Publications
Publications
2022 |
Tatsios, P. I.; Grammatopoulou, E.; Dimitriadis, Z.; Papandreou, M.; Paraskevopoulos, E.; Spanos, S.; Karakasidou, P.; Koumantakis, G. A. In: Diagnostics (Basel), vol. 12, no. 7, 2022, ISSN: 2075-4418 (Print) 2075-4418, (2075-4418 Tatsios, Petros I Grammatopoulou, Eirini Dimitriadis, Zacharias Papandreou, Maria Paraskevopoulos, Eleftherios Spanos, Savvas Karakasidou, Palina Koumantakis, George A). Abstract | Links | BibTeX | Tags: LAdPhyss 2; breathing exercises; breathing re-education; chronic neck pain; diaphragm; manual therapy; respiratory dysfunction @article{nokey, Patients with nonspecific chronic neck pain (NSCNP) exhibit respiratory dysfunction. This systematic review aimed to analyze randomized controlled trials (RCTs) investigating the effect of spinal and/or diaphragmatic and/or specific stabilization exercise manual therapy and/or respiratory exercises on musculoskeletal and respiratory diagnostic outcomes in patients with NSCNP. A systematic search and selection of RCTs was performed in three scientific databases (Pubmed, Scopus, and Physiotherapy Evidence Database (PEDro)) and one search engine (Google Scholar) from inception to April 2022. Relevant studies published in the English language were extracted, evaluated, and independently rated for methodological quality (PEDro scale). The quality of the evidence was assessed with the GRADE approach. Out of 1089 studies collected in total, 1073 were excluded (i.e., did not meet the inclusion criteria or were duplicates). Sixteen RCTs were finally included, rated on 5.62/10 (PEDro score) on average for methodological quality. Overall, there was sparse evidence that spinal and/or diaphragmatic manual therapy and/or trunk stabilization exercises and/or respiratory exercises significantly improved pain, disability, and respiratory outcomes in patients with NSCNP immediately post-treatment. However, the clinical heterogeneity between studies was significant, and the level of certainty of the evidence was low to very low. More, high-quality RCTs are required, contributing to the holistic diagnostic monitoring and management of patients with NSCNP. |
Kontakiotis, N.; Rushton, A. B.; Billis, E.; Papathanasiou, G.; Gioftsos, G. In: BMJ Open, vol. 12, no. 1, pp. e052119, 2022, ISSN: 2044-6055, (2044-6055 Kontakiotis, Nikolaos Rushton, Alison B). Abstract | Links | BibTeX | Tags: back pain; pain management; rehabilitation medicine @article{nokey, INTRODUCTION: Sciatica is one of the most common reasons for seeking healthcare for musculoskeletal pain. Sciatica is primarily considered as neuropathic in nature when neural tissue in the low back is compromised, but sometimes other non-neural structures may be involved. Appropriate assessment and management are important for patients with sciatica. Therapists use several outcome measures to assess patients to inform selection of the most suitable treatment. There is limited evidence for the best treatment of sciatica, and this is likely contributed to by having no reliable algorithm to categorise patients based on their clinical characteristics to inform physiotherapy treatment. The purpose of this study is to develop a clinical prediction model to categorise patients with sciatica, in terms of early clinical outcome, based on their initial clinical characteristics. METHODS AND ANALYSIS: A prospective observational multicentre design will recruit consecutive patients (n=467) with sciatica referred for physiotherapy. Each patient will be evaluated to determine whether or not they will be accepted into the study by answering some questions that will confirm the study's eligibility criteria. Patients' basic characteristics, patient-reported outcome measures and performance-based measures will be collected at baseline from multiple sites in the Greek territory using this same protocol, prior to commencement of treatment. The main researcher of this study will be responsible for data collection in all sites. On completion of the standard referred physiotherapy treatment after 3 weeks' time, participants will be asked by telephone to evaluate their outcome using the Global Perceived Effect Scale. For the descriptive statistical analysis, the continuous variables will be expressed in the form of 'mean' and 'SD'. In order to assess the prognostic value of each predictor, in terms of the level of improvement or worsening of the symptoms, multiple variable regression analysis will be used. ETHICS AND DISSEMINATION: Τhis study is approved from the Ethics and Deontology Committee of the University of West Attica, Athens, Greece, protocol number: 38313-09/06/2020, 10226-10/02/2021. The study's findings will be published in a peer-reviewed journal and disseminated at national and international conferences and through social media. PROSPERO REGISTRATION NUMBER: CRD42020168467. |
Chrysagis, N.; Koumantakis, G. A.; Theotokatos, G.; Skordilis, E. In: Human Movement, vol. 23, no. 4, 2022, ISSN: 1899-1955. Links | BibTeX | Tags: locomotion; mobility; ambulation; circuit training; diplegia; tetraplegia @article{nokey, |
Krekoukias, G.; Koumantakis, G. A.; Nikolaou, V. S.; Soultanis, K. Study on the Reliability and Accuracy of Scolioscope, a New Digital Scoliometer Journal Article In: Diagnostics, vol. 12, no. 1, 2022, ISSN: 2075-4418. Abstract | Links | BibTeX | Tags: scoliometer; reliability; accuracy; scolioscope; school screening @article{nokey, Early detection of scoliosis with school screening and quick, easy, and reliable assessment of its progress are of paramount importance in the management of patients. There have been several tools described, with the most common being the analog scoliometer. Most recently, smartphone applications have entered this area with and without the use of sleeves for the device. There is no research that has evaluated the accuracy of measurements both left and right in either digital or analog devices. In this study, we evaluated the reliability and validity of a new digital scoliometer called the Scolioscope. Thirty subjects were included for the intra-rater reliability study. ICC values >0.9 were calculated both for same-day and between-day measurements. The device was highly accurate with an average difference from the ones set on the sine bar of 0.03 deg for right-side measurements and 0.18 deg for the left. These measurements suggest a highly accurate and reliable tool. |
Paraskevopoulos, E.; Simeonidis, T.; Tsolakis, C.; Koulouvaris, P.; Papandreou, M. The adjunctive benefits of mirror cross education on kinetic chain exercise approach in volleyball athletes with scapular dyskinesis Journal Article In: J Sports Med Phys Fitness, vol. 62, no. 1, pp. 98-109, 2022, ISSN: 0022-4707, (1827-1928 Paraskevopoulos, Eleftherios Simeonidis, Theocharis Tsolakis, Charilaos Koulouvaris, Panagiotis Papandreou, Maria Journal Article Italy J Sports Med Phys Fitness. 2021 Feb 22. doi: 10.23736/S0022-4707.21.12174-7.). Abstract | Links | BibTeX | Tags: athletes; volleyball; postural balance @article{nokey, BACKGROUND: Volleyball players as overhead athletes have the highest risk of developing Scapular Dyskinesis. The kinetic chain exercise-approach has gained a lot of attention because of its claims to provide an improved motor control and scapular kinematics. A form of cross exercise, known as mirror therapy, may enhance the effects of a Kinetic-Chain-Approach on scapular posture, upper and lower limb performance. The aim of this study was to investigate the adjunctive benefits of Mirror-Cross-Education in a Kinetic-Chain-Approach, in volleyball athletes with SD. METHODS: 39 professional volleyball athletes were randomly assigned to three groups of 13 each, two experimental, the Mirror-Cross-Education and Kinetic-Chain-Approach, and one control. Both experimental groups performed a Kinetic-Chain-Approach programme, however, the Mirror-Cross-Education group performed the exercise programme with the addition of two mirrors that allowed athletes to observe their opposite non-dyskinetic scapula. Scapular posture asymmetries in cm, the Y-Balance and the Upper-Quarter YBalance after normalizing by limb length the reach distance in each direction, were assessed before and after performing each intervention for 6 weeks. RESULTS: 3x2 two-way Mixed ANOVAs detected significant interactions on scapular posture (p=0.001) on both experimental groups when compared with the control. The Y-Balance and the Upper Quarter Y-Balance scores at both Mirror-Cross-Education and Kinetic-Chain-Approach groups showed significant differences when compared with the control (p<0.05). Overall, variables showed significant superiority of the Mirror-Cross-Education group. CONCLUSIONS: The Mirror-Cross-Education demonstrated significant effects in scapular posture and in the functional balance tests of volleyball athletes with Scapular Dyskinesis. |
Paraskevopoulos, E.; Simeonidis, T.; Tsolakis, C.; Koulouvaris, P.; Papandreou, M. Mirror Cross-Exercise on a Kinetic Chain Approach Improves Throwing Performance in Professional Volleyball Athletes With Scapular Dyskinesis Journal Article In: J Sport Rehabil, vol. 31, no. 2, pp. 131–139, 2022, ISSN: 1056-6716, (1543-3072 Paraskevopoulos, Eleftherios Simeonidis, Theocharis Tsolakis, Charilaos Koulouvaris, Panagiotis Papandreou, Maria Journal Article Randomized Controlled Trial United States J Sport Rehabil. 2022 Feb 1;31(2):131–139. doi: 10.1123/jsr.2021-0103. Epub 2021 Oct 6.). Abstract | Links | BibTeX | Tags: biomechanics; shoulder complex; trunk/core @article{nokey, CONTEXT: Volleyball players have shown to be at an increased risk of developing scapular dyskinesis. The kinetic chain exercise approach has gained a lot of attention because of its claims to provide an improved motor control and scapular kinematics. A form of cross exercise, known as mirror therapy, may enhance the effects of a kinetic chain exercise approach in throwing performance. OBJECTIVE: To examine the effects of mirror cross exercise (MCE), based on a kinetic chain exercise approach in the throwing performance of volleyball athletes with scapular dyskinesis. DESIGN: Randomized controlled trial. SETTING: Biomechanics laboratory. METHODS: 39 volleyball players with scapular dyskinesis were randomly allocated into 3 groups. The first group completed a 6-week kinetic chain approach (KCA group), the second group completed a kinetic chain exercise approach program in addition to MCE group, and the control group followed only their regular training program. Before and after delivering both interventions, throwing accuracy, speed, and force were determined while measuring the ground reaction forces of the drive leg during throwing. Two-way mixed analysis of variance investigated the effects of intervention and time and their interaction. RESULTS: The results showed intervention × time statistically significant interactions for throwing accuracy, speed, and force for the MCE and the KCA groups. Over the 6-week training period, the MCE and the KCA groups showed significant improvements in throwing accuracy (P < .01) and speed (P < .01), while the ground reaction forces did not change (P > .05). Throwing force increased significantly in the MCE group (P = .01). Between-group comparison showed statistically significant improvements in the throwing accuracy for the MCE and KCA groups against the control group (P < .01) at posttesting. The MCE demonstrated superior results over the KCA in the aforementioned measures. CONCLUSIONS: This study suggests that the addition of MCE in a KCA program enhances energy transfer throughout the distal and proximal segments, thus improving kinetic chain recruitment and potentially preventing shoulder pathology. |
