Microcurrent: Advanced Wound Healing

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Publisher :
ISBN 13 : 9781726477079
Total Pages : 186 pages
Book Rating : 4.4/5 (77 download)

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Book Synopsis Microcurrent: Advanced Wound Healing by : John Hache

Download or read book Microcurrent: Advanced Wound Healing written by John Hache and published by . This book was released on 2018-09 with total page 186 pages. Available in PDF, EPUB and Kindle. Book excerpt: The care and treatment of wounds has long been attributed to the western medical system, which has developed within itself a method for treating wounds that can in effect extend the duration of the wound, and cause excruciating pain in the process. Wounds or pain can become such a detriment on people's lives that they have all but given up. Dr. John Hache has spent years of his life helping patients in these situations find relief from this pain. With Microcurrent technology we have the power to restore that life to them.This illustrated book aims to examine the current epidemic in the prescription of harmful medications for the management of acute and chronic pain as well as the reasons behind delayed wound healing. We will consider why wounds take so long to heal, and why a lot of them do not heal at all; furthermore, we will show you a non-invasive way to accelerate their repair. The prevalence of prescription medications and surgical intervention within the medical field has prevented, and still prevents, medical professionals from seeing the advantages that alternative methods can produce. Within this book we will go over individual cases, a full case study with over 100 participants, and reveal specific step-by-step protocols for a variety of types of wounds, both basic, and severe that you can do with your microcurrent technology.These studies presented within reveal remarkable evidence that correct use of microcurrent technology, could-right now-replace a portion of the current medical practices in the treatment of wound healing. Dr. John Hache earned a PhD in Integrative Medicine from Quantum University. His thesis focused on research and practice in the healing of wounds using microcurrent technology.

Avazzia Pro Sport III User's Guide

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781987412710
Total Pages : 136 pages
Book Rating : 4.4/5 (127 download)

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Book Synopsis Avazzia Pro Sport III User's Guide by : John Hache

Download or read book Avazzia Pro Sport III User's Guide written by John Hache and published by Createspace Independent Publishing Platform. This book was released on 2018-03-30 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: This 130+ page, fully illustrated, user's guide is the definitive go-to instruction in the use and application of the Avazzia Pro-Sport III technology as used in pain management by individuals and Doctors worldwide, written by world leaders and first movers in Microcurrent Dr John and Lorraine Hache, PhD. This book was written as an introductory training guide for health professionals who have recently been introduced to Biofeedback Electro Stimulation Technology (BESTTM), Pro-Sport(TM) devices. The subject matter contained herein covers the first of three training phases. In the hands of a skilled practitioner, the BESTTM device is an incredible tool for Biofeedback therapy, bio-electronic therapy and pain management. In reality, it is like a paintbrush in the hands of an artist. With the brush one may be capable of painting a Rembrandt or only a fence, depending on skill levels. Effective pain therapy is also an art, composed of many sciences, and skill must be acquired to use the brush that is Avazzia BESTTM to its fullest potential. This manual is intended to be a practical, simple to apply, fast to learn text for everyday use in practice of the art of pain management.

Wound Care

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Publisher : Lippincott Williams & Wilkins
ISBN 13 : 9780781774444
Total Pages : 786 pages
Book Rating : 4.7/5 (744 download)

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Book Synopsis Wound Care by : Carrie Sussman

Download or read book Wound Care written by Carrie Sussman and published by Lippincott Williams & Wilkins. This book was released on 2007 with total page 786 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designed for health care professionals in multiple disciplines and clinical settings, this comprehensive, evidence-based wound care text provides basic and advanced information on wound healing and therapies and emphasizes clinical decision-making. The text integrates the latest scientific findings with principles of good wound care and provides a complete set of current, evidence-based practices. This edition features a new chapter on wound pain management and a chapter showing how to use negative pressure therapy on many types of hard-to-heal wounds. Technological advances covered include ultrasound for wound debridement, laser treatments, and a single-patient-use disposable device for delivering pulsed radio frequency.

