GEORGIOS KOUTRAS - Academia.edu (original) (raw)

Papers by GEORGIOS KOUTRAS

Physical Therapy in Sport

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

PubMed, Feb 1, 2012

Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitati... more Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. Purpose: The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Methods: Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Results: Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p≤0.003). However, there were no group or group*time effects on any of the outcome variables (p≥0.33). Functional tests were better predictors of isokinetic deficits in the 14(th) compared to the 33(rd) postoperative day. Conclusion: No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were correlations between the hop tests and isokinetic deficits two weeks after meniscectomy but not at the fifth week. Level of evidence: 1b.

Journal of Science and Medicine in Sport, Jul 1, 2016

Please cite this article in press as: Koutras G, et al. Comparison of knee flexion isokinetic def... more Please cite this article in press as: Koutras G, et al. Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions.

Journal of Electromyography and Kinesiology, Aug 1, 2014

ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the a... more ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the athlete away from training and competition, ACL tear is a risk factor for early-onset of knee osteoarthritis, and, therefore addressing strategies to avoid such injury is pertinent not only for competitive athletes, but for all physically active subjects. Imbalances in the prelanding myoelectric activity of the hamstrings and quadriceps muscles have been linked to ACL injuries. We investigated the effect of landing from different heights on prelanding myoelectric activity of the hamstrings and quadriceps muscles in recreational athletes. Thirty recreational athletes (15 male and 15 female) performed three bilateral drop jumps from two different heights; 20cm and 40cm while myoelectric activity of the vastus medialis, rectus femoris, biceps femoris and medial hamstrings were collected. When increasing the height of drop landing tasks prelanding normalized myoelectric activity of the quadriceps was increased by 15-20% but no significant changes were found for the hamstrings. Female athletes exhibited higher activity of the medial hamstrings compared to their male counterparts. We concluded that increasing the height of drop landing tasks is associated with increased myoelectric activity of the quadriceps but not the hamstrings in recreational athletes. These differences in muscle activity may be related to increased risk for ACL injury when the height is increased. Female athletes demonstrated higher recruitment of the medial hamstrings.

International Journal of Sports Medicine, Jul 30, 2008

Critical Reviews in Physical and Rehabilitation Medicine

Journal of Back and Musculoskeletal Rehabilitation

BACKGROUND: Physical therapists use dry needling (DN) and percutaneous needle electrolysis (PNE) ... more BACKGROUND: Physical therapists use dry needling (DN) and percutaneous needle electrolysis (PNE) to treat musculoskeletal pain. OBJECTIVE: To investigate the efficacy of PNE vs. DN in the treatment of musculoskeletal pain. METHODS: This systematic review and meta-analysis was based on the PICOS and PRISMA protocols. The PubMed, PEDro, Cochrane Library, SCOPUS, and Google Scholar databases were searched for randomized clinical trials measuring pain intensity in various musculoskeletal syndromes using PNE and DN. Pain outcome measures were the visual analog scale or the numerical pain rating scale. Risk of bias was assessed according to Cochrane guidelines and quality of evidence was reported using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). Standardized mean differences were calculated using random effects models. RESULTS: The meta-analysis of the six included studies showed that the overall effect of PNE vs. DN for pain reduction was stat...

Background: Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer... more Background: Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer than 12 weeks. Objectives: To investigate the efficacy of manual therapy (MT) program combined with Capacitive and Resistive Electric Transfer (TECAR) therapy in individuals with CNSLBP. Method: Sixty adults with CNSLBP were randomly equally divided into three groups. The first group followed an MT protocol in the lumbar region (MT group), the second group followed the same MT protocol combined with TECAR therapy (MT + TECAR group) using a conventional capacitive electrode as well as a special resistive electrode bracelet and the third group (Control group) received no treatment. Both intervention programs included six treatments over two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), functional ability with the Roland-Morris Disability Questionnaire (RMDQ), Pressure Pain Threshold (PPT) in the lumbar region with pressure algometry, and mobility of the lumbo...

The purpose of this study is to investigate the influence of harvesting semitendinosus and gracil... more The purpose of this study is to investigate the influence of harvesting semitendinosus and gracilis tendons grafts, to reconstruct the ACL, on the strength of the flexors and internal rotators of the knee, on the dynamic stability of the lower limb and on the angle of peak torque maximum of knee flexors and the impact of other variables. The study involved 65 patients who received one week preoperatively and 2nd, 3rd. 4th, 6th and 9th months postoperatively, measurements with the Cybex Norm isokinetic dynamometer on strength of the knee flexors, extensors, internal and external rotators, on the dynamic and passive knee stability, on active range of motion, on the circumference of knee and thigh and on the level of functional capacity of the lower limb. The results showed that the isometric and isokinetic strength of knee flexors muscles is statistically greater in the sitting position than in the prone position, while the decrease of the flexors muscles strength is greater in large ...

1Morgana Alves de Britto, 1 Felipe Pivetta Carpes, 2 Georgios Koutras, 3 Evangelos Pappas 1 Labor... more 1Morgana Alves de Britto, 1 Felipe Pivetta Carpes, 2 Georgios Koutras, 3 Evangelos Pappas 1 Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, RS, Brazil; email: mo_britto@hotmail.com 2 Assistant Professor, Department of Physical Therapy, Technological Education Institute of Thessaloniki, Thessaloniki, Greece 3 Associate Professor, Department of Physical Therapy, Long Island University, Brooklyn NY, USA; Contributing Scholar, Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, School of Medicine, Ioannina, Greece

Microorganisms, 2020

Background: Antibiotic management of low-virulent implant-associated infections induced by Cutiba... more Background: Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. Methods: We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8–11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. Results: Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for interven...

Journal of science and medicine in sport / Sports Medicine Australia, Jan 31, 2015

Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvestin... more Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared ...

International journal of sports physical therapy, 2012

Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patien... more Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Mult...

International Journal of Sports Medicine, 2009

Knee Surgery, Sports Traumatology, Arthroscopy, 2012

Purpose Several studies have suggested that drilling the femoral tunnel through an anteromedial a... more Purpose Several studies have suggested that drilling the femoral tunnel through an anteromedial arthroscopic portal during anterior cruciate ligament reconstruction allows more anatomic placement of the graft. However, no studies have investigated whether the anteromedial approach results in better outcomes compared to the traditional transtibial drilling approach when a hamstring autograft is used. The purpose of the present study is to investigate short-term functional and clinical outcome differences between male patients recovering from anterior cruciate ligament reconstruction with a hamstring autograft using the transtibial femoral tunnel drilling approach versus the anteromedial approach. Methods Lysholm score, functional test and isokinetic data were collected at 3 and 6 months after surgery in 51 male patients who received a standardized rehabilitation in a large outpatient facility. Multivariate and univariate analyses of variance were used to assess group, time and interaction effects. Results All outcomes except isokinetic knee flexion at 180°/s improved from 3 to 6 months for both groups (p B 0.05). The anteromedial approach group had better Lysholm scores at 3 months (p B 0.05) and better performance in the timed lateral movement functional tests at 3 and 6 months (p B 0.05). No other comparisons were significant (n.s). Conclusions Both groups had comparable outcomes on most measures. The differences in the Lysholm score and lateral movement functional tests may suggest a quicker return of function and performance for the anteromedial approach group. Clinicians should take into consideration the surgical technique as they progress patients recovering from ACL reconstruction through the different phases of the rehabilitation protocol. Level of evidence Therapeutic study, Level II.

Journal of Electromyography and Kinesiology, 2014