Samaras, P.; Karanasios, S.; Stasinopoulos, D.; Gioftsos, G. Greek physiotherapists' contemporary knowledge and practice for lateral elbow tendinopathy: An online survey Journal Article In: Musculoskelet Sci Pract, vol. 57, pp. 102502, 2022, ISSN: 2468-7812, (2468-7812 Samaras, Panagiotis Karanasios, Stefanos Stasinopoulos, Dimitrios Gioftsos, George Journal Article Netherlands Musculoskelet Sci Pract. 2022 Feb;57:102502. doi: 10.1016/j.msksp.2022.102502. Epub 2022 Jan 5.). Abstract | Links | BibTeX | Tags: Evidence; Lateral elbow tendinopathy; Physiotherapy; Practice; Surveys and Questionnaires @article{nokey, OBJECTIVES: To investigate physiotherapists' current knowledge and practice in the management of patients with lateral elbow tendinopathy, to explore associations between the participants' education and management preferences and to identify potential evidence-to-practice gaps by making comparisons with recent research recommendations. DESIGN: An on-line cross-sectional survey. SUBJECTS: Registered physiotherapists working in Greece with previous experience in the management of lateral elbow tendinopathy. RESULTS: Three hundred and seventy eight responses met the inclusion criteria. Most responders (70.4%-91.5%) use pain provocation tests for the diagnosis of the condition, while a limited proportion uses patient rated outcome measures (6.9%-13%). Supervised exercise is the mainstay of rehabilitation (92.6%), followed by adjunctive research recommended treatment techniques such as manual therapy (72%) and advice (59.5%). Up to 83.6% of participants use adjunctive treatment techniques that are not recommended or without research recommendation (such as electrophysical agents, ice etc.). Physiotherapists with post-graduate education in musculoskeletal physiotherapy are almost three times more likely to choose only research recommended treatment approaches. There is a lack of consensus in an optimal exercise programme (type, volume, duration etc.) in patients with lateral elbow tendinopathy. CONCLUSION: Despite research recommendations a limited use of patient rated outcome measures in lateral elbow tendinopathy is recorded. Supervised exercise is the first line treatment option for most physiotherapists, although the optimal application is still unclear. A large proportion of physiotherapists apply adjunctive treatment techniques that are either ineffective or poorly researched suggesting a substantial evidence-to-practice gap. Better access to knowledge, organisational and peer-support can potentially help to bridge this gap. |
Moutzouri, M.; Gioftsos, G. In: PLoS One, vol. 17, no. 5, pp. e0268652, 2022, ISSN: 1932-6203, (1932-6203 Moutzouri, Maria Gioftsos, Georgios). Abstract | Links | BibTeX | Tags: @article{nokey, Due to the chronic nature of knee osteoarthritis (KOA) self-management is considered an essential part of therapy to improve physical function, activity, pain and quality of life (QoL). Web-based rehabilitation may be a potential innovative mode of patient' training to guide management compared to usual care, especially with the current restrictions pandemic imposed. Moreover, in order to alter KOA patients' behavior towards physical activity (PA), it may be more attractive and motivating to combine within their rehabilitation program, outdoor real life local activity that could feasible to be sustained in the future. Aim of the current study is to evaluate the effects of a blended web-based rehabilitation compared with structured PA alone in patients with KOA. This is a randomized multi-center study with two prospective arms. Fifty-six eligible participants with KOA will be recruited from the West Attica region (considered as structurally weak areas). After a comprehensive face-to face training session, participants will follow a 6-week web-based rehabilitation program, consisting of exercise, advice material enhanced outdoor structured PA. The control group will be encouraged to follow the outdoor structured PA alone. Baseline, 6-week and 12-week follow up assessments will be performed. The primary outcome is self-reported physical function as measured by the Knee Injury Osteoarthritis Outcome Score (KOOS). Secondary measures include pain, function (Timed Up and Go Test, Sit to Stand test), PA levels (Lower Extremity Activity Scale, Baecke Scale and pedometer), psychological perspective (Tampa Scale of Kinesiophobia) and health-related QoL (Short-Form 12). Baseline-adjusted Analysis of Variance will be used to test for group differences in the primary and secondary outcomes. The study will evaluate the blended web-based exercise and advice material, enhanced with outdoor PA in many respects compared to the outdoor PA alone so as to promote self-management care programs for KOA patients. Trial registration: Prospectively registered ISRCTN12950684 (27-09-2020). |
Karanasios, S.; Koutri, C.; Moutzouri, M.; Xergia, S. A.; Sakellari, V.; Gioftsos, G. In: Sports Health, vol. 14, no. 5, pp. 717-724, 2022, ISSN: 1941-7381 (Print) 1941-0921, (1941-0921 Karanasios, Stefanos Koutri, Charikleia Moutzouri, Maria Xergia, Sofia A Sakellari, Vasiliki Gioftsos, George Journal Article Randomized Controlled Trial Sports Health. 2022 Sep-Oct;14(5):717-724. doi: 10.1177/19417381211043877. Epub 2021 Sep 13.). Abstract | Links | BibTeX | Tags: LAdPhyss 2 ;Kaatsu training; arterial occlusion; blood flow restriction training; reliability @article{nokey, BACKGROUND: The precise calculation of arterial occlusive pressure is essential to accurately prescribe individualized pressures during blood flow restriction training. Arterial occlusion pressure in the lower limb varies significantly between different body positions while similar reports for the upper limb are lacking. HYPOTHESIS: Body position has a significant effect in upper limb arterial occlusive pressure. Using cuffs with manual pump and a handheld Doppler ultrasound can be a reliable method to determine upper limb arterial blood flow restriction. STUDY DESIGN: A randomized repeated measures design. LEVEL OF EVIDENCE: Level 3. METHODS: Forty-two healthy participants (age mean ± SD = 28.1 ± 7.7 years) completed measurements in supine, seated, and standing position by 3 blinded raters. A cuff with a manual pump and a handheld acoustic ultrasound were used. The Wilcoxon signed-rank test with Bonferroni correction was used to analyze differences between body positions. A within-subject coefficient of variation and an intraclass correlation coefficient (ICC) test were used to calculate reproducibility and reliability, respectively. RESULTS: A significantly higher upper limb arterial occlusive pressure was found in seated compared with supine position (P < 0.031) and in supine compared with standing position (P < 0.031) in all raters. An ICC of 0.894 (95% CI = 0.824-0.939, P < 0.001) was found in supine, 0.973 (95% CI = 0.955-0.985, P < 0.001) in seated, and 0.984 (95% CI = 0.973-0.991, P < 0.001) in standing position. ICC for test-retest reliability was found 0.90 (95% CI = 0.814-0.946, P < 0.001), 0.873 (95% CI = 0.762-0.93, P < 0.001), and 0.858 (95% CI = 0.737-0.923, P < 0.001) in the supine, seated, and standing position, respectively. CONCLUSION: Upper limb arterial occlusive pressure was significantly dependent on body position. The method showed excellent interrater reliability and repeatability between different days. CLINICAL RELEVANCE: Prescription of individualized pressures during blood flow restriction training requires measurement of upper limb arterial occlusive pressure in the appropriate position. The use of occlusion cuffs with a manual pump and a handheld Doppler ultrasound showed excellent reliability; however, the increased measurement error compared with the differences in arterial occlusive pressure between certain positions should be carefully considered for the clinical application of the method. STRENGTH OF RECOMMENDATIONS TAXONOMY (SORT): B. |
Karanasios, S.; Korakakis, V.; Diochnou, A.; Oikonomou, G.; Gedikoglou, I. A.; Gioftsos, G. Cross cultural adaptation and validation of the Greek version of the Western Ontario Rotator Cuff (WORC) index Journal Article In: Disabil Rehabil, pp. 1-10, 2022, ISSN: 0963-8288, (1464-5165 Karanasios, Stefanos Korakakis, Vasileios). Abstract | Links | BibTeX | Tags: LAdPhyss 2; WORC; patient-reported outcome measure; psychometric properties; quality of life; rotator cuff tendinopathy @article{nokey, PURPOSE: We aimed to translate and cross-culturally adapt the Western Ontario Rotator Cuff index into Greek (WORC-GR) and evaluate its reliability and validity in a Greek speaking population with rotator cuff (RC) disorders. MATERIALS AND METHODS: Translation and cross-cultural adaptation process followed published guidelines. Content and face validity were assessed by 9 experts and 16 patients with RC pathologies, respectively. Internal structure, reliability, measurement error, and convergent validity (correlation with the Disability of the Arm, Shoulder and Hand - DASH, Shoulder Pain and Disability Index - SPADI, and Short Form-36) of the index were evaluated in 104 participants (44.2% women, mean age ± SD: 44.9 ± 15.01 years) with RC related pain. RESULTS: The WORC-GR showed excellent item and scale content validity index (0.875-1.00 and 0.975, respectively), internal consistency (Cronbach's alpha range 0.749 - 0.903) and test-retest reliability (intraclass correlation coefficient: 0.942, 95% CI: 0.913-0.961). Factorial validity testing revealed a 4-factor structure explaining 69.7% of the total variance. High positive correlations were found with DASH (r = 0.806) and SPADI (r = 0.852). CONCLUSIONS: WORC-GR is a reliable and valid instrument to assess symptoms in patients with RC disorders. Further research on the content validity, internal structure, and responsiveness of the tool is required. Implications for rehabilitationThe Greek version of WORC (WORC-GR) is a clear and comprehensible patient reported outcome measure.WORC-GR has excellent internal consistency, test-retest reliability and with no floor and ceiling effects.WORC-GR is a valid outcome measure for patients with rotator cuff disorders. |
