep the shoulder in proper alignment. Not training the scapulae retractors effectively leads to plethora of shoulder issues from cartilage degeneration, labrum tears, osteoarthritis to name a few.

Tips on how to make them more effective:

Have a partner stick the fingers of one hand in the center of your spine, so that you don’t succumb to using your posterior chain to hoist more weight.

As you retract the scapulae , aim a squeezing your partner’s fingertips.)

Make sure to pull the center of the rope slightly up towards the face.

Concentrate pulling the ends of the rope apart, not simply pulling back.

As you near your face, bring your hands upwards so that the knuckles face the ceiling..

Hold for up to 6 seconds if you are a beginner, and/or your scapuale retractors are weaky weak in the shortened position. Lower the weight under control.

Stretch your pec minor muscles statically between sets, that will increase the load you can use on facepulls.

So here is a video on making sure the range is respected.

Note the use of the fingertips between the shoulder blades to make sure that the form is good, as mentionned in tip # 1 and 2.

You can also use a neutral grip where the index fingers make contact with the wooden stoppers, this allows for greater external rotation of the humerus. From experience, most people need 3 weeks of the pronated version before they can move on to this one.

Do face pulls and keep your shoulder girdle balanced and healthy

Stay strong,

Submolecular regulation of cell transformation by deuterium depleting water exchange reactions in the tricarboxylic acid substrate cycle

• Deuterium depletion seems to protect cells by maintaining strong hydrogen bond networks. • Deuterium depleted water inhibits cancer cell growth as well as tumor progression. • Hydratases and isomerases of the TCA and pentose cycles transfer deuterium depleted mitochondrial matrix water to intermediates and subsequently stabilize DNA. • Deuterium depletion protects cells from exceptional deuterium substitution effects in hydrogen bridging biological networks. • Ketogenic substrates, water and drugs promote deuterium depletion of mitochondrial metabolic matrix water, offering a means to prevent tumor cell growth.

What this study adds

• Defective mitochondrial functions, molecular oxygen deprivation and increased glycolysis induce cellular transformations which can cause a shift in 2H/1H ratio in mammalian cells. • Switching from a ketogenic to high sugar diet interferes with the deuterium depleting action of mitochondria serving as a potential oncogenic initiator. • The results of this analysis contain new data relevant to cancer prevention and treatment.

Questions for the experts

• Can cancer risk be identified by metabolic profiling with 2H as a probe? • Can 13C metabolic tracers assist early cancer diagnosis and response to therapy by detecting 2H loading in DNA of circulating blood cells and tumorous tissue? • Is the chemical behavior of hydrogen isotopes consistent with the involvement of oncometabolites in nutrition?

Closely attending to our bodies through mindfulness meditation might help us to become better, calmer, athletic performers, a small study suggests.

Credit Jonathan Fennell for The New York Times

Phys Ed

Gretchen Reynolds on the science of fitness.

When athletes learn how to be more aware of their bodies they may also change the workings of their brains and become more resilient to stress, according to a new study of the effects of mindfulness meditation on brain function in serious athletes.

The study, which was published recently in Frontiers in Behavioral Neuroscience, had its unusual origins in a balk at the starting gate by one of the top riders for the U.S. Men’s National BMX team. Watching, his baffled coach wondered how he could help his riders to better handle the anxiety and psychological rigors of competition. So he approached scientists affiliated with the department of psychiatry and the Center for Mindfulness at the University of California, San Diego, near where the team trains, and asked if they might be interested in working with and studying his seven-man team.

They were. Not long before, the scientists had completed a brain-imaging study of Marines who were about to be deployed, during which they had scanned the soldier’s brains while subjecting them to physical stress. The soldiers wore masks that made it slightly difficult for them to breathe — the body finds breathing difficulties acutely stressful — and then taught them various mindfulness techniques before scanning their brains again. After the training, portions of the soldiers’ brains responded quite differently to the same physical stress. The changes in brain activity, the scientists felt, should enable the soldiers to respond with less anxiety to difficult situations.

