Nurses Ethics and Jurisprudence for Patient Advocacy

Understand the critical role of ethics & jurisprudence for nurses. Their adherence to ethical guidelines improves patient outcomes.

The Power of Chiropractic Care and Nursing: A Holistic Approach to Reducing Musculoskeletal Pain

Musculoskeletal pain is like that annoying neighbor who keeps borrowing your lawnmower and never returns it—it’s persistent, disruptive, and can make even the simplest tasks feel like climbing a mountain. Whether it’s a nagging lower back ache from slouching at your desk, a stiff neck from a fender-bender, or joint pain that sneaks up like a plot twist in a thriller, musculoskeletal pain affects millions of people. In El Paso, Texas, where the sun shines bright and the community thrives, there’s a dynamic duo ready to tackle this pesky problem: chiropractic care combined with nursing, led by the expertise of Dr. Alexander Jimenez, DC, APRN, FNP-BC. At ChiroMed – Integrated Medicine, Dr. Jimenez and his team are rewriting the script on pain relief, blending the best of conventional and alternative medicine to help you get back to your blockbuster life.

This blog delves into why combining chiropractic care with nursing is a game-changer for managing musculoskeletal pain. We’ll explore the environmental factors that turn your body into a grumpy old troll, how the musculoskeletal system works (or doesn’t), and the ethical and legal guidelines that keep practitioners in check, like a referee in a wrestling match. We’ll also highlight non-surgical treatments, small lifestyle tweaks, and Dr. Jimenez’s unique role in personal injury cases in El Paso. With a touch of humor to keep things light, this comprehensive guide will show you how to take control of your pain and live your best life. Let’s roll!

Understanding Musculoskeletal Pain: The Body’s Not-So-Funny Tantrum

Your musculoskeletal system is like the scaffolding of a building—it holds everything together, from your bones and muscles to your joints and ligaments. When it’s working well, you can run, jump, and dance like nobody’s watching. But when it’s not, it’s like your body’s throwing a tantrum, complete with aches, stiffness, and pain that make you wince every time you reach for the remote.

Musculoskeletal pain can come from various sources, like injuries, overuse, or just bad habits. Here are some common culprits:

• Injuries: A slip, trip, or car accident can strain muscles, sprain ligaments, or cause microtears in tissue. Think of it as your body’s way of saying, “Ouch, that wasn’t in the script!”
• Poor Posture: Slouching at your desk or hunching over your phone for hours is like asking your spine to do yoga without warming up. Over time, it leads to chronic pain in the neck, back, or shoulders.
• Sedentary Lifestyle: Sitting all day is like telling your muscles, “Take a vacation, but don’t come back.” Lack of movement weakens muscles and stiffens joints, increasing pain risk (Warburton et al., 2018).
• Repetitive Motions: Jobs or hobbies that involve repetitive tasks—like typing or lifting—can overwork specific muscle groups, leading to pain that feels like a broken record.
• Environmental Factors: Factors such as cold weather, poor workplace ergonomics, or stress can cause your muscles to become tighter than a rubber band, ready to snap.

These factors don’t just cause pain; they can also lead to inflammation, reduced mobility, and even mental fatigue, which makes you feel like you’re running on empty (Mikkelsen et al., 2013). The good news? Chiropractic care and nursing can team up to calm your body’s tantrum and get you back to feeling like the star of your own show.

References

• Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2013). The effect of a single bout of exercise on energy and fatigue states: A systematic review and meta-analysis. Fatigue: Biomedicine, Health & Behavior, 1(4), 223–242. https://doi.org/10.1080/21641846.2013.843266
• Warburton, D. E. R., Bredin, S. S. D., & Jamnik, V. K. (2018). When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults. Journal of Physical Activity and Health. https://pubmed.ncbi.nlm.nih.gov/29405824/

The Musculoskeletal System: Your Body’s Framework

Before we dive into the solutions, let’s take a quick tour of the musculoskeletal system. Imagine it as the framework of a house, with bones as the beams, muscles as the walls, and joints as the hinges. Here’s how it works:

• Bones: These are the sturdy foundation, providing structure and support. They’re like the steel beams holding up your body’s skyscraper.
• Muscles: These are the powerhouses that move your bones. They contract and relax, letting you lift, run, or even scroll through your phone.
• Joints: These are the connectors, like hinges or ball-and-socket joints, that allow movement. Think of your knee or shoulder as the hinges of your body’s door.
• Ligaments and Tendons: Ligaments connect bones to bones, and tendons connect muscles to bones. They’re like the duct tape keeping everything in place.

