Pilates Pioneer Square Seattle

Arabesque/Bicycle Mashup

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This vlog is sort of an extension of my previous vlog post on Upstretch. Arabesque is a dynamic exercise and one of my favorites because you achieve both strengthening and stretching during practice of it. Also the dynamics of the movement provide tons of areas where one’s alignment can go wrong, so there is always a lot to focus on. Bicycle is also one of my favorites simply because it is challenging and can get your heart rate up. For those of you who are familiar with conventional gym exercises, Pilates Bicycle on the reformer, is kind of like a really ramped up mountain climber. We see a bit more Arabesque in this mashup than Bicycle, so I’ll have to make a post of Bicycle and some fun variations of it in the future.

Upstretch – Much More Than a Stretch

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Planking is all the rage and with good reason! It strengthens arm, shoulder, abdominal, back, and hip muscles. Want the specifics? Or course you do! The following muscles are utilized during your basic plank when practiced in good form:

  • Transversus abdominis (if you remember to contract it)
  • External obliques
  • Rectus abominus
  • Quadratus lumborum
  • Erector spinae
  • Gluteus medius and minimus
  • Anterior deltoids
  • Pectoralis major
  • Infraspinatus
  • Teres major and minor
  • Serratus anterior
  • Rhomboids
  • Lower trapezius
  • Biceps brachii
  • Brachialis
  • Triceps

That’s an awful lot of muscles for just one exercise and this is with just a basic plank. Think of all the additional muscles groups that are added as you modify your plank. In the video above I am demonstrating one of my favorite planking exercises called up stretch. As you can see, it is really much more than a stretch!

Can Pilates Help Your Yoga Practice?

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Why yes, it can! Really, Pilates enhances one’s performance of any physical activity or sport. This video is of Dr.Oz performing a classic Sun Salutation flow. Dr.Oz does an overall great job of this invigorating sequence and his coach provides some important reminders like to breathe deep and engage your core. With this said there were some elements of Dr.Oz’s flow that deserved some more detailed feedback. For those of you who have taken Pilates, you will recognize this to be an intrinsic and critical element to any Pilates practice – detail. You can think of Pilates instructors as your anatomy, physiology, and kinesiology geeks of the fitness world. This geekery may cause us to be a little on the type-A side, but the best instructors also teach this attention to detail with creativity and empathy. With this said, here is a critique of Dr.Oz’s Sun Salutation through the eyes of your very own Pilates instructor, moi!

Screen Shot 2016-07-18 at 4.40.46 PM

Given the above issues with alignment, here is a list of the corrections that need to be made:

1.      chaturanga dandasana

  • Correction – protract scapulas, pull cervical vertebrae posteriorly as if making a double chin, bend elbows less so they just touch the ribcage.

4.      urdhva mukha – went from dorsiflexion to plantarflexion in both feet simultaneously.

  • Correction – Plantarflex one foot at a time, less general extension to facilitate less lumbar and cervical extension and more thoracic extension.

 

Advanced Breast Stroke

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Today’s vlog post is of an advanced breast stroke variation I developed. My motivations for developing this variation were:

  • To provide greater to challenge to my advanced clients
  • To integrate more dynamic shoulder and arm strengthening into this exercise.

More specifically, I wanted to target muscles that abduct the arm, abduct (or protract) the scapulas, and upwardly rotate (or elevate) the scapulas.

Pro Tip: If you attend training session where the trainer in constantly barking at you to press your shoulders down or squeeze your shoulder blades together no matter what your arm position is, think twice about this. Remember that as your arms move, in order to maintain glenohumeral congruency (i.e.- safe and strong shoulders) the position of your scapulas should reflect the position of your arms to a certain extent.

