Evdokia Billis | Technological Educational Institute (TEI) of Western Greece (former TEI of Patras) (original) (raw)

Papers by Evdokia Billis

Please cite this article in press as: Moutzouri M, et al. What is the effect of sensori-motor tra... more Please cite this article in press as: Moutzouri M, et al. What is the effect of sensori-motor training on functional outcome and balance performance of patients' undergoing TKR? A systematic review. Physiotherapy (2015), http://dx. Abstract Objectives Total knee replacement (TKR) has a beneficial effect on patients' functional ability; however, incidence of falls and deficits on proprioception are not restored even 1-year after surgery. Early and intensive exercise post-TKR has received limited endorsement in the literature. The aim of this review was to systemically identify and critically appraise clinical studies investigating the effect of sensori-motor training on functional and balance performance in TKR patients. Data sources The electronic databases Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro and the register of current controlled trials were searched up to September 2014. Review methods Two independent reviewers used predefined inclusion and exclusion criteria to identify all eligible articles. Eligible articles were summarized and critically reviewed, using the PEDro scale. Results Two hundred and seventy six articles were screened, six were included. The studies, presented the results of 409 patients (269 intervention, 140 control). A range of rehabilitation protocols were defined by components of proprioception, postural control, balance perturbation and coordination. All studies supported the use of sensori-motor training as an additional element in patients' rehabilitation protocols. Clinical performance-based tests (more than relevant patient-reported measures) showed that functional ability and balance were improved compared to controls. The robustness of evidence was compromised because most of the studies were underpowered. Conclusions Limited robust (Ia) evidence supports the equal effectiveness of functional rehabilitation program as a functional rehabilitation enhanced with sensori-motor elements in patients post-TKR. However, dose-response parameters of exercise eliciting improvement warrant further investigation.

BMC Musculoskeletal Disorders, 2008

Background: Mulligan's mobilisation techniques are thought to increase the range of movement (ROM... more Background: Mulligan's mobilisation techniques are thought to increase the range of movement (ROM) in patients with low back pain. The primary aim of this study was to investigate the application of the Mulligan's Sustained Natural Apophyseal Glide (SNAG) technique on lumbar flexion ROM. The secondary aim was to measure the intra-and inter-day reliability of lumbar ROM employing the same procedure.

Rehabilitation Research and Practice, 2016

Background. We need to understand more about how DNF performs in different contexts and whether i... more Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p < 0.05). However, no differences were found within and between the therapeutic groups (p < 0.05) in the tested muscles' PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

British Journal of Medicine and Medical Research, 2017

World Journal of Orthopedics, 2016

To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists... more To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ (2) tests. The survey was divided into three subsections; PTs' attitudes on LBP assessment, patients' attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low (< 10%) and 8 statements demonstrated high (> 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a "privilege" which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as "executers", being unable to interfere with treatment plan, possibly implying lack of autonomy. Although similarities on history taking methods and on patients' attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.

Physiotherapy Research International, 2016

Journal of Sport Rehabilitation, 2016

Elastic bandages are commonly used in sports to treat and prevent sports injuries. To conduct a s... more Elastic bandages are commonly used in sports to treat and prevent sports injuries. To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic and sports injuries prevention and rehabilitation. We searched the following electronic databases: MEDLINE, CINAHL, SPORTDiscus, EMBASE and Physiotherapy Evidence Database (PEDro), with key words 'elastic bandaging' in combination, respectively, with (1) first aid, (2) sports injuries, (3) orthopedic injuries and (4) sports injuries prevention and rehabilitation. Research studies were selected based upon the use of the term 'elastic bandaging' in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were English, peer-reviewed clinical trials on the effects of elastic bandaging for orthopedic injuries prevention and rehabilitation. Twelve studies met the above criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were critically analyzed using the PEDro scale. The studies in this review fell into two (2) categories: studies in athletes (N=2) and non-athletes (N=10). All included trials had moderate-to-high quality, scoring (≥5 on the PEDro scale). The PEDro scores for the studies in athletes and non-athletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher to moderate methodological quality clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of the elastic bandaging could not be confirmed.