When any part of this system gets out of whack—say, a misaligned spine or an overworked muscle—it’s like a domino effect. Pain, stiffness, and reduced mobility can spread, making everyday tasks feel like a chore. For example, a study on low back pain found that isometric exercises, which strengthen muscles without movement, can significantly reduce pain by improving muscle activity (Alayat et al., 2018). This shows how targeting specific parts of the musculoskeletal system can restore balance and ease discomfort.

References

• Alayat, M. S. M., Mohamed, A. A., Aly, H. M., & Mahmoud, M. A. (2018). The Effects of Isometric Exercise Types on Pain and Muscle Activity in Patients with Low Back Pain. Journal of Back and Musculoskeletal Rehabilitation. https://pubmed.ncbi.nlm.nih.gov/30170511/

Why Chiropractic Care and Nursing Are the Perfect Tag Team

Chiropractic care and nursing might seem like an odd couple, like peanut butter and pickles, but together, they create a powerful recipe for pain relief. Chiropractic care focuses on aligning the spine and joints to restore proper function, while nursing provides comprehensive patient care, including assessments, education, and coordination with other treatments. Here’s why they’re a match made in heaven:

Chiropractic Care: Getting Your Body Back in Line

Chiropractors, such as Dr. Alexander Jimenez, use hands-on techniques, including spinal adjustments, to correct misalignments (called subluxations) in the spine and joints. These misalignments can pinch nerves, strain muscles, and cause pain that feels like a bad plot twist. By realigning the spine, chiropractic care reduces nerve irritation, improves blood flow, and helps muscles relax. It’s like hitting the reset button on your body’s control panel.

Research supports this approach. A systematic review found that direct access to physical therapy, which includes chiropractic-like interventions, is cost-effective and leads to better outcomes for musculoskeletal disorders compared to physician-first care (Ojha et al., 2021). This means chiropractic care can get you moving again without breaking the bank.

Nursing: The Glue That Holds It All Together

Nurses, especially those with advanced training like Dr. Jimenez as a Family Nurse Practitioner (FNP), bring a holistic perspective to the table. They assess your overall health, manage chronic conditions, and educate you on lifestyle changes to prevent pain from recurring. Nurses also coordinate care, ensuring that your chiropractic treatments work seamlessly with other therapies, like physical therapy or nutrition counseling.

The Texas Nurse Practice Act emphasizes that nurses must provide safe, competent care within their scope of practice, which includes patient education and collaboration with other healthcare providers (Texas Board of Nursing, n.d.). This ensures that your treatment plan is as cohesive as a well-directed movie, with every scene (or therapy) working toward the same happy ending: pain relief.

The Synergy: Why They Work Better Together

When chiropractic care and nursing join forces, it’s like Batman and Robin fighting crime. Chiropractic adjustments address the mechanical issues—like a misaligned spine—while nursing tackles the broader picture, such as inflammation, stress, or poor nutrition. For example, a nurse might notice that your chronic back pain is linked to poor posture and stress, then work with the chiropractor to create a plan that includes adjustments, stress management techniques, and ergonomic advice.

This integrated approach is especially effective for musculoskeletal pain because it addresses both the symptoms and the root causes. A study on isometric neuromuscular electrical stimulation showed that targeted muscle activation can reduce pain and improve function after muscle damage, highlighting the importance of combining therapies for optimal results (Veldman et al., 2014).