The Resonance Effect

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Publisher : North Atlantic Books
ISBN 13 : 1623171113
Total Pages : 248 pages
Book Rating : 4.6/5 (231 download)

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Book Synopsis The Resonance Effect by : Carolyn McMakin

Download or read book The Resonance Effect written by Carolyn McMakin and published by North Atlantic Books. This book was released on 2017-04-25 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Resonance Effect is both the author's story of her inspirational journey of having the courage to find her true calling and an account of the development of a remarkable newly rediscovered treatment, frequency specific microcurrent (FSM), that takes advantage of the body's ability to respond to frequencies in order to heal a number of chronic conditions. Carolyn McMakin, a chiropractor specializing in fibromyalgia and myofascial pain, describes her experience using a two-channel microcurrent device that has achieved astounding results that have changed medicine and created new possibilities for suffering patients over the past twenty years. Nerve pain, fibromyalgia, diabetic neuropathies, muscle pain, athletic performance, injury repair, joint pain, low back pain, neck pain, kidney stone pain, the kidney stones themselves, liver disease, diabetic wounds, brain and spinal cord injuries, PTSD, depression, shingles, asthma, ovarian cysts, abdominal adhesions, and scarring all respond to specific frequencies. McMakin explains that results are predictable, reproducible, and teachable—all without side effects—offering hope and healing to millions of people. McMakin tells the story of how thousands of patients with conditions that did not respond to other medical therapies recovered from pain and disability through the non-invasive treatment that she developed. For example, asthma resolves with specific frequencies that remove inflammation, allergy reaction, and spasm from the bronchi. One frequency combination eliminates shingles pain in minutes and stops the shingles attack with a single three-hour treatment. Since 2005, a series of frequencies has been used to treat hundreds of PTSD patients. Post-surgical patients use FSM to reduce pain, prevent bruising, and increase healing. NFL, NHL, and Olympic athletes use it to heal injuries and improve performance. McMakin includes case histories that illustrate the efficacy of the treatment and shares the specific frequencies that each condition requires so that patients direct their own treatments.

Frequency Specific Microcurrent in Pain Management

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Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0702049255
Total Pages : 264 pages
Book Rating : 4.7/5 (2 download)

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Book Synopsis Frequency Specific Microcurrent in Pain Management by : Carolyn McMakin

Download or read book Frequency Specific Microcurrent in Pain Management written by Carolyn McMakin and published by Elsevier Health Sciences. This book was released on 2011-10-28 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive text describes the origins, mechanisms, beneficial applications and practical details of frequency specific therapy - a treatment technique that uses frequencies, micro amperage current and the principles of biological resonance to treat pain and a wide range of medical conditions. It includes condition specific frequency protocols for the treatment of various pain complaints, and multi-center clinical case reports documenting successful application of the technique. Each section includes a review of condition pathophysiology and differential diagnosis, plus current research. A DVD feature a lecture from the author, Powerpoint teaching slides, practical demonstrations of techniques, fully searchable text and downloadable images from the book!

Dressings for Advanced Wound Care

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Publisher : CRC Press
ISBN 13 : 0429523610
Total Pages : 255 pages
Book Rating : 4.4/5 (295 download)

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Book Synopsis Dressings for Advanced Wound Care by : Sharon Lam Po Tang

Download or read book Dressings for Advanced Wound Care written by Sharon Lam Po Tang and published by CRC Press. This book was released on 2021-07-15 with total page 255 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dressings for Advanced Wound Care focuses on helping the reader better understand advanced wound care and relevant technologies. It explains how different types of wounds may require different environments to heal and how dressings can help in creating the right environment. It gives an overview of the various dressing technologies that are available to help manage wounds that are difficult to heal. Finally, this book highlights the current trends that may be directing the future of the advanced wound dressing sector. FEATURES: Relates technologies with commercially available end-products, giving the reader a more specific overview of the advanced wound dressing sector Provides a realistic overview of the process of developing an advanced wound care dressing Summarises recent clinical evidence on advanced wound dressings Explains how dressings differ and what works best for which wound type Examines clinical evidence on technologies and on-market products Describes the requirements for launching a new advanced wound dressing This book is aimed at medical clinicians and professionals in the fields of biomedical engineering, textile science, and materials engineering.