Karanasios, S.; Korakakis, V.; Moutzouri, M.; Xergia, SΑ; Tsepis, Ε; Gioftsos, G. In: J Orthop Sports Phys Ther, pp. 1-30, 2022, ISSN: 0190-6011, (1938-1344 Karanasios, Stefanos Korakakis, Vasileios Moutzouri, Maria Xergia, Sofia Α Tsepis, Εlias Gioftsos, George Journal Article Review United States J Orthop Sports Phys Ther. 2022 Sep 13:1-30. doi: 10.2519/jospt.2022.11211.). Abstract | Links | BibTeX | Tags: LAdPhyss 2; exercises; kaatsu training; lateral epicondylitis; rehabilitation; tennis elbow @article{nokey, Objective: To evaluate the effect of low-load resistance training with blood flow restriction (LLRT-BFR) when compared to LLRT with sham-BFR in patients with lateral elbow tendinopathy (LET). Design: Randomized controlled trial Methods: Forty-six patients with LET were randomly assigned to a LLRT-BFR or a LLRT with sham-BFR treatment group. All patients received soft tissue massage, supervised exercises with BFR or sham-intervention (twice a week for six weeks), advice and a home exercise programme. The primary outcome measures were pain intensity, patient-rated tennis elbow evaluation (PRTEE) score, pain-free grip strength (PFGS) and global rating of change (GROC), measured at baseline, 6 weeks, and 12 weeks. Between-group differences were evaluated using mixed-effects models with participant-specific random effects for continuous data. GROC was analysed using logistic regression. Results: Statistically significant between-group differences were found in favor of LLRT-BFR compared to LLRT with sham-BFR in pain intensity at 12-weeks (-1.54, 95%CI:-2.89 to -0.18; p=0.026), PFGS ratio at 6-weeks (0.20, 95%CI:0.06 to 0.34; p=0.005) and PRTEE at 6- and 12-weeks (-11.92, 95%CI:-20.26 to -3.59; p=0.006 and -15.23, 95%CI:-23.57 to -6.9; p<0.001, respectively) follow-up. At 6- and 12-weeks, patients in the LLRT-BFR group had greater odds of reporting complete recovery or significant improvement (OR=6.0 |
2021 |
Karanasios, S.; Korakakis, V.; Moutzouri, M.; Drakonaki, E.; Koci, K.; Pantazopoulou, V.; Tsepis, E.; Gioftsos, G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET) - A systematic review Journal Article In: J Hand Ther, 2021. Abstract | Links | BibTeX | Tags: diagnosis, elbow, sensitivity, specificity, tennis @article{Karanasios2021, Background Reviews on the diagnostic performance of the examination tests for lateral elbow tendinopathy (LET) based on updated context-specific tools and guidelines are missing. Purpose To review the diagnostic accuracy of examination tests used in LET. Design Systematic review following PRISMA-DTA guidelines. Methods We searched MEDLINE, PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, and Cochrane Library databases. The QUADAS-2 checklist was used to assess the methodological quality of the eligible studies. We included diagnostic studies reporting the accuracy of physical examination tests or imaging modalities used in patients with LET. Results Twenty-four studies with 1370 participants were identified reporting the diagnostic performance of Ultrasound Imaging (USI) (18 studies), physical examination tests (2 studies) and Magnetic Resonance Imaging (MRI) (4 studies). Most studies (97%) were assessed with “unclear” or “high risk” of bias. Sonoelastography showed the highest sensitivity (75- 100%) and specificity (85- 96%). Grayscale with or without Doppler USI presented poor to excellent values (sensitivity: 53%-100%, specificity: 42%-90%). MRI performed better in the diagnosis of tendon thickening and enthesopathy (sensitivity and specificity: 81%-100%). The Cozen's test reported high sensitivity (91%) while a grip strength difference of 5%-10% between elbow flexion and extension showed high sensitivity (78%-83%) and specificity (80%-90%). Conclusions Cozen's test and grip strength measurement present high accuracy in the diagnosis of LET but are poorly investigated. USI and MRI provide variable diagnostic accuracy depending on the entities reported and should be recommended with caution when differential diagnosis is necessary. Substantial heterogeneity was found in inclusion criteria, operator/ examiner, mode of application, type of equipment and reference standards across the studies. |
Patsaki, I.; Santikai, M.; Vasiliou, V.; Chelmis, G.; Garvanos, C.; Sakellari, V.; Gioftsos, G. Prevalence of frailty in elderly with fall-related hip fracture Conference World Physiotherapy Congress 2021 Online 2021, (E-Poster PO-02198). Links | BibTeX | Tags: falls, hip fracture @conference{Patsaki2021b, |
Patsaki, I.; Dimitriadi, N.; Tzoumi, D.; Despoti, A.; Leventakis, N.; Roussou, G.; Papathanasiou, R.; Nanas, S.; Karatzanos, E. Promoting physical recovery in neurological diseases through immersive virtual reality: A systematic review Conference World Physiotherapy Congress 2021 Online 2021, (E-Poster PO-02029). BibTeX | Tags: neurological diseases, physical recovery, technology, virtual reality @conference{Patsaki2021, |
Moutzouri, M.; Stamouli, A.; Gioftsos, G. Effectiveness of technology-assisted rehabilitation for patients with knee osteoarthritis: A systematic review Conference World Physiotherapy Congress 2021 Online 2021, (E-Poster PO-02165). BibTeX | Tags: knee osteoarthritis, patient, technology @conference{Moutzouri2021, |
Paraskevopoulos, E.; Plakoutsis, G.; Gioftsos, G.; Georgoudis, G.; Papandreou, M. The intra-rater and inter-rater reliability of scapular asymmetry assessment in volleyball athletes with clinical evaluation methods Conference World Physiotherapy Congress Online April 2021 2021, (E-Poster PO-00733). BibTeX | Tags: athlete, scapular asymmetry, volleyball @conference{Paraskevopoulos2021c, |
Atsidakou, N.; Matsi, A. E.; Christakou, A. The effectiveness of exercise program after lumbar discectomy surgery Journal Article In: J Clin Orthop Trauma, vol. 16, pp. 99-105, 2021. Abstract | Links | BibTeX | Tags: disability, discectomy, exercise, pain, quality of life, strength @article{, A lumbar herniation disc appears as a major cause of lumbar pain and sciatica. The purpose of the present systematic review is to examine the effectiveness of such exercise programs on pain, disability, quality of life, strength and the assessed time required to return to work/normal activities after undergoing lumbar discectomy surgery. PubMed, MEDLINE, and Google Scholar were used for the selection of randomized controlled trials (RCTs). The PEDro scale was chosen to assess the methodological quality of the included studies. Seven RCTS met the inclusion criteria. According to the evaluation of the PEDro scale, one was considered as « high quality», five as « moderate quality» and one as « low quality». The mean score of the studies was 5.14. The results showed that after such exercise there was an improvement in pain, disability, quality of life, muscle strength and in time required to return to work. The exercise programs have a positive impact on the reduction of pain, disability, time required to return to work/normal activities as well as an increase in quality of life and muscle strength in patients with lumbar discectomy surgery. |
Tsokanos, A.; Livieratou, E.; Billis, E.; Tsekoura, M.; Tatsios, P.; Tsepis, E.; Fousekis, K. The Efficacy of Manual Therapy in Patients with Knee Osteoarthritis: A Systematic Review Journal Article In: Medicina, vol. 57, no. 7, pp. 696, 2021. Abstract | Links | BibTeX | Tags: knee osteoarthritis, manual therapy, Mulligan technique @article{Tsokanos2021, Background and objectives: Osteoarthritis (OA) is among the most common degenerative diseases that induce pain, stiffness and reduced functionality. Various physiotherapy techniques and methods have been used for the treatment of OA, including soft tissue techniques, therapeutic exercises, and manual techniques. The primary aim of this systemic review was to evaluate the short-and long-term efficacy of manual therapy (MT) in patients with knee OA in terms of decreasing pain and improving knee range of motion (ROM) and functionality. Materials and Methods: A computerised search on the PubMed, PEDro and CENTRAL databases was performed to identify controlled randomised clinical trials (RCTs) that focused on MT applications in patients with knee OA. The keywords used were ‘knee OA’, ‘knee arthritis’, ‘MT’, ‘mobilisation’, ‘ROM’ and ‘WOMAC’. Results: Six RCTs and randomised crossover studies met the inclusion criteria and were included in the final analysis. The available studies indicated that MT can induce a short-term reduction in pain and an increase in knee ROM and functionality in patients with knee OA. Conclusions: MT techniques can contribute positively to the treatment of patients with knee OA by reducing pain and increasing functionality. Further research is needed to strengthen these findings by comparing the efficacy of MT with those of other therapeutic techniques and methods, both in the short and long terms. |
Tsekoura, M.; Stasi, S.; Gliatis, J.; Sakellari, V. Prescription of exercise for older adults recommendations for clinical practice Journal Article In: Arch Hellenic Med, vol. 38, no. 1, pp. 12-17, 2021, ISSN: 11-05-3992. Abstract | Links | BibTeX | Tags: clinical practice, exercise, older adults, prescription @article{Tsekoura2021b, Regular exercise and general daily activity provide substantial health benefits, improve quality of life and increase functionality in older adults. Elderly people often do not benefit fully from exercise prescription, however, because they receive vague or inappropriate instructions. This paper reviews the components of exercise prescription and the approaches to developing appropriate exercise prescription for older persons, which should be multi-component, including aerobic, muscle strengthening, balance and flexibility training. The elderly should be encouraged to participate in therapeutic exercise programs as primary or adjunctive therapy in the treatment of various chronic diseases associated with aging. |
Tsekoura, M.; Stasi, S.; Gliatis, J.; Sakellari, V. Methodology of a home-based motor control exercise and ergonomic intervention programme for community-dwelling older people: The McHeELP study Journal Article In: J Frailty Sarcopenia Falls, vol. 15, 2021. Abstract | Links | BibTeX | Tags: exercise, falls, home modification, lower extremities, motor control @article{Tsekoura2021, The aim of this research (Motor control Home ergonomics Elderlies' Prevention of falls; McHeELP study) was to develop a novel intervention combining motor control home-based exercises and a home ergonomic safety-improvement strategy in order to reduce falls in frail ambulatory older adults. A randomized controlled trial of a novel intervention is proposed including motor control exercises and home ergonomic assessment and modification in older adults who have at least one fall experience. Participants are randomized to control or intervention group in a 1:1 ratio. Participants will be assessed three times: at baseline, at 3rd month (end of intervention period) and again at 6th month (follow-up measurement). The primary outcome is of the effect on functional mobility using the Timed Up and Go test. Secondary outcomes include assessments of functionality, fear of falling and quality of life. This will be the first study to develop an exercise intervention approach that combines home-based motor control exercise intervention with home assessment and modification. This study is expected to explore a low-cost, easy-to-popularize, and effective exercise intervention approach for improving functional mobility and prevent falls among older adults. |