References

• Ojha, H. A., Fritz, J. M., & Maletsky, A. J. (2021). Cost-effectiveness and outcomes of direct access to physical therapy for musculoskeletal disorders compared to physician-first access in the United States: Systematic review and meta-analysis. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/33034809/
• Texas Board of Nursing. (n.d.). CE Broker – Lesson 1: The Texas Nurse Practice Act. 
• Veldman, M. P., Gondin, J., Place, N., & Maffiuletti, N. A. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. European Journal of Applied Physiology. https://pubmed.ncbi.nlm.nih.gov/25156685/

Environmental Factors and Musculoskeletal Pain: The Usual Suspects

Your environment can be like a mischievous gremlin, sneaking in to mess with your musculoskeletal system. Here are some environmental factors that contribute to pain and how chiropractic care and nursing can help:

• Workplace Ergonomics: Sitting at a poorly designed desk is like asking your spine to do a marathon in flip-flops. Poor chair height, bad monitor placement, or repetitive tasks can strain your back and neck. Chiropractic adjustments can realign your spine, while nurses can teach you how to set up your workspace like a pro.
• Stress: Stress is like that annoying pop-up ad that won’t go away—it tightens your muscles and amplifies pain. Nurses can guide you through stress management techniques, such as deep breathing or mindfulness, while chiropractic care helps relieve physical tension.
• Weather: Cold or damp weather can make your joints feel like rusty hinges. Chiropractic adjustments improve joint mobility, and nurses can suggest ways to stay warm and active, like layering up or doing gentle stretches.
• Sedentary Lifestyle: Sitting too much is like letting your muscles binge-watch TV all day—they get lazy and weak. Research shows that increasing physical activity, even in small doses, can reduce pain and improve function in sedentary adults (Warburton et al., 2018).
• Injuries: Car accidents or workplace mishaps can throw your musculoskeletal system into chaos. Dr. Jimenez specializes in personal injury cases, using advanced imaging and diagnostics to pinpoint the damage and create a tailored recovery plan.

By addressing these environmental factors, chiropractic care, and nursing work together to turn your body from a creaky old house into a well-oiled machine.

References

• Warburton, D. E. R., Bredin, S. S. D., & Jamnik, V. K. (2018). When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults. Journal of Physical Activity and Health. https://pubmed.ncbi.nlm.nih.gov/29405824/

Ethics and Jurisprudence: Keeping Care on the Straight and Narrow

Healthcare is like a high-stakes game of chess—every move matters, and there are rules to follow. The Texas Nurse Practice Act (NPA) is like the rulebook, ensuring that nurses like Dr. Jimenez provide safe, ethical care. Here’s how ethics and jurisprudence tie into the chiropractic-nursing combo:

• Patient-Centered Care: The NPA emphasizes that nurses must prioritize patient safety and well-being (Texas Board of Nursing, n.d.). This means creating treatment plans that respect your needs, like ensuring chiropractic adjustments are safe for your specific condition.
• Scope of Practice: Nurses and chiropractors must adhere to their respective roles, much like actors staying in character. Nurses assess and educate, while chiropractors perform adjustments. Dr. Jimenez’s dual credentials as a chiropractor and nurse practitioner allow him to bridge these roles seamlessly.
• Collaboration: The NPA encourages nurses to work with other healthcare providers, like chiropractors, to deliver comprehensive care. This teamwork ensures that your treatment plan is as coordinated as a synchronized swim team.
• Informed Consent: Before any treatment, you have the right to know what’s happening, like getting a spoiler alert for a movie. Nurses and chiropractors must explain the risks and benefits, ensuring you’re on board with the plan.

By following these ethical guidelines, Dr. Jimenez and his team at ChiroMed ensure that your care is not only effective but also trustworthy, like a friend who always keeps their promises.

References

• Texas Board of Nursing. (n.d.). CE Broker – Lesson 1: The Texas Nurse Practice Act.

Non-Surgical Treatments: A Pain Relief Toolkit

Chiropractic care and nursing don’t work alone—they’re like the Avengers, teaming up with other non-surgical treatments to fight pain. Here are some key players in the toolkit:

• Physical Therapy: Exercises like the Timed Up and Go (TUG) test can assess mobility and guide rehabilitation, helping you move better and feel stronger (Hassett et al., 2019).
• Retro Walking: Walking backward might sound like a dance move gone wrong, but it can reduce pain and improve strength in conditions like knee osteoarthritis (Alghadir et al., 2019).
• Acupuncture: This ancient technique is like giving your body a gentle nudge to release natural painkillers. It’s a great complement to chiropractic adjustments.
• Nutrition Counseling: Consuming anti-inflammatory foods, such as fruits and vegetables, can help reduce pain from the inside out. Nurses at ChiroMed can guide you on what to munch.
• Massage Therapy: A good massage is like a warm hug for your muscles, reducing tension and boosting circulation.