Athletics, of course, is hardly combat, but serious athletes can feel considerable stress when anticipating competition. The U.C.S.D. scientists wondered whether focused mindfulness training might likewise change athletes’ brains and potentially help them cope better.

So they agreed to work with the elite BMX riders and teach them how to be mindful of their bodies. The scientists defined mindfulness to mean an absorbed concentration on signals to the brain from elsewhere within the body.

To test how well the athletes attended to stress-related signals at the start of the study, the researchers first fitted the riders with masks that, at the discretion of the scientists, could be made to hinder breathing slightly, thereby inducing stress.

Next they had the young men lie in a brain-scanning machine and watch images of various colors and images flash across an overhead screen. When the color yellow appeared, the scientists would often — but not always — make it harder to breathe. The athletes quickly learned to anticipate that yellow could mean trouble. Their brains responded accordingly. The scientists watched.

Then the athletes completed seven weeks of mindfulness training, during which they were taught to focus intently on their bodies and not on noise or disruptions around them. Among other exercises, the scientists asked them to mentally scan their bodies, carefully noting how each limb and internal organ felt at that moment. They also had them breathe through straws and stick their hands in ice water to accentuate their ability to focus on immediate and stressful physical sensations.

The scientists generally did not refer to this work as mindfulness training, though. “We called it ‘tactical training,’” said Lori Haase, an assistant clinical professor of psychiatry who led the new study. The athletes “rolled their eyes if we called it mindfulness,” she said.

After eight weeks of tactical training, the cyclists again lay in the brain-scan machines while more images flashed by overhead and the scientists tracked their brains’ responses.

In general and in interesting ways, the responses were different. When the color yellow appeared, the athletes showed increased activity in a part of the brain involved in motivating future actions and controlling attention. But the flow of messages between that part of the brain and another that can initiate abrupt increases in bodily arousal actually slowed.

Essentially, their response to impending stress seemed to involve greater recognition that they were about to be in a potentially stressful situation but without attendant physiological panic — a response that, in real life, could translate into desirable physical results, such as a whip-quick start to a race’s starting buzzer, instead of freezing.

However, the experiment did not look at actual, subsequent athletic performance, Dr. Haase said, so that possibility remains theoretical. The study also was small and involved only young, fit, male BMX riders, which is a very specialized sample.

Still, the results could mean that closely attending to our bodies might help us to be better, calmer athletic performers.

Should you wish to put that possibility to the test, Dr. Haase and her colleagues offer specialized, on-campus mindfulness training courses for athletes.

Or, she said, simply try “thinking about your feet.” The goal of mindfulness training is focused attention and bodily awareness, she explained. “And,” she said, “when you are concentrating on your feet, you aren’t thinking about other things.”

#phys ed

Elevated postprandial blood glucose levels constitute a global epidemic and a major risk factor for pre-diabetes and type II diabetes, but existing dietary methods for controlling them have limited efficacy.

Here, we continuously monitored week-long glucose levels in an 800-person cohort, measured responses to 46,898 meals, and found high variability in the response to identical meals, suggesting that universal dietary recommendations may have limited utility. We devised a machine-learning algorithm that integrates blood parameters, dietary habits, anthropometrics, physical activity, and gut microbiota measured in this cohort and showed that it accurately predicts personalized postprandial glycemic response to real-life meals. We validated these predictions in an independent 100-person cohort. Finally, a blinded randomized controlled dietary intervention based on this algorithm resulted insignificantly lower postprandial responses and consistent alterations to gut microbiota configuration. Together, our results suggest that personalized diets may successfully modify elevated postprandial blood glucose and its metabolic consequences.

Pain scientists are reasonably agreed that pain is an unpleasant feeling in our body that makes us want to stop and change our behaviour.

If someone has a pain in his hand […] one does not comfort the hand, but the sufferer. – Philosopher Ludwig Wittgenstein, 1953

What is pain? It might seem like an easy question. The answer, however, depends on who you ask.