 

Motherhood, Leaky Bladders, and Back Pain – Part 2

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In last week’s blog post, “Motherhood, Leaky Bladders, and Back Pain – Part 1” I introduced the musculoskeletal structures of the pelvic diaphragm and their purpose. This week’s follow-up post will cover:

  • Correlation Between Chronic Back Pain and Stress Urinary Incontinence
  • Pelvic Diaphragm Facilitation and Multifidus Facilitation
  • Exercises to identify the Muscles of the Pelvic Diaphragm!!!
  • Exercises to Strengthen Muscles of the Pelvic Diaphragm

Correlation Between Chronic Back Pain and Stress Urinary Incontinence

Research has established the role that the pelvic diaphragm muscles play in continence.  Given that the pelvic diaphragm muscles facilitate sacroiliac joint stability, which in turn support lumbar vertebral column stability, one could hypothesize that there is a positive correlation between chronic back pain and stress urinary incontinence.  That is, the likelihood of having stress urinary incontinence is increased if one suffers from chronic back pain.

Bush et al., (2013), conducted a survey of 2,341 women who suffered from chronic back pain and found that 44% of these women also suffered from stress urinary incontinence (p.4).  Furthermore, Bush et al., (2013), references multiple studies with similar findings:

Finkelstein et al reported a strong association between “back problems” and UI in both men and women.  A cross-sectional study of women only by Smith et al found a relationship between continence disorders and back pain “in the past 12 months.”  In addition, Kim et al found women with greater UI severity also have a higher perceived severity of LBP and LBP perceived disability.  Lastly, Elliason et al surveyed women who were receiving physical therapy for LBP and reported 78% of these women also reported UI  (Bush, Pagorek, Kuperstein, Guo, Ballert, and Crofford, 2013, p.2).

Multifidus
Multifidus

Pelvic Diaphragm Facilitation and Multifidus Facilitation

Multifidus originates at the sacrum, the posterior superior iliac spine, the mammillary processes of the lumbar vertebrae, the transverse processes of the thoracic vertebrae, and the articular process of C04-C07.  It inserts to the spinous process two to four vertebrae superior from it’s origin.  According to Martini, Nath, Bartholomew (2012), it’s action is to extend the vertebral column and rotate towards the opposite side (p.341).

A study involving thirteen men and women who had chronic low back pain was conducted by Huang et al.  The goal of this study was to investigate the effects of an intervention that involved: 1) proprioceptive neuromuscular facilitation, 2) neuromuscular joint facilitation, and 3) neuromuscular joint facilitation combined with pelvic diaphragm muscle exercises.  According to Huang et al. (2013), neuromuscular joint facilitation combined with pelvic diaphragm exercises produced the greatest multifidus change (p.813).  Huang et al. (2013), speculates that while neuromuscular joint facilitation promoted isometric contractions of the multifidus, the pelvic floor exercises promoted increased intraabdominal pressure, thereby increasing lumbopelvic stability and enhancing the effectiveness of multifidus (p.813).

Case Study

Jellad, Bouzaouache, Salah, Migaou, & Sana (2009), conducted a case study in which they designed a rehabilitation program for a patient suffering from osteoarthritis of the sacroiliac joint.  The rehabilitation program involved strengthening the transversus abdominis, internal obliques, coccygeus, pubococcygeus, and iliococcygeus, as well as stretching psoas (p.511).  The program was found to have a positive effect on reducing the patient’s pain and functional impairments.

Exercises to identify the Muscles of the Pelvic Diaphragm!!!

Calais-Germain (2003) recommends the following two exercises for identifying muscles of the pelvic diaphragm:

  1.  Balloon Exercise
    1. While sitting, pretend you are blowing into a balloon.  Look to identify one of the three possible pelvic region responses:
      1. blowing caused the urge to urinate
      2. blowing caused the pelvic floor to be pushed down
      3. blowing caused the pelvic floor to draw up (p.104)

Calais-Germain (2003), notes that the urge to urinate is symptomatic or weak pelvic diaphragm, while the drawing up sensation is symptomatic of well-toned pelvic diaphragm (p.105).

  1. Face Cloth Exercise
    1. Fold a small face cloth into quarters.  Place the folded cloth between the two ischia, and between the coccyx and the pubis.
    2. Notice  pelvic sensations during normal breathing and while practicing the balloon exercise in this position.