These treatments work together to address the overlapping risk profiles of musculoskeletal pain, like inflammation, muscle weakness, and poor mobility. For example, a study on retro walking showed significant improvements in pain and function for knee osteoarthritis patients, proving that small, targeted interventions can make a big difference (Alghadir et al., 2019).

References

• Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: A randomized controlled trial (retro-walking trial). BMC Musculoskeletal Disorders. https://pubmed.ncbi.nlm.nih.gov/31205824/
• Hassett, L., McKay, M., & Cole, M. (2019). Timed Up and Go (TUG) test: Normative reference values for ages 20 to 59 years and relationships with physical and mental health risk factors. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/31594206/

Dr. Alexander Jimenez: El Paso’s Personal Injury Hero

In El Paso, personal injury cases—like car accidents or workplace mishaps—are as common as tacos on a Tuesday. Dr. Alexander Jimenez stands out as a distinguished practitioner for victims of these injuries. With his dual expertise as a chiropractor and nurse practitioner, he’s like a superhero with a stethoscope and a spinal adjustment tool.

Dr. Jimenez uses advanced imaging (like X-rays or MRIs) and diagnostic evaluations to pinpoint the exact cause of your pain, whether it’s a herniated disc, whiplash, or a strained muscle. His dual-scope procedures—combining chiropractic and nursing assessments—ensure a thorough understanding of your injury. For example, he might use a 6-minute walk test to assess mobility in patients with chronic conditions like rheumatoid arthritis, which can be affected by injuries (Yocum et al., 2019).

What makes Dr. Jimenez truly unique is his ability to act as a liaison between medical care and legal documentation. Personal injury cases often require detailed reports for insurance claims or lawsuits, and Dr. Jimenez’s expertise ensures that your medical records are as clear as a sunny El Paso day. He works closely with attorneys to provide accurate documentation, helping you get the compensation you deserve while focusing on recovery.

Learn more about his approach at ChiroMed and LinkedIn.

References

• Yocum, D. E., Castro, J. R., & Cornett, A. C. (2019). Clinical Associations and Prognostic Implications of the 6-Minute Walk Test in Rheumatoid Arthritis. Arthritis Care & Research. https://pubmed.ncbi.nlm.nih.gov/31594207/

Small Changes, Big Impact: Lifestyle Tweaks for Pain Relief

You don’t need to overhaul your life to reduce musculoskeletal pain—sometimes, small changes are like adding a pinch of salt to a recipe: they make all the difference. Here are some tips inspired by Dr. Jimenez’s clinical insights:

• Fix Your Posture: Sit up straight, as if you’re posing for a yearbook photo. Use a chair with lumbar support or a standing desk to maintain a healthy spine.
• Move More: Even a 10-minute walk can boost energy and reduce fatigue, as shown in a study on exercise and energy states (Mikkelsen et al., 2013). Try walking backward for a fun twist that strengthens your legs.
• Stretch It Out: Gentle stretches, like touching your toes or doing shoulder rolls, are like giving your muscles a mini-vacation.
• Stay Hydrated: Drinking water helps keep your joints lubricated, much like oiling a squeaky door.
• Manage Stress: Try deep breathing or meditation to keep stress from turning your muscles into a tight knot.

These changes, combined with chiropractic care and nursing support, can help you manage pain and prevent it from coming back like an unwanted sequel.

References

• Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2013). The effect of a single bout of exercise on energy and fatigue states: A systematic review and meta-analysis. Fatigue: Biomedicine, Health & Behavior, 1(4), 223–242. https://doi.org/10.1080/21641846.2013.843266

The Role of Integrated Care in Long-Term Pain Management

Integrated care at ChiroMed doesn’t just stop at immediate pain relief—it’s about keeping you pain-free for the long haul. Think of it like maintaining a car: regular tune-ups prevent breakdowns. Here’s how chiropractic care, nursing, and other therapies work together for lasting results:

• Personalized Treatment Plans: Dr. Jimenez tailors plans to your unique needs, much like a custom playlist tailored to your recovery. This might include weekly adjustments, monthly check-ins with a nurse, and a home exercise routine.
• Preventive Care: Nurses educate you on habits to prevent pain, like proper lifting techniques or stress reduction, while chiropractors keep your spine aligned to avoid future issues.
• Holistic Approach: By addressing physical, emotional, and environmental factors, integrated care ensures that all bases are covered, like a coach preparing a team for the big game.
• Monitoring Progress: Tools like the Timed Up and Go test or 6-minute walk test help track your mobility and strength over time, ensuring you’re on the right path (Hassett et al., 2019; Yocum et al., 2019).