Tatsios, P.; Koumantakis, G. A.; Karakasidou, P.; Philippou, A. The effectiveness of manual therapy on musculoskeletal and respiratory parameters in patients with chronic low back pain: A systematic review Journal Article In: Crit Rev Phys Rehabil Med, vol. 33, no. 2, pp. 71-101, 2021. Abstract | Links | BibTeX | Tags: breathing education, breathing exercises, chronic low back pain, manual therapy, randomized controlled trials, respiratory dysfunction @article{Tatsios2021, Patients with chronic low back pain (CLBP) exhibit respiratory dysfunction. Dysfunction in motor control of trunk muscles (diaphragm included) negatively affects the mechanics and biochemistry of breathing. The aim of this systematic review was to analyze evidence from randomized controlled trials (RCTs) investigating the effect of manual therapy on musculoskeletal and respiratory parameters in patients with CLBP. Systematic search and selection of RCTs was performed using specific keywords in three scientific databases (Medline, Scopus, and the Physiotherapy Evidence Database, or PEDro) from inception to March 2021. Relevant studies published in English were extracted, evaluated, and independently rated for methodological quality by two assessors using the PEDro scale. Data extraction and methodological ratings were inspected by a third assessor. Out of 943 initially collected studies, 922 were excluded (did not meet inclusion criteria or were duplicates). Twenty-one clinical trials were finally included, though they were characterized by moderate methodological quality (PEDro scale). Meta-analysis was not performed due to differences in techniques utilized (targeting spinal joints or trunk or respiratory muscles) and the outcomes were assessed across studies. Overall, there was evidence, of moderate methodological quality, that manual therapy on the low back joints or trunk stabilization exercises, diaphragmatic release techniques, and respiratory exercises significantly improve musculoskeletal as well as respiratory parameters in patients with CLBP. More and higher-quality RCTs are required, especially those that will utilize respiratory reeducation and exercise of the respiratory muscles as therapeutic interventions contributing to the holistic management of patients with CLBP. |
S.Stasi,; Tsekoura, M.; Gliatis, J.; Sakellari, V. In: Cureus, vol. 13, no. 4, pp. e14336, 2021. Abstract | Links | BibTeX | Tags: ergonomics, falls, home-based programme, lower limb, motor control, older adults, physiotherapy @article{S.Stasi2021, Objectives Falls are a serious problem that can reduce living autonomy and health-related quality of life of older adults. A decrease in the muscular strength of the lower limbs and the deterioration of balance or motor performance deficits may lead to falls. "Motor Control Home Ergonomics Elderlies' Prevention of Falls" (McHeELP) is a novel motor control exercise program combined with ergonomic arrangements of the home environment. This pilot trial is conducted in order to examine the feasibility and acceptability of the McHeELP program, the selection of the most appropriate outcome measures, and the exact sample size calculation that should be used for the randomized controlled trial (RCT) with Clinical Trial Identifier: ISRCTN15936467. Patients and methods Twenty older adults (aged ≥65 years) who had experienced at least one fall-incident in the past 12 months have participated in the trial; they were randomized in a 1:1 ratio to the McHeELP group (McHeELP-G) and the Control group (CG). The McHeELP-G received a personalized therapeutic motor control and learning exercise program performed three times per week for 12 weeks. Regarding McHeELP - home modification, a booklet that contained basic advice and tips on the modification for their inside and outside home environment was provided to the participants. Objective and self-reported outcome measures, collected at baseline and post-intervention (end of the third month), included functional, fear of falling, and quality of life measurements. Results The McHeELP intervention was very feasible and acceptable to the participants, and the adherence was excellent (100%). The majority of outcome measures seemed appropriate and significant differences were also revealed between the two groups. Specifically, post-intervention statistically significant improvement was found in the 4 meters walking test, Timed Up and Go test, Sit to Stand test, Tandem Stance test, Functional Reach test, Foot tapping test, EuroQoL-5D-5L - visual analog scale (VAS), Lower Extremity Functional Scale, Falls Self-Efficacy International Scale, and Home Falls and Accidents Screening Tool (HOMEFAST) questionnaire of McHeELP-G (all p-values ≤0.002). No statistically significant difference was observed in the mobility, self-care, usual activities, pain/discomfort subscales of Euro QoL-5D-5L (all p-values >0.05), except the anxiety/depression subscale of McHeELP-G (p=0.008). Moreover, no statistically significant improvement was found regarding McHeELP participants' knee flexion/extension restriction and ankle dorsiflexion/plantar-flexion restrictions. Regarding CG, no statistically significant difference was found (p>0.05), except the Tandem Stance test (p=0.003) and HOMEFAST (p<0.001). Referring to the future McHeELP RCT, it was estimated that a sample size of 25 evaluable patients per group is required. Conclusions This pilot trial's findings suggest that it is feasible to deliver an RCT of the McHeLP program to this population. Exercise programs that are easy to administer need to be developed and implemented to reduce the burden of falls in older adults. |
Patselas, T.; Karanasios, S.; Sakellari, V.; Fysekis, I.; Patselas, M. I.; Gioftsos, G. EMG activity of the serratus anterior and trapezius muscle during elevation and push up exercises Journal Article In: J Bodyw Mov Ther, vol. 27, pp. 247-255, 2021. Abstract | Links | BibTeX | Tags: elevation exercises, EMG, push up exercises, serratus anterior, trapezius @article{Patselas2021, Background: Elevation and push up (Pu) exercises are considered to be beneficial for the rehabilitation of shoulder complex pathology. Despite their clinical utility, there is a lack of evidence comparing scapulothoracic muscles recruitment during these exercises. Objective: To evaluate the EMG activity of upper trapezius (UT), Lower Trapezius (LT), Upper Serratus anterior (USa) and Lower Serratus anterior (LSa) muscles during a variety of elevation and Pu exercises. Methods: Thirteen healthy participants (non, athlete, male, mean ± standard deviation; age: 21.1 ± 1.8 years; height: 1.80 m ± 0.04; weight: 79 ± 12 kg) were assessed. EMG data was collected during Scaption, wall slide and elevation with external rotation (EleEr) with and without load. Pu classic, Pu plus (PuP) on stable/unstable surfaces and Pu with shoulder internal rotation were also assessed. Results: UT had a significant higher activity during ‘Scaption load’ (p < .05) and LT in ‘EleEr load’ and ‘Scaption load’ (p < .05). USa and LSa had a significant higher activity on ‘PuP unstable surface’ and ‘PuP internal rotation’ compared to elevation exercises (p < .05). Scaption had greater activity ratio compared to the other exercises on UT/LT (p < .05). Pu variations had lower results in UT/USa and UT/LSa ratios compared to shoulder elevation exercises (p < .05). Conclusions: Elevation exercises produce significant effects on upper and lower trapezius activation while Pu exercises on Sa muscles. Wall slide exercise notes the lowest activation in all muscles. A descending order of muscle activity during different variations of elevation and Pu exercises is provided in order to guide exercise selection in everyday clinical practice. |
Karanasios, S.; Korakakis, V.; Whiteley, R.; Vasilogeorgis, I.; Woodbridge, S.; Gioftsos, G. In: Br J Sports Med, vol. 55, no. 9, pp. 477-485, 2021. Abstract | Links | BibTeX | Tags: elbow, exercise, tendinopathy @article{Karanasios2021b, Objective: To evaluate the effectiveness of exercise compared with other conservative interventions in the management of lateral elbow tendinopathy (LET) on pain and function. Design Systematic review and meta-analysis. Methods: We used the Cochrane risk-of-bias tool 2 for randomised controlled trials (RCTs) to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation methodology to grade the certainty of evidence. Self-perceived improvement, pain intensity, pain-free grip strength (PFGS) and elbow disability were used as primary outcome measures. Eligibility criteria RCTs assessing the effectiveness of exercise alone or as an additive intervention compared with passive interventions, wait-and-see or injections in patients with LET. Results: 30 RCTs (2123 participants, 5 comparator interventions) were identified. Exercise outperformed (low certainty) corticosteroid injections in all outcomes at all time points except short-term pain reduction. Clinically significant differences were found in PFGS at short-term (mean difference (MD): 12.15, (95% CI) 1.69 to 22.6), mid-term (MD: 22.45, 95% CI 3.63 to 41.3) and long-term follow-up (MD: 18, 95% CI 11.17 to 24.84). Statistically significant differences (very low certainty) for exercise compared with wait-and-see were found only in self-perceived improvement at short-term, pain reduction and elbow disability at short-term and long-term follow-up. Substantial heterogeneity in descriptions of equipment, load, duration and frequency of exercise programmes were evident. Conclusions: Low and very low certainty evidence suggests exercise is effective compared with passive interventions with or without invasive treatment in LET, but the effect is small. |