Oral Wound Healing

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Publisher : John Wiley & Sons
ISBN 13 : 0813804817
Total Pages : 433 pages
Book Rating : 4.8/5 (138 download)

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Book Synopsis Oral Wound Healing by : Hannu Larjava

Download or read book Oral Wound Healing written by Hannu Larjava and published by John Wiley & Sons. This book was released on 2012-05-15 with total page 433 pages. Available in PDF, EPUB and Kindle. Book excerpt: Oral Wound Healing: Cell Biology and Clinical Management brings experts from around the world together to provide an authoritative reference on the processes, principles and clinical management of wound healing in the oral mucosa. Promoting a thorough understanding of current research on the topic, this new resource draws together thinking on the basic biological processes of wound healing in the oral environment, as well as providing more detailed information and discussion on processes such as inflammation, reepithelialization and angiogenesis. Beyond this, the book goes on to examine topics pertinent to the effective clinical management of oral wound healing, bringing together chapters on large dento-facial defects, dental implants, periodontal regeneration, and pulp healing.An essential synthesis of current research and clinical applications, Oral Wound Healing will be an indispensable resource for dental specialists, oral and maxillofacial surgeons as well as researchers in oral medicine and biology.

Advanced Wound Repair Therapies

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Publisher : Elsevier
ISBN 13 : 0857093304
Total Pages : 672 pages
Book Rating : 4.8/5 (57 download)

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Book Synopsis Advanced Wound Repair Therapies by : David Farrar

Download or read book Advanced Wound Repair Therapies written by David Farrar and published by Elsevier. This book was released on 2011-06-21 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Wound repair is an important and growing sector of the medical industry with increasingly sophisticated biomaterials and strategies being developed to treat wounds. Advanced wound repair therapies provides readers with up-to-date information on current and emerging biomaterials and advanced therapies concerned with healing surgical and chronic wounds.Part one provides an introduction to chronic wounds, with chapters covering dysfunctional wound healing, scarring and scarless wound healing and monitoring of wounds. Part two covers biomaterial therapies for chronic wounds, including chapters on functional requirements of wound repair biomaterials, polymeric materials for wound dressings and interfacial phenomena in wound healing. In part three, molecular therapies for chronic wounds are discussed, with chapters on topics such as drug delivery, molecular and gene therapies and antimicrobial dressings. Part four focuses on biologically-derived and cell-based therapies for chronic wounds, including engineered tissues, biologically-derived scaffolds and stem cell therapies for wound repair. Finally, part five covers physical stimulation therapies for chronic wounds, including electrical stimulation, negative pressure therapy and mechanical debriding devices.With its distinguished editor and international team of contributors, Advanced wound repair therapies is an essential reference for researchers and materials scientists in the wound repair industry, as well as clinicians and those with an academic research interest in the subject. - Provides readers with up-to-date information on current and emerging biomaterials and advanced therapies concerned with healing surgical and chronic wounds - Chapters include the role of micro-organisms and biofilms in dysfunctional wound healing, tissue-biomaterial interaction and electrical stimulation for wound healing - Covers biologically-derived and cell-based therapies for chronic wounds, including engineered tissues, biologically-derived scaffolds and stem cell therapies for wound repair

Chi Nei Tsang and Microcurrent Therapy

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Publisher : Destiny Books
ISBN 13 : 9781620557433
Total Pages : 0 pages
Book Rating : 4.5/5 (574 download)

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Book Synopsis Chi Nei Tsang and Microcurrent Therapy by : Mantak Chia