This comprehensive approach reduces the risk of chronic pain becoming a permanent guest in your life, helping you stay active and healthy.

References

• Hassett, L., McKay, M., & Cole, M. (2019). Timed Up and Go (TUG) test: Normative reference values for ages 20 to 59 years and relationships with physical and mental health risk factors. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/31594206/
• Yocum, D. E., Castro, J. R., & Cornett, A. C. (2019). Clinical Associations and Prognostic Implications of the 6-Minute Walk Test in Rheumatoid Arthritis. Arthritis Care & Research. https://pubmed.ncbi.nlm.nih.gov/31594207/

Movement Medicine: Chiropractic Care- Video

The Importance of Patient Education and Empowerment

One of the biggest strengths of combining chiropractic care and nursing is patient education. Nurses at ChiroMed don’t just treat you—they teach you how to take charge of your health. It’s like learning to drive instead of always being a passenger. Here’s how education plays a role:

• Understanding Your Condition: Nurses explain why your back hurts or why your knee feels like it’s auditioning for a creaky door contest. This knowledge helps you make informed decisions.
• Learning Self-Care: From stretches to ergonomic tips, nurses and chiropractors provide you with tools to manage pain at home, much like a DIY repair kit for your body.
• Building Confidence: Knowing how to prevent and manage pain empowers you to live actively, whether it’s playing with your kids or hitting the hiking trails.

The Texas Nurse Practice Act emphasizes patient education as a core duty, ensuring that you leave ChiroMed not only feeling better but also more informed about your health (Texas Board of Nursing, n.d.).

References

• Texas Board of Nursing. (n.d.). CE Broker – Lesson 1: The Texas Nurse Practice Act.

Addressing Overlapping Risk Profiles for Musculoskeletal Pain

Musculoskeletal pain often comes with overlapping risk factors, like a tangled ball of yarn. These include inflammation, poor mobility, muscle weakness, and even mental health challenges like stress or depression. Chiropractic care and nursing tackle these risks head-on:

• Inflammation: Chiropractic adjustments can reduce nerve irritation, which in turn may lower inflammation. Meanwhile, nurses might recommend anti-inflammatory diets.
• Poor Mobility: Tests like the 6-minute walk test can identify mobility issues, and therapies like retro walking can improve gait and reduce pain (Yocum et al., 2019; Alghadir et al., 2019).
• Muscle Weakness: Isometric exercises and physical therapy strengthen muscles without overloading them, as shown in studies on low back pain (Alayat et al., 2018).
• Mental Health: Stress and fatigue amplify pain, but nurses can teach coping strategies, and even a single bout of exercise can boost energy and mood (Mikkelsen et al., 2013).

By addressing these overlapping risks, ChiroMed ensures that your pain relief is comprehensive, much like a multi-tool that fixes every problem at once.

References

• Alayat, M. S. M., Mohamed, A. A., Aly, H. M., & Mahmoud, M. A. (2018). The Effects of Isometric Exercise Types on Pain and Muscle Activity in Patients with Low Back Pain. Journal of Back and Musculoskeletal Rehabilitation. https://pubmed.ncbi.nlm.nih.gov/30170511/
• Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: A randomized controlled trial (retro-walking trial). BMC Musculoskeletal Disorders. https://pubmed.ncbi.nlm.nih.gov/31205824/
• Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2013). The effect of a single bout of exercise on energy and fatigue states: A systematic review and meta-analysis. Fatigue: Biomedicine, Health & Behavior, 1(4), 223–242. https://doi.org/10.1080/21641846.2013.843266
• Yocum, D. E., Castro, J. R., & Cornett, A. C. (2019). Clinical associations and prognostic implications of the 6-minute walk test in rheumatoid arthritis. Arthritis Care & Research. https://pubmed.ncbi.nlm.nih.gov/31594207/

The Science Behind Chiropractic and Nursing Synergy

The science backing this dynamic duo is as solid as a rock. Chiropractic care works by restoring proper alignment, which reduces pressure on nerves and improves muscle function. Nursing complements this by addressing systemic issues, like inflammation or poor lifestyle habits, that can exacerbate pain. For example:

• Chiropractic Adjustments: These reduce pain by improving spinal alignment and joint mobility, as supported by research on direct access to physical therapy (Ojha et al., 2021).
• Nursing Interventions: Nurses monitor vital signs, assess overall health, and provide education, ensuring that treatments are safe and effective, as mandated by the Texas Nurse Practice Act (Texas Board of Nursing, n.d.).
• Combined Effect: Together, they reduce pain, improve function, and prevent recurrence by addressing both mechanical and systemic factors, like a two-pronged attack on a stubborn enemy.

This synergy is why ChiroMed’s approach is so effective—it’s like having a personal trainer and a nutritionist working together to get you in top shape.

References

• Ojha, H. A., Fritz, J. M., & Maletsky, A. J. (2021). Cost-effectiveness and outcomes of direct access to physical therapy for musculoskeletal disorders compared to physician-first access in the United States: Systematic review and meta-analysis. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/33034809/
• Texas Board of Nursing. (n.d.). CE Broker – Lesson 1: The Texas Nurse Practice Act.

Conclusion: A Serious Note on Your Path to Pain Relief

While we’ve had some fun comparing musculoskeletal pain to annoying neighbors and creaky doors, the journey to pain relief is a serious matter. At ChiroMed – Integrated Medicine in El Paso, Texas, Dr. Alexander Jimenez and his team offer a powerful combination of chiropractic care and nursing to address musculoskeletal pain holistically. By addressing the root causes—whether stemming from injuries, poor posture, or environmental factors—and utilizing non-surgical treatments such as physical therapy, acupuncture, and lifestyle modifications, they help you reclaim your life from pain.

For personal injury victims, Dr. Jimenez’s expertise in advanced imaging, diagnostics, and legal documentation makes him a trusted partner in both recovery and justice. His integrated approach, grounded in ethical guidelines like the Texas Nurse Practice Act, ensures that your care is safe, effective, and tailored to your needs.

Disclaimer: This blog is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider, like Dr. Jimenez, for personalized guidance on your condition. To learn more or schedule a consultation, visit ChiroMed or call +1 (915) 412-6680. Your health is worth it—take the first step today.

References

• Alayat, M. S. M., Mohamed, A. A., Aly, H. M., & Mahmoud, M. A. (2018). The Effects of Isometric Exercise Types on Pain and Muscle Activity in Patients with Low Back Pain. Journal of Back and Musculoskeletal Rehabilitation. https://pubmed.ncbi.nlm.nih.gov/30170511/
• Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: A randomized controlled trial (retro-walking trial). BMC Musculoskeletal Disorders. https://pubmed.ncbi.nlm.nih.gov/31205824/
• Hassett, L., McKay, M., & Cole, M. (2019). Timed Up and Go (TUG) test: Normative reference values for ages 20 to 59 years and relationships with physical and mental health risk factors. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/31594206/
• Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2013). The effect of a single bout of exercise on energy and fatigue states: A systematic review and meta-analysis. Fatigue: Biomedicine, Health & Behavior, 1(4), 223–242. https://doi.org/10.1080/21641846.2013.843266
• Ojha, H. A., Fritz, J. M., & Maletsky, A. J. (2021). Cost-effectiveness and outcomes of direct access to physical therapy for musculoskeletal disorders compared to physician-first access in the United States: Systematic review and meta-analysis. Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/33034809/
• Texas Board of Nursing. (n.d.). CE Broker – Lesson 1: The Texas Nurse Practice Act. 
• Veldman, M. P., Gondin, J., Place, N., & Maffiuletti, N. A. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. European Journal of Applied Physiology. https://pubmed.ncbi.nlm.nih.gov/25156685/
• Warburton, D. E. R., Bredin, S. S. D., & Jamnik, V. K. (2018). When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults. Journal of Physical Activity and Health. https://pubmed.ncbi.nlm.nih.gov/29405824/
• Yocum, D. E., Castro, J. R., & Cornett, A. C. (2019). Clinical Associations and Prognostic Implications of the 6-Minute Walk Test in Rheumatoid Arthritis. Arthritis Care & Research. https://pubmed.ncbi.nlm.nih.gov/31594207/