Paraskevopoulos, E.; Plakoutsis, G.; Georgoudis, G.; Gioftsos, G.; Papandreou, M. The intra-rater and inter-rater reliability of scapular asymmetry assessment in volleyball athletes with clinical evaluation methods Journal Article In: 2021, (Paper presented at the World Physiotherapy Congress 2021 Online). Abstract | Links | BibTeX | Tags: clinical evaluation, reliability, scapula asymmetry, volley ball players @article{Paraskevopoulos2021, Background: It has been suggested that Scapular Asymmetries (SA) can have a significant effect on shoulder function and in the development of shoulder pain. SA present with increased protraction and depression in the dominant side and can be seen in either symptomatic or asymptomatic athletes. These are much more prominent in unilateral overhead athletes. Several clinical evaluation methods of SA have been used in the past in order to detect SA. However, less is known about the intra-rater and inter-rater reliability of these methods in professional volleyball players. Purpose: The aim of this retrospective study was to establish the intra-rater reliability of five different methods for quantifying SA in asymptomatic professional volleyball players. Methods: Ten male asymptomatic professional volleyball players were recruited (Age 30.5±2.67 years, BMI 23.1±0.32). In regards to sample size, for an expected reliability of 92%, based on the findings of previous studies, and acceptable reliability of at least 60%, in order to represent substantial reliability, 9 athletes were required for 5% significance level and a power of 80% for two examiners or at two different time points. These five methods measured a series of anthropometric characteristics of the scapula including 1) Height asymmetries of the Scapulae (SH), 2) the difference in the distance between the scapulae from the spine (DS), 3) the difference in the Posterior Displacement of each Scapula from the thoracic cage with a modified caliper (SPD), as well as, 4, 5) the posterior displacement of both scapulae from the thoracic cage in a static (SPDR) and a dynamic position (SPD-PUE). A written informed consent, which was approved by the University, was obtained from all the athletes who participated in this study. All experimental procedures conformed to the Declaration of Helsinki. The research protocol was approved by the University of West Attica. Results: Reliability values for the first and the second method were excellent for the inter-rater (ICC 0.90-0.97; SEM 0.17-0.16) and the intra-rater (ICC 0.90-0.98; SEM 0.16-0.13) evaluation. For the third method, the inter-rater and the intra-rater values were good to excellent (ICC 0.84-0.92; SEM 0.23-0.13). The last two methods showed good to acceptable inter-rater (ICC 0.70-0.68; SEM 0.23-0.27) and intra-rater values (ICC 0.66-0.77; SEM 0.20 for both). The Bland and Altman analysis did not reveal any systematic bias in any method. Conclusions: The findings of the present study propose several reliable methods for evaluating SA of asymptomatic male professional volleyball players in clinical practice. The Bland and Altman plots constructed in the study, along with the SEM and the SDD calculations, allowed to conclude that the methods proposed should reliably measure male asymptomatic overhead athletes. Implications: It would be regarding the reliability of several evaluation methods in scapula asymmetry assessment as an important diagnostic tool in overhead athletes. |
Korakakis, V.; Kotsifaki, A.; Korakaki, A.; Karanasios, S.; Whiteley, R. In: Phys Ther Sport, vol. 52, pp. 103-114, 2021. Abstract | Links | BibTeX | Tags: anterior cruciate ligament reconstruction, physical therapy, rehabilitation, return to sport @article{Korakakis2021, Objectives: To evaluate the perspectives and clinical practice of physiotherapists regarding rehabilitation after anterior cruciate ligament reconstruction (ACLR). Design: Online survey. Setting: Survey platform. Participants: Greek physiotherapists. Outcome measures: The survey consisted of 7 sections: participant demographics, importance of ACLR rehabilitation, clinical measurements, practice, criteria to progress rehabilitation, return to running and return to sport. Results: Significant variability in measures and criteria used for clinical decision-making were found including: limb symmetry in strength and function, knee range of motion and effusion, progression, and return to sport criteria. The majority of the practitioners (28.3%) extrapolate knee strength from hop capacity. Return to running ranged from 3 to 5 months post-operatively reflecting that this was tied to physical capacities, not time from surgery. 70.0% of the Greek physiotherapists would allow return to sport ≤9 months after ACLR. Agreement was found in using: physical measures, function, and dynamic stability in ACLR rehabilitation, but the mode and interpretation varied substantially. Less than 29.0% of the physiotherapists reported using patient-reported outcome measures in their decision-making. Conclusion: Current ACLR rehabilitation practices in Greece are largely not aligned with the contemporary scientific evidence and guidelines. |
Christakou, A.; Vasileiadis, G.; Kapreli, E. Motor imagery as a method of maintaining performance in pianists during forced non-practice: a single case study. Journal Article In: Physiother Theory Pract, vol. 37, no. 4, pp. 540-548, 2021. Abstract | Links | BibTeX | Tags: imagery, motor, piano, synthesia @article{Christakou2021, Musicians suffer from upper limb playing-related musculoskeletal disorders that often oblige them to periodic inactivity. Objectives: To assess the effectiveness of motor imagery as a means of practice when the physical piano practice is restricted. Methods: A 17-year-old healthy pianist participated in a single subject case study with a multiple baseline design (ABC design). Performance ability was assessed during a period of the no practice, then a period of performing motor imagery and again during a period of another no practice. Assessments were performed subjectively by a professional piano teacher and objectively by the Synthesia software. Three visual analog scales were used to record stress, fatigue, and general psychological state. The participant’s motor imagery ability was recorded by the use of the Movement Imagery Questionnaire. Results: There was a statistically significant reduction in performance after no practice. There was no change in performance during motor imagery intervention. The pianist’s scores moderately correlated with the general psychological state. The Synthesia scoring presented high correlations with professional piano teacher scoring. Conclusions: Motor imagery seemed to have a positive effect in maintaining the musician’s performance level. Synthesia shows promise as an outcome measure for assessing music performance, although further research is needed. |
Grigoriadis, K.; Efstathiou, I.; Dimitriadis, Z.; Konstantopoulou, G.; Grigoriadou, A.; Vasileiadis, G.; Micha, M.; Tsagaris, I.; Armaganidis, A. Handgrip Force and Maximum Inspiratory and Expiratory Pressures in Critically Ill Patients With a Tracheostomy Journal Article In: Am J Crit Care, vol. 30, no. 2, pp. e48-e53, 2021. Abstract | Links | BibTeX | Tags: patient, physiotherapy, tracheostomy @article{Grigoriadis2021, Background: The association between peripheral striated muscle strength and respiratory muscle strength has been confirmed in a number of disorders. However, this association is unknown in intensive care unit patients with tracheostomies. Objective: To examine correlations between handgrip force, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) in intensive care unit patients with tracheostomies. Methods: Twenty patients (7 women, 13 men) with tracheostomies, in the intensive care unit longer than 11 days, in stable condition, with functional limbs, and with Glasgow Coma Scale scores of 15 were recruited. Both MIP and MEP were measured with a membrane manometer; handgrip force was measured with a hydraulic hand dynamometer. Results: Handgrip force was significantly correlated with MIP (r = 0.45, P = .04) and MEP (r = 0.78, P = .001). Handgrip force was significantly predicted by MIP and MEP when the effect of sex was controlled for (P < .05). However, when MIP and MEP were included as predictors in a regression model, MEP was the only significant predictor (R = 0.80, R2 = 0.63, adjusted R2 = 0.57). Conclusions: Strength of the hand flexors and strength of the expiratory muscles (abdominal) were significantly correlated in intensive care unit patients. Handgrip strength appears to be an easy, fast way to evaluate expiratory muscle strength by using a simple handhold command without special equipment. A strong handhold may also correspond to strong expiratory muscles. ClinicalTrials.gov: NCT03457376. |
Krekoukias, G.; Sakellari, V.; Anastasiadi, E.; Gioftsos, G.; Dimitriadis, Z.; Soultanis, K.; Gelalis, I. D. Gait Kinetic and Kinematic Changes in Chronic Low Back Pain Patients and the Effect of Manual Therapy: A Randomized Controlled Trial Journal Article In: J Clin Med, vol. 10, no. 16, 2021. Abstract | Links | BibTeX | Tags: chronic low back pain, gait, manual therapy, physiotherapy, spinal mobilization @article{Krekoukias2021, Patients with chronic back pain as a result of degenerated disc disease, besides pain, also present with impaired gait. The purpose of the article was to evaluate kinetic and kinematic characteristics during gait analysis in patients with chronic low back pain as a result of degenerated disc disease, before and after the application of physiotherapy, including manual therapy techniques. Seventy-five patients suffering from chronic low back pain were randomly divided into 3 groups of 25 each. Each group received five sessions (one per week) of interventions with the first group receiving manual therapy treatment, the second a sham treatment and the third, classic physiotherapy (stretching exercises, TENS and massage). The effectiveness of each treatment was evaluated using an optoelectronic system for recording and analysis of gait (kinetic and kinematic data). Patients overall showed an impaired gait pattern with a difference in kinetic and kinematic data between the left and the right side. Following the application of the above-named interventions, only the group that received manual therapy showed a tendency towards symmetry between the right and left side. In patients suffering from chronic low back pain as a result of degenerated disc disease, the application of five manual therapy sessions seems to produce a tendency towards symmetry in gait. |