Download or read book Chi Nei Tsang and Microcurrent Therapy written by Mantak Chia and published by Destiny Books. This book was released on 2018-08-14 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: An illustrated guide to combining the new healing modality of microcurrent therapy with Chi Nei Tsang energy massage • Explains how microcurrent therapy harmonizes the body’s cells, regenerates the nervous system, and boosts the body’s natural self-healing abilities • Provides illustrated, step-by-step instructions for using microcurrent therapy during massage and for the basic techniques of Chi Nei Tsang massage • Shows how combining these therapies can relieve pain, reduce inflammation, and help specific ailments, such as arthritis, sciatica, fibromyalgia, and shingles Each cell of the body is animated by a highly organized and intelligent bioenergy, or bioelectricity. When cells are damaged, they become electrically imbalanced. Recently it has been discovered that microcurrent therapy--applying low-amperage electrical currents to the body--harmonizes the cells, returns them to a normal state of cellular activity, and boosts the body’s natural self-healing abilities. Combining this innovative new modality with ancient Taoist healing methods, Mantak Chia and Aisha Sieburth detail how to integrate microcurrent therapy with Chi Nei Tsang energy massage for pain relief, self-healing, and rejuvenation. The authors explain how microcurrent has a regenerative effect on the nervous system, helping to increase energy levels, promote circulation of blood and lymph, relieve acute or chronic pain, restore pH balance of the blood, balance hormone function, and improve the immune system. Its effects on circulation extend to all the body’s vessels, tissues, and cells as well as enhancing toxin elimination and reducing inflammation. The authors show how microcurrent therapy pairs extraordinarily well with Chi Nei Tsang massage. The microcurrent, flowing through the hands of the massage practitioner into the body, enhances the effects of the massage within the nerves and tissues, making it easier to harmonize the flow of energy, release tensions, and dissolve energetic knots in the meridians. With illustrated, step-by-step instructions, the authors explain how to use microcurrent therapy during massage and describe the basic techniques of CNT massage. They also show how CNT microcurrent therapy is beneficial for general physical health and for a host of specific ailments, such as nerve pain, arthritis, sciatica, fibromyalgia, shingles, headaches, slow-healing wounds, and tendon and ligament pain.

Therapeutic Dressings and Wound Healing Applications

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Publisher : John Wiley & Sons
ISBN 13 : 1119433266
Total Pages : 444 pages
Book Rating : 4.1/5 (194 download)

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Book Synopsis Therapeutic Dressings and Wound Healing Applications by : Joshua Boateng

Download or read book Therapeutic Dressings and Wound Healing Applications written by Joshua Boateng and published by John Wiley & Sons. This book was released on 2020-03-09 with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: The latest research on techniques for effective healing of chronic and difficult to heal wounds The healing of chronic wounds is a global medical concern, specifically for patients suffering from obesity and type II diabetes. Therapeutic Dressing and Wound Healing Applications is an essential text for research labs, industry professionals, and general clinical practitioners that want to make the shift towards advanced therapeutic dressing and groundbreaking wound application for better healing. This book takes a clinical and scientific approach to wound healing, and includes recent case studies to highlight key points and areas of improvement. It is divided into two key sections that include insight into the biochemical basis of wounds, as well as techniques and recent advancements. Chapters include information on: ● Debridement and disinfection properties of wound dressing ● Biofilms, silver nanoparticles, and honey dressings ● Clinical perspectives for treating diabetic wounds ● Treating mixed infections ● Wound healing and tissue regeneration treatments ● Gene based therapy, 3D bioprinting and freeze-dried wafers Anyone looking to update and improve the treatment of chronic wounds for patients will find the latest pertinent information in Therapeutic Dressing and Wound Healing Applications.

Advanced Textiles for Wound Care

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Publisher : Woodhead Publishing
ISBN 13 : 0081021933
Total Pages : 608 pages
Book Rating : 4.0/5 (81 download)

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Book Synopsis Advanced Textiles for Wound Care by : S. Rajendran

Download or read book Advanced Textiles for Wound Care written by S. Rajendran and published by Woodhead Publishing. This book was released on 2018-09-20 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advanced Textiles for Wound Care, Second Edition, provides a detailed review of how textiles are incorporated into wound care applications, also explaining the importance and suitability of using textiles on different wound types. It is an interdisciplinary book which directly links textile technology with advances in wound care. The book discusses new developments and techniques related to antimicrobial dressings, the use of biopolymers in infection control management, advanced dressings for managing cavity and cancerous wounds, and the application of nanofibers and novel textile structures in scaffolds, among other new areas. This updated edition also reflects recent changes in regulatory affairs. The book is essential reading for manufacturers, designers, scientists and producers of wound care materials. It is a valuable resource for professionals within the medical sector, as well as those in academia, enabling materials scientists and engineers in both academia, and at medical device companies, to stay abreast of new technology. - Provides a comprehensive introduction to wound care, from the different types of wound and wound healing mechanisms, to the importance of testing in relation to wound care - Analyzes the application of textiles to wound healing, covering minor wounds, burns, ulcers and other deep skin wounds - Reviews the current use of smart textiles for wound care, including drug delivery dressings and textile-based scaffolds for tissue engineering