Exercises to Strengthen Muscles of the Pelvic Diaphragm

Calais-Germain (2003) recommends the following exercises for strengthening muscles of the pelvic diaphragm:

  1. In a sitting, or supine-crook position, visualize your two ischia and your pubic symphysis.  From here mentally visualize two inches above the ischias and pubic symphysis.  Now, draw theses two areas of visualization upward and inward.
  2. Contract your anal sphincter.  Notice how it constricts and draws up.  Now, try to contract your anal sphincter without constricting it, but just drawing it up.
  3. After performing the above exercises, relax completely and feel the weight of pelvic organs dilate.

The research suggesting that pelvic diaphragm muscles enhance lumbopelvic stability is convincing.  Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders (2008) showed a decrease in sacroiliac joint shear force by 20% with a 400% increase of transversus abdominis and pelvic diaphragm muscles (p.415).   Additionally, Bush et al. showed that nearly one-half of women who suffer from chronic low-back pain also suffer from urinary incontinence (p.4).  Huang et al (2013), suggests that the compressive forces that the pelvic diaphragm muscles can exert between the coxal bones and the scarum enhance lumbar vertebral and trunk stability (p.813).  Lastly, Jellad, Bouzaouache, Salah, Migaou, & Sana (2009) successfully applied a rehabilitation protocol for a women suffering from sacroiliac joint pain that involved pelvic diaphragm exercises (p.511).

That’s it ladies (and gents) not only will strengthening your pelvic floor muscle recover urinary incontinence it will also enhance lower back strength. Get to it, find those pelvic floor muscles and when you can, incorporate pelvic floor contractions into whatever exercises you are working on, whether that be supine ab exercises, standing arm exercises, leg exercises like squats, or whatever. Now, onward, upward, and inward!

References

Bush, H. M., Pagorek, S., Guo, J., Ballert, K. N., & Crofford, L. J.  (2013).  The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study.  Journal of women’s health physical therapy, 37(1), p.11-18.  doi: 10.1097/JWH.0b013e31828c1ab3

Calais-Germain, B.  (2003).  The Female Pelvis: Anatomy & Exercises.  Seattle, Wa.: Eastland Press Inc.

Floyd, R.T.  (2012).   Manual of Structural Kinesiology.  New York, NY: McGraw Hill.

Huang , Q., Li, D., Yokotsuka, N., Zhang, Y., Ubukata, H., Huo, M., & Maruyama, H.  (March 1 2013).  The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle.  Journal of Physical Therapy Science, 25(7), p.811-813.  doi: 10.1589/jpts.25.811

Jellad, A.,  Bouzaouache, H., Ben Salah, Z., & Sana, S. (July 2009).  Osteoarthritis of the sacroiliac joint complicating resection of the pubic symphysis. Interest of a rehabilitation programme.  Annals of Physical and Rehabilitation Medicine, 52(6), p.510-517.  doi: 10.1016/j.rehab.2009.03.002

Martini, F. H., Nath J. L., & Bartholomew, E. F.  (2012).  Introduction to Anatomy and Physiology.  San Francisco, CA: Pearson Education Inc.

Nestor, K.  (n.d.).  Sacroiliac Joint.  Physiopedia.  Retrieved from: http://www.physio-pedia.com/Sacroiliac_joint.

Pel, J. J. M., Spoor, C. W., Pool-Goudzwaard, A. L., Hoek Van Dijike, G. A., & Snijders, C. J.  (18 January 2008).  Biomechanical Analysis of Reducing Sacroiliac Joint Shear Load by Optimization of Pelvic Muscle and Ligament Forces.  Annals of Biomedical Engineering, 36(3), p. 415-424.  doi: 10.1007/s10439-007-9385-8

Visible Body Software.  (2014).  [All images].