Grammatopoulou, E.; Sdravou, D.; Gkiliri, F.; Bourtzi, A.; Polymerou, A.; Metallidis, S.; Geka, E.; Koumantakis, G. A.; Christakou, A.; Evangelodimou, A. 1st International Electronic Conference on Medicine 2021, (MDPI: Basel, Switzerland). Abstract | Links | BibTeX | Tags: COVID-19, physical functioning, physiotherapy, respiratory function @conference{Grammatopoulou2021, Background and Objectives: According to the recent physiotherapy recommendations (WHO, WCPT, 2020) for patients with COVID-19, after discharge from ICU, they are expected to experience respiratory, physical, cognitive, and psychological problems due to the duration and nature of the immobilization and sedation, ventilation duration, and underlying morbidity. Moreover, only patients with a limitation in physical capacity and/or physical activity have an indication for physiotherapy. However, little is known about the effect of physiotherapy treatment on the functional capacity of patients with COVID-19. Purpose: The aim of the present study was to provide information for the effectiveness of physiotherapy intervention on the respiratory and physical functional status of patients with COVID-19, since there will be a great demand for physiotherapy treatment for these people soon. Materials and Methods: The Ethics Committee of the AHEPA University Hospital, School of Medicine, Health Sciences Faculty, Aristotle University of Thessaloniki, Greece granted approval for this study. This pilot clinical study was conducted from March to June 2020. The sample consisted of 11 patients with COVID-19, discharged form ICU and hospitalized in the COVID-19 clinic of AHEPA University Hospital. All participants had indication for physiotherapy, according to the recommendations, and medical referral as well. The duration of their hospitalization ranged from two to six weeks. Among participants, there were seven males and four females, aged from 44 to 75 yrs, five smokers and six nonsmokers, four obese and seven nonobese. According to the recommendations, physiotherapy intervention was tailored to the patients’ needs and goals. Breathing exercises, early mobilization and self-management for daily living were performed once a day, for five days a week, as tolerated. Measurement tools: Pulse Oximeter (SpO2), Respiratory Rate (RR), Borg scale (intensity of dyspnea), Medical Research Council scale for disability (MRCd), clinical evaluation for dysfunctional breathing (DB), Medical Research Council scale for muscle strength (MRCms), Berg balance scale, Sit to Stand test (leg strength and endurance), Time Up and Go test (TUG) (general mobility), 1 minute walk test (1MWT) (aerobic capacity) and Barthel Index (BI) (performance in daily activities). For the purposes of the study, two measurements were conducted: at admission and at discharge from the COVID-19 clinic. Results: Dependent samples tests showed a significant effect (p <0.001) for the recommended physiotherapy treatment on respiratory variables: 6.9(1.4) % for SpO2, 3.4(0.9) breaths for Respiratory Rate, 5.0(1.3) for Borg scale score. Significant improvements (p <0.001) were additionally noted for physical functioning: 25.3(13.0) for Berg balance scale, 18.5(11.2) for MRCms score, 3(1.3) s for Sit to Stand and 40.4(40.6) s for TUG efforts, 44.1(25.5) s for 1MWT and 65.9(20.2) for BI. All patients displayed DB at admission to the COVID-19 clinic, while nine of them adopted a diaphragmatic breathing pattern at discharge. At admission to the COVID-19 clinic, all patients were at level 5 disability (MRCd), whereas at discharge 10 out of 11 patients improved (three at level 4, four at level 3 and three at level 2). Conclusion: The present pilot study provided a first evidence for the effectiveness of the WHO and WCPT physiotherapy recommendations on the respiratory and physical functioning status of patients with COVID-19. Further studies are needed to support these early findings. |
Karanasios, S.; Tsamasiotis, G. K.; Michopoulos, K.; Sakellari, V.; Gioftsos, G. Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis Journal Article In: Clin Rehabil, 2021. Abstract | Links | BibTeX | Tags: lateral epicondylitis, meta-analysis, shockwave therapy, tennis elbow @article{Karanasios2021c, Objective: To evaluate the effectiveness of extracorporeal shockwave therapy compared with other interventions on pain, grip strength and disability in patients with lateral elbow tendinopathy. Data Sources: MEDLINE, PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, Cochrane Library and clinical trial registries. Review methods: We included randomized controlled trials assessing the effectiveness of extracorporeal shockwave therapy alone or as an additive intervention compared with sham or other interventions. Pain intensity, grip strength and elbow disability were used as primary outcome measures. We assessed methodological quality with the PEDro score and quality of evidence with the GRADE approach. Results: Twenty-seven studies with 1871 patients were finally included. Extracorporeal shockwave therapy reduced pain intensity at mid-term follow-up (standardized mean difference: −1.21, 95% confidence interval:−1.53, −0.89, P < 0.001) and improved grip strength at very short- (mean difference:3.92, 95% confidence interval: 0.91, 6.94, P = 0.01) and short-term follow-up (mean difference:4.87, 95% confidence interval:2.24, 7.50, P < 0.001) compared with sham treatment. However, no clinically significant results were found between comparators in all outcomes and follow-up times. Extracorporeal shockwave therapy presented clinically better compared to Laser in grip strength at short-term (mean difference:3.50, 95% confidence interval:2.40, 4.60, P < 0.001) and ultrasound in pain intensity at very-short-term follow-up (standardized mean difference: −1.54, 95% confidence interval: −2.60, −0.48, P = 0.005). Conclusion: Low to moderate certainty of evidence suggests that there are no clinical benefits of extracorporeal shockwave therapy compared to sham interventions or corticosteroid injections. Based on very-low and moderate certainty of evidence, extracorporeal shockwave therapy outperforms against Laser and ultrasound, respectively. |
Koumantakis, G. A.; Tsiampokalou, A.; Chrysagis, N.; Grammatopoulou, E.; Tatsios, P. Chronic Whiplash Syndrome: Associated Disorders and Physiotherapy Management – A Literature Review Journal Article In: British Journal of Healthcare and Medical Research, vol. 8, no. 5, pp. 12-37, 2021. Abstract | Links | BibTeX | Tags: physiotherapy; neck pain @article{nokey, <p><em>Purpose: </em>The purpose of the current literature review is to present the Whiplash Associated-Disorders through diagnosis, scales, physical examination and to identify the most suitable physiotherapy management of these conditions. The long-term effectiveness of physiotherapy interventions is also examined.</p><p><em>Methods:</em> Sixteen randomized controlled trials (RCTs) and seven case-control and cohort studies related to chronic WAD fulfilled the inclusion and exclusion criteria. The design, diagnosis, population, methodology, results, methodological quality and physiotherapy management were examined. The PEDro Scale and the Newcastle-Ottawa Scale were used for the examination of the methodological quality.</p><p><em>Results:</em> The methodological quality of the studies used, were high. Significantly important on minimizing the symptoms of chronic WAD were the combination of Exercise therapy &amp; Advice both at 6 and 12 months follow up. Other interventions such as Exercise therapy, Interdisciplinary approach and Multimodal physiotherapy treatment, Spinal Manual therapy and Advice were not equally effective in the long-term.</p><p><em>Conclusion: </em>The most suitable intervention for the physiotherapy management of chronic WAD, with long-term effectiveness was the combination of Exercise &amp; Advice, which was established with various outcome measures, such as NDI, VAS, NRI and SF-36. On the contrary, Exercise therapy, Interdisciplinary approach and Multimodal physiotherapy treatment, Spinal Manual therapy and Advice were not that effective on minimizing the symptoms of chronic WAD in the long-term.</p> |
Korakakis, V.; Kotsifaki, A.; Korakaki, A.; Karanasios, S.; Whiteley, R. In: Phys Ther Sport, vol. 52, pp. 103-114, 2021, ISSN: 1466-853x, (1873-1600 Korakakis, Vasileios Kotsifaki, Argyro Korakaki, Alexandra Karanasios, Stefanos Whiteley, Rodney Journal Article England Phys Ther Sport. 2021 Aug 30;52:103-114. doi: 10.1016/j.ptsp.2021.08.012.). Abstract | Links | BibTeX | Tags: anterior cruciate ligament reconstruction; physical therapy; rehabilitation; return to sport @article{nokey, OBJECTIVES: To evaluate the perspectives and clinical practice of physiotherapists regarding rehabilitation after anterior cruciate ligament reconstruction (ACLR). DESIGN: Online survey. SETTING: Survey platform. PARTICIPANTS: Greek physiotherapists. OUTCOME MEASURES: The survey consisted of 7 sections: participant demographics, importance of ACLR rehabilitation, clinical measurements, practice, criteria to progress rehabilitation, return to running and return to sport. RESULTS: Significant variability in measures and criteria used for clinical decision-making were found including: limb symmetry in strength and function, knee range of motion and effusion, progression, and return to sport criteria. The majority of the practitioners (28.3%) extrapolate knee strength from hop capacity. Return to running ranged from 3 to 5 months post-operatively reflecting that this was tied to physical capacities, not time from surgery. 70.0% of the Greek physiotherapists would allow return to sport ≤9 months after ACLR. Agreement was found in using: physical measures, function, and dynamic stability in ACLR rehabilitation, but the mode and interpretation varied substantially. Less than 29.0% of the physiotherapists reported using patient-reported outcome measures in their decision-making. CONCLUSION: Current ACLR rehabilitation practices in Greece are largely not aligned with the contemporary scientific evidence and guidelines. |
Chrysagis, N.; Koumantakis, G. A.; Grammatopoulou, E.; Skordilis, E. Active Joint Position Sense in Children With Unilateral Cerebral Palsy Journal Article In: Cureus, vol. 13, no. 9, pp. e18075, 2021, ISSN: 2168-8184 (Print) 2168-8184, (2168-8184 Chrysagis, Nikolaos Koumantakis, George A Grammatopoulou, Eirini Skordilis, Emmanouil Journal Article Cureus. 2021 Sep 18;13(9):e18075. doi: 10.7759/cureus.18075. eCollection 2021 Sep.). Abstract | Links | BibTeX | Tags: assessment; cerebral palsy; hemiplegia; position sense; proprioception; spasticity @article{nokey, Objective The aim of the study was to examine the differences in joint position sense at the elbow joint between 15 children with unilateral cerebral palsy (CP) and 15 typically developing (TD) controls without neurological or other health deficits. Methodology Joint position sense, a major proprioceptive component, was evaluated actively using a Kin Com 125 AP isokinetic dynamometer (Chattanooga Group, Chattanooga, TN). Results A significant interaction was found (p<0.05) between disability and side, with respect to the active reproduction movement scores. Post-hoc independent t-tests, with Bonferroni adjustments, revealed significant differences for the dominant (t=-3.63 |