Antibiofilm Agents

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Publisher : Springer Science & Business Media
ISBN 13 : 3642538339
Total Pages : 495 pages
Book Rating : 4.6/5 (425 download)

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Book Synopsis Antibiofilm Agents by : Kendra P. Rumbaugh

Download or read book Antibiofilm Agents written by Kendra P. Rumbaugh and published by Springer Science & Business Media. This book was released on 2014-05-08 with total page 495 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a survey of recent advances in the development of antibiofilm agents for clinical and environmental applications. The fact that microbes exist in structured communities called biofilms has slowly become accepted within the medical community. We now know that over 80% of all infectious diseases are biofilm-related; however, significant challenges still lie in our ability to diagnose and treat these extremely recalcitrant infections. Written by experts from around the globe, this book offers a valuable resource for medical professionals seeking to treat biofilm-related disease, academic and industry researchers interested in drug discovery and instructors who teach courses on microbial pathogenesis and medical microbiology.

Pain Free for Life

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Publisher : Center Street
ISBN 13 : 1599951320
Total Pages : 223 pages
Book Rating : 4.5/5 (999 download)

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Book Synopsis Pain Free for Life by : Scott Brady

Download or read book Pain Free for Life written by Scott Brady and published by Center Street. This book was released on 2007-10-15 with total page 223 pages. Available in PDF, EPUB and Kindle. Book excerpt: More than fifty million Americans suffer today from chronic pain. Dr. Scott Brady was one of them. Doctors told him he would live with his back pain for the rest of his life. Having exhausted all options offered by conventional medicine, Dr. Brady overcame his pain using a mind-body-spirit approach'in an incredible four weeks. In 2000, he founded the Brady Institute, where more than 80 percent of his patients have achieved 80-100 percent pain relief, without surgery or drugs. In Pain Free For Life, Dr. Brady sets a clear course for readers to diagnose what is really causing their pain 'autonomic overload syndrome, which is brought on by the repression of harmful negative emotions with profiles of pain-prone personalities and an innovative spiritual health inventory. He reveals the techniques behind his remarkably effective recovery plan, including the practice of depth journaling and prescriptions to boost the power of personal belief. Dr. Brady's approach has helped his patients overcome such conditions as chronic back pain, nagging neck and shoulder pain, migraine or tension headaches, muscle pain, irritable bowel syndrome, insomnia, and many other chronic pain-associated ailments. The principles and techniques described in Pain Free For Life will be illustrated by in-depth case studies. His proven 6-week program produces results in as little as thirty minutes a day.

Advanced Textiles for Wound Care

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Publisher : Elsevier
ISBN 13 : 1845696301
Total Pages : 358 pages
Book Rating : 4.8/5 (456 download)

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Book Synopsis Advanced Textiles for Wound Care by : S. Rajendran

Download or read book Advanced Textiles for Wound Care written by S. Rajendran and published by Elsevier. This book was released on 2009-04-30 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: An important and growing area of the textile industry is the medical sector. The extent of this growth is due to constant improvements in both textile technology and medical procedures. This collection provides a detailed review of how textiles are incorporated into wound care applications, explaining the importance and suitability of using textiles on different wound types.Part one of the book provides an overview of the use of textiles in particular aspects of wound care, providing details of wound management and the importance of laboratory testing in relation to wound care. Further chapters cover minor wounds, moist wound management and bioactive dressings to promote healing. Given their increasing importance, part two describes how advanced textiles, such as smart temperature controlled textiles and composites, can be used for wound care products. The final chapter gives an interesting insight into the use of fibrous scaffolds for tissue engineering.Advanced textiles for wound care is essential reading for any manufacturers, designers, scientists and producers of wound care materials. It is a valuable resource for professionals within the medical sector, as well as those in academia. - Provides a comprehensive introduction to wound care from types of wound and wound healing mechanisms to the importance of testing in relation to wound care - Analyses the application of textiles to wound healing covering minor wounds, burns, ulcers and other deep skin wounds - Reviews the current use of smart textiles for wound care including drug delivery dressings and textile-based scaffolds for tissue engineering as well as future trends