Motherhood, Leaky Bladders, and Low Back Pain – Part 1

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I recently mentioned that I am a new mother. Becoming a mother has been the best thing that has ever happened to me. So much joy, anticipation, and learning to be had. Of the many things that women anticipate through their journey of pregnancy and motherhood are the physical changes that lay ahead. I have personally always thought that pregnant women are the most beautiful, perhaps it’s the delight of life blossoming within us that shines through somehow. With this said, I actually really enjoyed being pregnant, both emotionally and physically. After my sons birth and the day after our discharge from the hospital I immediately started taking daily walks and doing very gentle rehab oriented Pilates. I took it slowly initially as I could feel that my pelvis had sustained some serious changes; it literally felt like my coxal bones were less attached to my sacrum. I felt physically ready to return to my pre-pregnancy physical activities at about 5 weeks postpartum, but wasn’t emotionally ready to leave my babe, so I waited until 8 weeks to return to my pre-pregnancy exercise routine. Enter more anticipation. What I wondered most was how my pelvic floor would hold up during plyometric exercises such as jumping jacks and burpees. It did not. I totally peed myself in kickboxing. As I continued to get back in shape and focus on pelvic floor rehabilitation I gradually leaked less and less during plyometrics and by around 3 months postpartum was able to perform jumping jacks with zero leakage.

This brings me to my main point, the importance of pelvic floor rehabilitation for postpartum mothers, not only so they can perform jumping jacks without peeing themselves, but also because the pelvic floor muscles play an important role in back stability and strength. For the remainder of this post I will introduce:

  • Skeletal Structures of the Sacroiliac Joint
  • Skeletal Structures of the Lumbar Vertebral Column
  • Muscles of the Pelvic Diaphragm (with images, so you have something to visualize when your Pilates or yoga instructor cues this evasive and mysterious muscle group)
  • The Purpose of the Sacroiliac Joint
  • How the Muscles of the Pelvic Diaphragm Support Sacroiliac Joint Stability

Next week, I will post Motherhood, Leaky Bladders, and Low Back Pain Part Two. In this post I will cover:

  • Correlation Between Chronic Back Pain and Stress Urinary Incontinence
  • Pelvic Diaphragm Facilitation and Multifidus Facilitation
  • Exercises to identify the Muscles of the Pelvic Diaphragm
  • Exercises to Strengthen Muscles of the Pelvic Diaphragm

Now please bear with me as I take on a much more formal tone… 🙂

SI Joint
Sacroilliac Joint

Skeletal Structures of the Sacroiliac Joint

The sacroiliac joint is a large diarthrodial joint comprised of the lateral surfaces of the sacrum and the medial surfaces of the iliums of the coxal bones.  The areas of articulation are known as the auricular surfaces.  The auricular surfaces are textured with symmetrical ridges and depressions which facilitate stability and guard against vertical shear forces.  According to Nestor, the motions of the sacroiliac joint involve two to four millimeters of nutation and counternutation.  During nutation the superior surface of the sacrum moves anteriorly and inferiorly while the coccyx moves posteriorly.  During counternutation, the superior surface of the sacrum moves posteriorly as the coccyx moves anteriorly.

Lumbar Vertebral Column
Lumbar Vertebral Column

Skeletal Structures of the Lumbar Vertebral Column

The lumbar vertebral column consists of 5 articulating vertebrae which sit just superior to the sacrum.  According to Floyd (2012), the lumbar spine is responsible for the majority of trunk  movement as it flexes eighty degrees, extends twenty to thirty degrees, laterally flexes thirty-five degrees, and rotates forty-five degrees (p .333).

Muscles of the Pelvic Diaphragm

The primary muscles of the pelvic diaphragm are coccygeus, iliococcygeus, pubococcygeus, and the external anal sphincter (Martini, Nath, Bartholomew, 2012, p. 347).  For the purposes of this article, it is only necessary to examine coccygeus, iliococcygeus, and pubococcygeus

coccygeus
Coccygeus

Coccygeus

Coccygeus originates at the ischial spine and the sacrospinous ligament and it inserts at the lateral and inferior borders of the sacrum and coccyx.  It’s action is to flex the coccygeal joints, tense the pelvic floor, and support the pelvic viscera (Martini, Nath, Bartholomew, 2012, p. 347).