Koumantakis, G. A.; Oldham, J. A. In: World J Orthop, vol. 12, no. 11, pp. 816-832, 2021, ISSN: 2218-5836 (Print) 2218-5836, (2218-5836 Koumantakis, George A Oldham, Jacqueline A Journal Article World J Orthop. 2021 Nov 18;12(11):816-832. doi: 10.5312/wjo.v12.i11.816. eCollection 2021 Nov 18.). Abstract | Links | BibTeX | Tags: low back pain; multifidus; power spectral analysis; reliability; surface electromyography @article{nokey, BACKGROUND: Paraspinal muscle strength and fatigue are considered important in low back pain (LBP) prevention and rehabilitation. High reliability of paraspinal strength and electromyographic (EMG)-fatigue parameters has not been universally reported. Moreover, the discriminative validity of these parameters requires further exploration, under the threat of potentially poor reliability of the methods examined. AIM: To investigate the reliability and discriminative validity of paraspinal strength and EMG-related fatigue in subjects with recurrent LBP and healthy participants. METHODS: Test-retest measurements were performed in 26 healthy and 66 LBP volunteers, for reliability. Paraspinal isometric maximal and mean strength were determined with a maximum voluntary isometric contraction (MVIC) protocol, performed in a custom-made device. For the fatigue test, participants performed a 60% MIVC level continuous isometric contraction of the paraspinals, in conjunction with EMG analysis from 4 muscle sites of the lumbar spine. Initial median frequency (IMF), the median frequency slope (MFslope), as well as the root mean square (RMS) slope EMG parameters were used as fatigue measures. Data were analysed with repeated measures ANOVA for test-retest differences. For reliability, the intraclass correlation coefficient (ICC(3,1)), standard error of the measurement (SEM) and the smallest detectable difference (SDD) were reported. Group-related differences for fatigue measures were analysed with a Multivariate Analysis of Covariance, with age, weight and strength as covariates. RESULTS: Isometric strength presented statistically significant between-day differences (P < 0.01), however these did not exceed 10% (healthy: 7.2%/LBP-patients: 9.7%) and ICC reliability values were excellent, yet test-retest error was increased for the patient group (healthy: ICC(3,1): 0.92-0.96, SEM: 5.72-5.94 Hz, SDD: 18.51%-18.57%/LBP-patients: ICC(3,1): 0.91-0.96, SEM: 6.49-6.96, SDD: 30.75%-31.61%). For the frequency data, IMF reliability was excellent (healthy: ICC(3,1): 0.91-0.94, SEM: 3.45-7.27 Hz, SDD: 9.56%-20.14%/patients: ICC(3,1): 0.90-0.94, SEM: 6.41-7.59 Hz, SDD: 17.75%-21.02%) and of MF raw and normalised slopes was good (healthy: ICC(3,1): 0.78-0.82, SEM: 4.93-6.02 Hz, SDD: 13.66-16.67%/LBP-patients: ICC(3,1): 0.83-0.85, SEM: 6.75-7.47 Hz, SDD: 18.69%-20.69%). However, the reliability for RMS data presented unacceptably high SDD values and were not considered further. For discriminative validity, less MVIC and less steep MFslopes were registered for the patient group (P < 0.01). CONCLUSION: Reliability and discriminative ability of paraspinal strength and EMG-related frequency parameters were demonstrated in healthy participants and patients with LBP. |
Chrysagis, N.; Theotokatos, G.; Skordilis, E.; Sakellari, V.; Grammatopoulou, E.; Koumantakis, G. A. Effectiveness of Treadmill Training on Walking Ability in Adults with Cerebral Palsy: A Systematic Review and Meta-Analysis Journal Article In: 2021, vol. 9, no. 4, pp. 9, 2021, ISSN: 2202-946X. Abstract | Links | BibTeX | Tags: cerebral palsy; adults; treadmill; exercise; physical therapy; walking; gait @article{nokey, Background: Patients with cerebral palsy (CP) may necessitate long-term treatment and monitoring of their condition, not only during the period of development but also during adulthood. Objectives: This systematic review aimed to analyze evidence from randomized controlled trials (RCTs) that have investigated the effect of treadmill training on walking ability in adults with cerebral palsy. Methods: RCTs were identified and selected systematically, with appropriate keywords applied in four scientific databases (Medline, Scopus, the Cochrane Library, and the Physiotherapy Evidence Database) and one bibliographic search engine (Google Scholar) from January 1980 to September 2021. Two assessors extracted and analyzed data from relevant RCTs published in English and then independently rated those studies for risk of bias with the Risk of Bias (RoB 2) tool. Results: Out of the 96 studies that were initially identified, 93 were excluded, as these either did not meet the inclusion criteria or were duplicates. Three clinical trials were finally included, characterized by some concerns and a high risk of bias (RoB 2). Meta-analysis was only performed for the maximum distance in the ‘6-minute walk for distance test’, due to differences in the remaining outcomes utilized between studies. Overall, there was evidence of some concerns and high risk of bias that treadmill training did not significantly improve the walking ability in adult patients with CP relative to the control conditions. Conclusion: More high-quality RCTs are required, examining the effectiveness of treadmill training on different aspects of walking ability such as gait speed, endurance, and energy expenditure. |
Daskalakis, A.; Brisimis, V.; Grammatopoulou, E.; Smyrli, E.; Chaniotou, A. Validity and reliability evidence of the general self-efficacy scale in Greek patients with COPD Journal Article In: European Respiratory Journal, vol. 58, no. suppl 65, pp. PA3907, 2021. Abstract | Links | BibTeX | Tags: Behavioral science, COPD - management, quality of life @article{nokey, Background: Self-efficacy is associated with functional capacity and quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients.Aims and Objectives: The present study was designed to examine the validity and reliability of the General Self-Efficacy scale (GSE) responses in Greek patients with COPD.Methods: The GSE scale (n=50) was examined for construct and criterion validity as well as internal consistency.Results: Principal Components Analysis (PCA) revealed a two (2) factors solution (action self-efficacy and coping self-efficacy with eigen values 1.65 and 5.31 respectively) and with 69.67% total variability. Higher GSE scores were found in the following groups: a) smokers versus non-smokers (p&lt;0.001), b) patients without visiting the emergency department versus patients with 1-2 visits in the last year (p&lt;0.001), c) patients with regular follow-up versus patients with follow-up only in deterioration of symptoms (p&lt;0.001), and d) among patients of the four quarters of the BODE index (F=2.89 |
Daskalakis, A.; Smyrli, E.; Grammatopoulou, E.; Brisimis, V.; Chaniotou, A. Validity and reliability evidence of general self-efficacy scale in Greek adults with asthma Journal Article In: European Respiratory Journal, vol. 58, no. suppl 65, pp. PA314, 2021. Abstract | Links | BibTeX | Tags: Asthma - management; Behavioral science; quality of life @article{nokey, Background: Self-efficacy is associated with asthma control and quality of life in asthma patients.Aims and Objectives: The present study was designed to examine the validity and reliability of the General Self-Efficacy scale (GSE) responses in Greek adults with asthma.Methods: The GSE (n=50) was examined through construct validity (factor analysis and differences between groups), criterion validity (concurrent and predictive validity) as well as internal consistency reliability.Results: Principal component analysis (PCA) revealed a two-factor solution (action self-efficacy and coping self-efficacy with eigen values 4.13 and 1.94 respectively) and 60.70% of explained variability. The GSE showed high internal consistency (Cronbach’s alpha=0.84). Higher GSE scores were found in the following groups: patients with controlled versus uncontrolled asthma (p<0.001), patients without versus with hyperventilation (p<0.001) and patients with mild versus moderate and severe asthma (p<0.001). Concurrent validity testing showed moderate to high positive correlations for the GSE score with Forced Expiratory Volume in 1'' (FEV1%) (r=0.49, p<0.01), 6 Minute Walk Distance Test (6MWDT) (r=0.80, p<0.01), and Asthma Control Test (ACT) (r=0.81, p<0.01), while low to high negative correlations were found for the GSE score with age (r=-0.29, p<0.05), Nijmegen Questionnaire (NQ) (r=-0.75, p<0.01), and Borg scale as well (r=-0.77, p<0.01). Further, multiple linear regression analysis showed that the 6MWDT was the predictor variable (Beta=0.56, p<0.001) of the GSE for the specific sample of asthma patients.Conclusions: The GSE provided validity and reliability evidence for the specific Greek sample with asthma.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA314.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). |
Grammatopoulou, E.; Sdravou, D.; Gkiliri, F.; Bourtzi, A.; Polymerou, A.; Metallidis, S.; Geka, E.; Koumantakis, G. A.; Christakou, A.; Evangelodimou, A. The Effect of Post-ICU Physiotherapy on Respiratory and Physical Functioning Status in Patients with COVID-19: A Pilot Study Miscellaneous 2021, ISBN: 2673-9992. Links | BibTeX | Tags: physiotherapy; respiratory; physical functioning; COVID-19 @misc{nokey, |
Karanasios, S.; Koutri, C.; Moutzouri, M.; Xergia, S. A.; Sakellari, V.; Gioftsos, G. In: Sports Health, pp. 19417381211043877, 2021, ISSN: 1941-0921, (1941-0921 Karanasios, Stefanos Koutri, Charikleia Moutzouri, Maria Xergia, Sofia A Sakellari, Vasiliki Gioftsos, George Journal Article United States Sports Health. 2021 Sep 13:19417381211043877. doi: 10.1177/19417381211043877.). Abstract | Links | BibTeX | Tags: Kaatsu training; arterial occlusion; blood flow restriction training; reliability @article{nokey, BACKGROUND: The precise calculation of arterial occlusive pressure is essential to accurately prescribe individualized pressures during blood flow restriction training. Arterial occlusion pressure in the lower limb varies significantly between different body positions while similar reports for the upper limb are lacking. HYPOTHESIS: Body position has a significant effect in upper limb arterial occlusive pressure. Using cuffs with manual pump and a handheld Doppler ultrasound can be a reliable method to determine upper limb arterial blood flow restriction. STUDY DESIGN: A randomized repeated measures design. LEVEL OF EVIDENCE: Level 3. METHODS: Forty-two healthy participants (age mean ± SD = 28.1 ± 7.7 years) completed measurements in supine, seated, and standing position by 3 blinded raters. A cuff with a manual pump and a handheld acoustic ultrasound were used. The Wilcoxon signed-rank test with Bonferroni correction was used to analyze differences between body positions. A within-subject coefficient of variation and an intraclass correlation coefficient (ICC) test were used to calculate reproducibility and reliability, respectively. RESULTS: A significantly higher upper limb arterial occlusive pressure was found in seated compared with supine position (P < 0.031) and in supine compared with standing position (P < 0.031) in all raters. An ICC of 0.894 (95% CI = 0.824-0.939, P < 0.001) was found in supine, 0.973 (95% CI = 0.955-0.985, P < 0.001) in seated, and 0.984 (95% CI = 0.973-0.991, P < 0.001) in standing position. ICC for test-retest reliability was found 0.90 (95% CI = 0.814-0.946, P < 0.001), 0.873 (95% CI = 0.762-0.93, P < 0.001), and 0.858 (95% CI = 0.737-0.923, P < 0.001) in the supine, seated, and standing position, respectively. CONCLUSION: Upper limb arterial occlusive pressure was significantly dependent on body position. The method showed excellent interrater reliability and repeatability between different days. CLINICAL RELEVANCE: Prescription of individualized pressures during blood flow restriction training requires measurement of upper limb arterial occlusive pressure in the appropriate position. The use of occlusion cuffs with a manual pump and a handheld Doppler ultrasound showed excellent reliability; however, the increased measurement error compared with the differences in arterial occlusive pressure between certain positions should be carefully considered for the clinical application of the method. STRENGTH OF RECOMMENDATIONS TAXONOMY (SORT): B. |