Some say pain is a warning signal that something is damaged, but what about pain-free major trauma? Some say pain is the body’s way of telling you something is wrong, but what about phantom limb pain, where the painful body part is not even there?

Pain scientists are reasonably agreed that pain is an unpleasant feeling in our body that makes us want to stop and change our behaviour. We no longer think of pain as a measure of tissue damage – it doesn’t actually work that way even in highly controlled experiments. We now think of pain as a complex and highly sophisticated protective mechanism.

How does pain work?

Our body contains specialised nerves that detect potentially dangerous changes in temperature, chemical balance or pressure. These “danger detectors” (or “nociceptors”) send alerts to the brain, but they cannot send pain to the brain because all pain is made by the brain.

When you’re injured, the brain makes an educated guess which part of the body is in danger and produces the pain there. www.shutterstock.com

Pain is not actually coming from the wrist you broke, or the ankle you sprained. Pain is the result of the brain evaluating information, including danger data from the danger detection system, cognitive data such as expectations, previous exposure, cultural and social norms and beliefs , and other sensory data such as what you see, hear and otherwise sense.

The brain produces pain. Where in the body the brain produces the pain is a “best guess scenario”, based on all the incoming data and stored information. Usually the brain gets it right, but sometimes it doesn’t. An example is referred pain in your leg when it is your back that might need the protecting.

It is pain that tells us not to do things – for example, not to lift with an injured hand, or not to walk with an injured foot. It is pain, too, that tells us to do things – see a physio, visit a GP, sit still and rest.

We now know that pain can be “turned on” or “turned up” by anything that provides the brain with credible evidence that the body is in danger and needs protecting.

All in your head?

So is pain all about the brain and not at all about the body? No, these “danger detectors” are distributed across almost all of our body tissues and act as the eyes of the brain.

When there is a sudden change in tissue environment – for example, it heats up, gets acidic (cyclists, imagine the lactic acid burn at the end of a sprint), is squashed, squeezed, pulled or pinched – these danger detectors are our first line of defence.

They alert the brain and mobilise inflammatory mechanisms that increase blood flow and cause the release of healing molecules from nearby tissue, thus triggering the repair process.

Local anaesthetic renders these danger detectors useless, so danger messages are not triggered. As such, we can be pain-free despite major tissue trauma, such as being cut into for an operation.

Just because pain comes from the brain, it doesn’t mean it’s all in your head. from www.shutterstock.com

Inflammation, on the other hand, renders these danger detectors more sensitive, so they respond to situations that are not actually dangerous. For example, when you move an inflamed joint, it hurts a long way before the tissues of the joint are actually stressed.

Danger messages travel to the brain and are highly processed along the way, with the brain itself taking part in the processing. The danger transmission neurones that run up the spinal cord to the brain are under real-time control from the brain, increasing and decreasing their sensitivity according to what the brain suggests would be helpful.

So, if the brain’s evaluation of all available information leads it to conclude that things are truly dangerous, then the danger transmission system becomes more sensitive (called descending facilitation). If the brain concludes things are not truly dangerous, then the danger transmission system becomes less sensitive (called descending inhibition).

Danger evaluation in the brain is mindbogglingly complex. Many brain regions are involved, some more commonly that others, but the exact mix of brain regions varies between individuals and, in fact, between moments within individuals.

To understand how pain emerges into consciousness requires us to understand how consciousness itself emerges, and that is proving to be very tricky.

To understand how pain works in real-life people with real-life pain, we can apply a reasonably easy principle: any credible evidence that the body is in danger and protective behaviour would be helpful will increase the likelihood and intensity of pain. Any credible evidence that the body is safe will decrease the likelihood and intensity of pain. It is as simple and as difficult as that.

Implications

To reduce pain, we need to reduce credible evidence of danger and increase credible evidence of safety. Danger detectors can be turned off by local anaesthetic, and we can also stimulate the body’s own danger-reduction pathways and mechanisms. This can be done by anything that is associated with safety – most obviously accurate understanding of how pain really works, exercise, active coping strategies, safe people and places.