Illiococcygeus
Illiococcygeus

 

Iliococcygeus

Iliococcygeus originates at the ischial spine and the tendinous arch that runs along the obturator internus fascia.  It then inserts at the coccyx and anococcygeal raphe.  It’s action is to flex the coccygeal joint, tense the pelvic floor, and elevate and retract the anus (Martini, Nath, Bartholomew, 2012, p. 347).

Pubbococcygeus
Pubbococcygeus

 

Pubococcygeus

Pubococcygeus originates at the inner margins of the pubis and from the anterior part of the obturator fascia.  It then inserts onto the side of the anal canal towards the coccyx and sacrum.  It’s action, like iliococcygeus, is to flex the coccygeal joint, tense the pelvic floor, and elevate and retract the anus (Martini, Nath, Bartholomew, 2012, p. 347).

The Purpose of the Sacroiliac Joint

The vertebral column and trunk are supported by the sacrum, and in turn, the sacrum is supported by the two coxal bones.  Given this, the primary role of the sacroiliac joint is to support the weight of the body, transmit forces from the upper body to lower body, and to provide shock absorption against vertical shear forces that may occur during spinal loading or movements such as walking or jumping.

How Muscles of the Pelvic Diaphragm Support Sacroiliac Joint Stability

According to Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders (2008), vertical sacroiliac joint shear is reduced by transversely oriented pelvic muscles that increase the interlocking and compressive forces between the coxal bones and the sacrum (p. 415).  Research conducted by Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders (2008), suggests that contraction of transversus abdominis along with muscles of the pelvic diaphragm can increase compressive forces of the sacroiliac joint by 400%, producing a reduction in sacroiliac joint shear force by 20% (p. 415).

The pelvic floor muscles, M. coccygeus, and M pubococcygeus, and iliococcygeus, contribute to the stabilization with respect to the sacrum.  It has been suggested that this stabilization by force closure has an analogy with a classical stone arc.  When sideways displacement of both ends of the arc is opposed, mechanical equilibrium of the stones is achieved by compression forces and not by shear forces.  In the pelvis, the pelvic floor muscles may help coxal bones to support the sacrum by compression forces, while shear forces between the sacrum and coxal bones are minimized  (Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders, 2008, p. 419-420).

 

 

References

Bush, H. M., Pagorek, S., Guo, J., Ballert, K. N., & Crofford, L. J.  (2013).  The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study.  Journal of women’s health physical therapy, 37(1), p.11-18.  doi: 10.1097/JWH.0b013e31828c1ab3

Calais-Germain, B.  (2003).  The Female Pelvis: Anatomy & Exercises.  Seattle, Wa.: Eastland Press Inc.

Floyd, R.T.  (2012).   Manual of Structural Kinesiology.  New York, NY: McGraw Hill.

Huang , Q., Li, D., Yokotsuka, N., Zhang, Y., Ubukata, H., Huo, M., & Maruyama, H.  (March 1 2013).  The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle.  Journal of Physical Therapy Science, 25(7), p.811-813.  doi: 10.1589/jpts.25.811

Jellad, A.,  Bouzaouache, H., Ben Salah, Z., & Sana, S. (July 2009).  Osteoarthritis of the sacroiliac joint complicating resection of the pubic symphysis. Interest of a rehabilitation programme.  Annals of Physical and Rehabilitation Medicine, 52(6), p.510-517.  doi: 10.1016/j.rehab.2009.03.002

Martini, F. H., Nath J. L., & Bartholomew, E. F.  (2012).  Introduction to Anatomy and Physiology.  San Francisco, CA: Pearson Education Inc.

Nestor, K.  (n.d.).  Sacroiliac Joint.  Physiopedia.  Retrieved from: http://www.physio-pedia.com/Sacroiliac_joint.

Pel, J. J. M., Spoor, C. W., Pool-Goudzwaard, A. L., Hoek Van Dijike, G. A., & Snijders, C. J.  (18 January 2008).  Biomechanical Analysis of Reducing Sacroiliac Joint Shear Load by Optimization of Pelvic Muscle and Ligament Forces.  Annals of Biomedical Engineering, 36(3), p. 415-424.  doi: 10.1007/s10439-007-9385-8

Visible Body Software.  (2014).  [All images].  