Karanasios, S.; Tsamasiotis, G. K.; Michopoulos, K.; Sakellari, V.; Gioftsos, G. Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis Journal Article In: Clin Rehabil, vol. 35, no. 10, 2021, ISSN: 0269-2155, (1477-0873 Karanasios, Stefanos Tsamasiotis, Georgios K Michopoulos, Konstantinos Sakellari, Vasiliki). Abstract | Links | BibTeX | Tags: tennis elbow; lateral epicondylitis; meta-analysis; shockwave therapy @article{nokey, OBJECTIVE: To evaluate the effectiveness of extracorporeal shockwave therapy compared with other interventions on pain, grip strength and disability in patients with lateral elbow tendinopathy. DATA SOURCES: MEDLINE, PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, Cochrane Library and clinical trial registries. REVIEW METHODS: We included randomized controlled trials assessing the effectiveness of extracorporeal shockwave therapy alone or as an additive intervention compared with sham or other interventions. Pain intensity, grip strength and elbow disability were used as primary outcome measures. We assessed methodological quality with the PEDro score and quality of evidence with the GRADE approach. RESULTS: Twenty-seven studies with 1871 patients were finally included. Extracorporeal shockwave therapy reduced pain intensity at mid-term follow-up (standardized mean difference: -1.21, 95% confidence interval:-1.53, -0.89, P < 0.001) and improved grip strength at very short- (mean difference:3.92, 95% confidence interval: 0.91, 6.94 |
Karkaletsi, F.; Theotokatos, G.; Chrysagis, N.; Tsifopanopoulou, Z.; Staebler, T.; Papadopoulou, V.; Yin, M.; Hussey, M.; Vougiouka, A.; Skordilis, E. The Effect of the Special Olympics’ Unified Program upon the Attitudes towards Inclusion of Students with Intellectual Disabilities in Greece. Journal Article In: Advances in Physical Education, vol. 11, pp. 460-480, 2021. Links | BibTeX | Tags: inclusion, LAdPhyss 2; unified sports; attitudes; intellectual disability, Special Olympics @article{nokey, |
2020 |
Kontakiotis, N.; Billis, E.; Gioftsos, G. Discrimination of sciatica problems based on clinical assessment tools Conference 5th European Congress Physiotherapy Education 2020, (ER WCPT Online Event). BibTeX | Tags: clinical practice, sciatica problems @conference{Kontakiotis2020, |
Sakellari, V.; Karadimitri, D.; Papairakli, C. Vestibular rehabilitation in children Journal Article In: Rev Clin Pharmacol Pharmacokinet, vol. 34, no. 3, pp. 121-132, 2020. BibTeX | Tags: children, vestibular rehabilitation @article{Sakellari2020, |
Patsaki, I.; Christakou, A.; Papadopoulos, E.; Katartzi, M.; Kouvarakos, A.; Siempos, I.; Tsimouris, D.; Skoura, A.; Xatzimina, A.; Malachias, S.; Koulouris, Ν.; Grammatopoulou, E.; Zakinthinos, S.; Ischaki, E. In: ERJ Open Res, vol. 6, no. 3, 2020. Abstract | Links | BibTeX | Tags: high-flow nasal cannula oxygen, inspiratory muscle, patient @article{Patsaki2020, Background: According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation. Material and methods: A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay. Conclusion: The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation. |
Paraskevopoulos, E.; Papandreou, M.; Gliatis, J. Reliability of assessment methods for scapular dyskinesis in asymptomatic subjects: A systematic review Journal Article In: Acta Orthop Traumatol Turc, vol. 54, no. 5, pp. 546-556, 2020. Abstract | Links | BibTeX | Tags: evidence, physiotherapy, scapular dyskinesis @article{Paraskevopoulos2020b, Objective: The aim of this systematic review was to evaluate the available published evidence on the intra- and inter-rater reliabilities of assessment methods used for identifying and measuring scapular dyskinesis (SD) in asymptomatic subjects. Methods: A systematic electronic literature search was performed in PubMed, Physiotherapy Evidence Database, Scopus, and the Cochrane Library, and studies on the intra- and inter-rater reliabilities of physical examination tests used for identifying SD in asymptomatic people were identified. Methodological quality of the studies meeting the inclusion criteria was assessed using the Quality Appraisal of Reliability Studies (QAREL) checklist by two reviewers. The overall level of evidence of this systematic review was determined by the Modified Cochrane Back Pain Criteria based on previous research which was modified for reliability studies of the shoulder complex. Results: The literature search generated 388 results, and only 14 articles met the inclusion criteria. In these studies, reliabilities of two qualitative and five quantitative methods for the assessment of SD were analyzed. The QAREL checklist revealed that 12 studies had moderate risk of bias and 2 had high risk of bias. Additionally, none of the studies were of high quality. On the basis of the Modified Cochrane Back Pain Criteria, the overall level of evidence was moderate. Most of the studies including quantitative measurement methods found good to excellent inter- and intra-rater reliability values. Most of the studies including qualitative methods found low-to-moderate intra- and inter-rater reliability values. Conclusion: Considering the available published evidence, there is lack of high-quality studies evaluating the inter- and intra-rater reliabilities of qualitative or quantitative methods used for the assessment of SD. There are no qualitative methods with high reliability that are fit for clinical applications. Some quantitative methods with higher reliability are present, but clinicians should be aware of the methodological flaws that studies evaluating these methods suffer from. |
Paraskevopoulos, E.; Papandreou, M. Systematic infection control in Greek physiotherapy practices during the COVID-19 pandemic Journal Article In: Work, vol. 66, no. 2, pp. 367-370, 2020. Links | BibTeX | Tags: covid, pandemic, physiotherapy @article{Paraskevopoulos2020, |
Moutzouri, M.; Tsoumpos, P.; Bania, T.; Billis, E.; Gliatis, J. “Greek KOOS-Child: a valid, disease specific, diagnostically accurate and responsive PROM in children with knee-related pathology” Journal Article In: Knee Surg Sports Traumatol Arthrosc, vol. 29, no. 6, pp. 1841-1849, 2020. Abstract | Links | BibTeX | Tags: arthroscopy, knee surgery, sports traumatology @article{Moutzouri2020, Purpose: The Knee Injury Osteoarthritis Outcome Score (KOOS)-Child questionnaire is one of the frequently child-friendly measures used in pediatric studies. The aim of this study was to transculturally adapt the Greek version of KOOS-Child and evaluate its clinimetric properties in children with knee disorders. Methods: Children visiting the Outpatients Orthopaedic Clinic of a Greek Paediatric General Hospital were considered eligible if they were aged 8–14 years, had a knee soft tissue injury and associated physical limitations. The transcultural adaptation was based on a multistage backward translation approach. Participants completed the KOOS-Child at their first visit to the orthopedic specialist (baseline), 2 weeks and 3 months after baseline. Content validity of the KOOS-Child was evaluated using general QoL measures (KIDSCREEN and Kid-KINDL) and construct validity was explored by correlating relevant items. Responsiveness was evaluated according to the children’s response on the given orthopeadic treatment. Results: Sample consisted of 59 children (30 males), aged: 11 ± 1.8 years. The KOOS-Child showed high internal consistency (Cronbach’s a: 0.80–0.96). Adequate convergent validity with > 75% relevant a priori hypotheses was confirmed. Construct validity was moderate to strong (Pearson’s r correlations between related KOOS and Kid-KINDL subdimensions: 0.54–0.62). KOOS and KIDSCREEN subdimensions correlations were fair (Pearson’s r correlations: 0.32–0.65). KOOS-Child’s diagnostic accuracy was high. Factor analysis extracted height factors accounting for 76.15% of the total variance, confirmed by the scree plot. Responsiveness was moderate to high with Cohen’s d from 0.6 to 1.4. Conclusion: The Greek version of the KOOS-Child demonstrated excellent internal consistency, good construct validity, diagnostic accuracy and interpretability as well as good responsiveness. The measure could be used across Greek children with orthopaedic knee problems. Generalisability of findings is limited due to the relatively limited cohort. |
Mitsiou, G.; Karatzanos, E.; Smilios, I.; Psarra, K.; Patsaki, I.; Douda, H. T.; Ntalianis, A.; Nanas, S.; Tokmakidis, S. P. Exercise promotes endothelial progenitor cell mobilization in patients with chronic heart failure Journal Article In: Eur J Prev Cardiol, 2020, (Online ahead of print). Abstract | Links | BibTeX | Tags: chronic heart failure, endothelial progenitor cells, exercise @article{Mitsiou2020, Regular exercise affects the vascular system, endothelial function, and facilitates microcirculation in patients with chronic heart failure (CHF). It promotes mobilization of endothelial progenitor cells (EPCs) into circulation which repair dysfunctional or injured endothelium and contribute to angiogenesis. Furthermore, haematopoietic progenitor cells (HPCs), a related cell population with progenitor-like properties, support regeneration and facilitate reparatory mechanisms in the vascular system. During exercise, using either a continuous or an interval training method, EPCs circulate into the bloodstream, ‘home to’ sites of ischaemic vascular injury and promote vascular regeneration. |
Koumantakis, G. A. Addressing Fear Avoidance and Self-efficacy Beliefs to Reduce Disability in Patients with Non-specific Low Back Pain: From Theory to Application Journal Article In: AS Orthopaedics, vol. 3, no. 12, pp. 43-51, 2020. Links | BibTeX | Tags: low back pain, patient, physical therapy @article{Koumantakis2020, |