A very effective way to reduce pain is to make something else seem more important to the brain – this is called distraction. Only being unconscious or dead provide greater pain relief than distraction.

In chronic pain the sensitivity of the hardware (the biological structures) increases so the relationship between pain and the true need for protection becomes distorted: we become over-protected by pain.

This is one significant reason there is no quick fix for nearly all persistent pains. Recovery requires a journey of patience, persistence, courage and good coaching. The best interventions focus on slowly training our body and brain to be less protective.

This article is the first in our series on Pain. Further articles will explore who pain affects, how we describe and experience pain across cultures and genders, and the effect of chronic pain on the economy.

Author

Lorimer Moseley

Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia

Placebos can work magic. But that’s no argument for the health service to privilege a form of mock medicine that defies science and common sense

Vials containing homeopathic pills. Photograph: Peter Macdiarmid/Getty Images

Sunday 15 November 2015 20.39 GMT Last modified on Monday 16 November 2015 01.05 GMT

Western medicine doesn’t know it all. There are treatments that don’t work at all well, others that work for reasons that nobody can fathom, and all sorts of others again that are still to be discovered. It is also true – as western medicine itself has firmly established – that the sugar pill can sometimes be a wonder drug. The administration of anything with the form of a treatment can do real good, and remarkably this applies even where the patient knows that “treatment” is nothing but a placebo. Administering placebos with extra ritual appears to redouble the effect, and so it would be no surprise, either, if a spoonful of mumbo-jumbo helped the medicine go down.

Homeopathy on prescription could be banned from NHS

Threat of judicial review has apparently forced ministers into launching a consultation to ensure funds are spent only on most effective treatments

All this may sound like an argument for the NHS to give homeopathy a go. Sure, there might be, as the health service bluntly surmises, no decent evidence of any effect. Sure, too, the homeopathic practice of diluting agents until there are no molecules left defies not only science, but common sense too. No matter, it may be said, if the quackery can work placebo magic, then that’s OK. But this line of thinking is confused. Ministers are quite right to consider blacklisting homeopathy from the English health service.

For why should this one form of mock medicine be favoured over others? Until and unless homeopathy can outperform general placebo effects, it is surely better to stick with sugar pure and simple, rather than squandering time and effort on the dilution charade. In this era of punishingly tough financial choices, every frittered resource leaves the NHS failing to fund something else that’s important.

If magical thinking is allowed into one corner of medicine, how are doctors supposed to root it out in other contexts?

More controversially, there is also an educational duty on the NHS here; it is meant to foster public health, which means encouraging public understanding of science. It cannot do so while lending its chequebook and its good name to homeopathy. If magical thinking is allowed into one corner of medicine, then how are doctors supposed to root it out in other contexts? When, for example, they confront the smoker, who maintains, in the face of all evidence, that their habit will do them no harm because they know an old lady who reached 99 while getting through 30 a day; or the patient demanding antibiotics that cannot conceivably do anything at all for their viral infection?

Medics must grapple with many such irrational impulses. They will be best placed to do if they act consistently on the evidence. And that means saying no to homeopathy.

optimisefit

Mean (A) and individual (B) muscle glycogen concentrations at baseline (pre-exercise), immediate post-exercise (IP), and 120 post-exercise (PE-120). Subjects ran on a treadmill at 65% VO2max for 180 min. *Indicates significant (P=0.000) difference from baseline. †Indicates significant (P=0.000) difference from IP. No significant differences between groups. LC = low-carbohydrate diet group; HC = high-carbohydrate diet group.

Metabolic characteristics of keto-adapted ultra-endurance runners Jeff S. Volek, Daniel J. Freidenreich, Catherine Saenz, Laura J. Kunces, Brent C. Creighton, Jenna M. Bartley, Patrick M. Davitt, Colleen X. Munoz, Jeffrey M. Anderson, Carl M. Maresh, Elaine C. Lee, Mark D. Schuenke, Giselle Aerni, William J. Kraemer, Stephen D. Phinney Metabolism - Clinical and Experimental

DOI: 10.1016/j.metabol.2015.10.028

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