 

 

First Vlog – The Teaser!

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Over the past year or so I began video documenting myself performing various Pilates exercises. The purpose of this is 3-fold: 1) to document exercise ideas, 2) to serve as a visual tool in finessing these exercise ideas, and 3) to critique my own form during certain exercises. I returned to teaching from maternity leave recently and found myself visiting some of these videos for inspiration. While reviewing these videos I thought why not share these with the world? They offer an interesting peek at the exercise creation process, plus show off some of the fun exercises that Bodytonic Pilates clients perform.

My video debut features advanced Teaser variations. I start with the Teaser simply because it is a classic. I created this particular video more so to critique my own form as the variations seen in this video have long been in my advanced clients repertoire. The video starts out with me performing a few basic teasers, then I gradually move through a few advanced variations. I never intended for anyone to watch these videos aside from myself, so please forgive funny hairdos and faces. 🙂

My main critique to myself:

  1. Slow down. 🙂 (something I frequently ask of my clients)
  2. Be more mindful of harnessing iliopsoas with regards to hip versus lumbar flexion.

Now for a little anatomy geek-out. Iliopsoas is a group of muscles: iliacus, psoas major, and psoas minor. Iliacus flexes the hip, rotates the pelvis anteriorly, rotates the hip externally, and creates transverse pelvic rotation contralaterally when the ipsilateral femur is stabilized. Psoas major and minor does all that iliacus does, plus flexes the lumbar spine, laterally flexes the spine, and rotates the pelvis laterally to the contralateral side. During this teaser I needed to tease out lumbar flexion from hip flexion to create more lumbar stability. Pun intended. Hardy-har-har!

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Back to School Special 3 Privates/$99

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Back to School Special! Back-to-School

3 Privates for $99

To help you settle back into your fall routine we are offering a special package of 3 private lessons for $99. This package serves as great introduction to Pilates or is a great way to dust off your Pilates bones if it’s been awhile since we’ve seen you.

Offer valid for first time clients & for clients returning from a 3+ month hiatus from the studio (AKA summer vacays).

Offer Valid until 10/31/14.

Contact us to Schedule your Appointment Today!

Too little movement or too much food?

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Take a Booster Break!

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booster breakHow do you spend your work breaks?  Do you find yourself munching on M&Ms, smoking a cigarette, or even working more?  A qualitative analysis conducted at the University of Texas investigated the effectiveness of structured work-break activities designed to enhance physical and psychological health.

The study involved 35 subjects across 5 worksites and was conducted over a period of 6 months to one year.   While Booster Breaks may involve physical activity, meditation, and rhythmic breathing, this study focused on using physical activity oriented breaks to reduce sedentary behavior.  Subjects were required to participate in one 15-minute physical activity booster break per work day.  Researchers found three themes among the subjects response:

  • Reduced stress and increased workplace enjoyment.

  • Increased health awareness and facilitate positive behavior changes outside of the workplace.

  • Enhanced interpersonal relationships with coworkers.

Subjects noted two barriers to participation in the interventions:

  • Desire for greater variety in intervention’s activities.

  • Lack of permission, encouragement, and support from managers and supervisors.

To support workplace health promotion, Bodytonic Pilates is now offering 30-minute private sessions!  We hope your bosses support you in creating a healthier, happier, and more efficient workplace.   See our rates page for more pricing details.  For a limited time we will be offering a booster break promotion:

3 30-minute private lessons for $99!

 

References

Taylor W. C., King K. E.,  Shegog R., Paxton R. J., Evans-Hudnall G. L., Rempel D. M., Chen V., Yancey A. K. (2013).  Booster Breaks in the workplace: participants’ perspectives on health-promoting work breaks.  Oxford University Press Health Education Research, 28(3), 414-425.   doi:  10.1093/her/cyt001

 

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