Avazzia Life Genesis Official User's Guide

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Publisher :
ISBN 13 :
Total Pages : 52 pages
Book Rating : 4.6/5 (791 download)

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Book Synopsis Avazzia Life Genesis Official User's Guide by : Lorry Hache

Download or read book Avazzia Life Genesis Official User's Guide written by Lorry Hache and published by . This book was released on 2020-08-25 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: This handy microcurrent user's guide is the official handbook for the Avazzia Life Genesis technology used by people all around the world to resolve their chronic pain and illness.This book contains illustrated protocols and instructions for the Avazzia Life Genesis technology - the easiest to use microcurrent device on the market! This book teaches you how to quickly apply the automatic treatment technology by using the same trigger point charts used by Pain Management Specialists worldwide, while also showing you how you can take the device off autopilot and approach a variety of different problems with protocols designed to rid the body of pain and allow you to take your life back.With this guidebook and your Genesis device, get ready to say goodbye to your pain today!

Canine Sports Medicine and Rehabilitation

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Publisher : John Wiley & Sons
ISBN 13 : 1119380456
Total Pages : 1260 pages
Book Rating : 4.1/5 (193 download)

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Book Synopsis Canine Sports Medicine and Rehabilitation by : Chris Zink

Download or read book Canine Sports Medicine and Rehabilitation written by Chris Zink and published by John Wiley & Sons. This book was released on 2018-02-21 with total page 1260 pages. Available in PDF, EPUB and Kindle. Book excerpt: Canine Sports Medicine and Rehabilitation This thoroughly revised and updated new edition offers a gold standard reference for all aspects of sports medicine and rehabilitation, encompassing basic science and integrated veterinary and physical therapy approaches. New chapters cover biological therapies, working dogs, and business management, and every chapter has been extensively revised and expanded with state-of-the-art information—providing an even greater wealth of evidence, expertise, and experience to this complex discipline. Presented in full color, with illustrations and photographs throughout and real-world case studies,the book is a detailed yet practical guide ideal for the clinical setting. Providing must-have information for anyone working with active dogs or rehabilitation patients, Canine Sports Medicine and Rehabilitation offers enlightening chapters including: Locomotion and Athletic Performance; Canine Therapeutic Exercise; Canine Aquatic Therapy; Conditioning and Retraining the Canine Athlete; Veterinary Orthotics and Prosthetics; Diagnosis of and Treatment Options for Disorders of the Canine Spine; Rehabilitation for Geriatric Canine Patients; The Role of Acupuncture and Manipulative Therapy in Canine Rehabilitation; and much more. Presents current, state-of-the-art information on sports medicine and rehabilitation in dogs Offers perspectives from an international list of expert authors Covers all topics related to veterinary care of the canine athlete and all active dogs Includes illustrations and photographs throughout to demonstrate key concepts Provides clinical cases that set the information in context Canine Sports Medicine and Rehabilitation is a complete resource for veterinarians, physical therapists,veterinary technicians, and anyone interested in working with canine athletes or in offering rehabilitation therapy in their practice.

Science and Practice of Pressure Ulcer Management

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Author :
Publisher : Springer Science & Business Media
ISBN 13 : 9781852338398
Total Pages : 256 pages
Book Rating : 4.3/5 (383 download)

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Book Synopsis Science and Practice of Pressure Ulcer Management by : Marco Romanelli

Download or read book Science and Practice of Pressure Ulcer Management written by Marco Romanelli and published by Springer Science & Business Media. This book was released on 2005-12-23 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: Only comprehensive reference book on pressure ulcers and their management Only book in its field endorsed by the European Pressure Ulcer Advisory Panel, the leading European authority on pressure ulcers