Disability and Rehabilitation 2011 33 1776 84, Sep 1, 2011

ABSTRACT The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES... more ABSTRACT The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES-I) in community-dwelling seniors in Greece. For cross-cultural adaptation, the back-translation procedure was utilised by four bi-lingual translators. For validation, 89 community-dwellings (50 males, 39 females) aged 61-90 years old (mean: 72.87 ± 6.04) completed four questionnaires adapted into Greek; two instrument specific ones, FES-I and Confidence in Maintaining Balance (CONFbal), and two generic Questionnaires, Short-form Health Survey (SF-36v2) and General Health Questionnaire (GHQ30). Additionally, three functional/balance tests were compared against the FES-I. All questionnaires and measurements were repeated after 7-10 days to explore repeatability. Content validity was achieved as all participants found the questionnaire appropriate and comprehensible. Validity of the FES-I yielded moderate to strong correlations with CONFbal (r = 0.694, p<0.01), three SF-36 subscales (r ranging between 0.560 and 6.55, p<0.01), GHQ30 (r = 0.584, p<0.01) and one functional test (r = 0.638, p<0.01 for Timed Up and Go test). FES-I's test-retest reliability (ICC:0.951, SEM: 1.79, SDD:20.44%, r = 0.950) and internal consistency (Cronbach's α = 0.925) were excellent, and responsiveness across fallers and non-fallers yielded a large effect size (0.89), indicating good discriminant validity. The Greek FES-I was valid, reliable, comprehensible and acceptable for the sample tested and may thus, be used in cross-cultural rehabilitation research and practice.

Journal of Rehabilitation Medicine Official Journal of the Uems European Board of Physical and Rehabilitation Medicine 2013 45 177 185, Jan 16, 2013

To identify potential subgroups amongst patients with non-specific low back pain based on a conse... more To identify potential subgroups amongst patients with non-specific low back pain based on a consensus list of potentially discriminatory examination items. Exploratory study. A convenience sample of 106 patients with non-specific low back pain (43 males, 63 females, mean age 36 years, standard deviation 15.9 years) and 7 physiotherapists. Based on 3 focus groups and a two-round Delphi involving 23 health professionals and a random stratified sample of 150 physiotherapists, respectively, a comprehensive examination list comprising the most "discriminatory" items was compiled. Following reliability analysis, the most reliable clinical items were assessed with a sample of patients with non-specific low back pain. K-means cluster analysis was conducted for 2-, 3- and 4-cluster options to explore for meaningful homogenous subgroups. The most clinically meaningful cluster was a two-subgroup option, comprising a small group (n = 24) with more severe clinical presentation (i.e. more widespread pain, functional and sleeping problems, other symptoms, increased investigations undertaken, more severe clinical signs, etc.) and a larger less dysfunctional group (n = 80). A number of potentially discriminatory clinical items were identified by health professionals and sub-classified, based on a sample of patients with non-specific low back pain, into two subgroups. However, further work is needed to validate this classification process.

Journal of Rehabilitation Medicine Official Journal of the Uems European Board of Physical and Rehabilitation Medicine 2012 44 851 857, 2012

Objective: To investigate the inter-tester reliability of a nonspecific low back pain examination... more Objective: To investigate the inter-tester reliability of a nonspecific low back pain examination procedure, for sub-classifying non-specific low back pain. Design: Reliability study. Participants: Thirty patients with non-specific low back pain (12 males, 18 females, mean age 27.7 years, standard deviation 10.3) and 7 physiotherapists (raters). Methods: Based on a health professionals' consensus via focus groups and a Delphi servey, an examination procedure was developed comprising 206 items discriminatory for nonspecific low back pain, 108 of which were from the History (clinical questions) and 98 from the Physical Examination (clinical tests) section. Utilizing this procedure, each patient was examined by a blinded pair of raters. Results: Moderate to excellent agreement was obtained in 125 (61%) items (77 History and 48 Physical Examination items), 47 of which obtained substantial or excellent agreement (kappa>0.61), 37 moderate agreement (kappa between 0.41 and 0.6), and 41 excellent percentage agreements. Poor reliability (kappa < 0.41) was yielded in the remaining 81 items (31 History and 50 Physical Examination items). Conclusion: Satisfactory reliability was obtained in nearly two-thirds of History and half of the Physical Examination items on a non-specific low back pain assessment list generated through consensus agreement. These findings provide clinicians and researchers with valuable information regarding which items are considered reliable and can be utilized in non-specific low back pain patient evaluation/assessment procedures, classification attempts and clinical trials.

Purpose Of the most commonly encountered clinical sign in shoulder patients is loss of muscular c... more Purpose Of the most commonly encountered clinical sign in shoulder patients is loss of muscular control around scapula. One of the muscles which is subject to electromyographic (EMG) alterations is trapezius. Especially its upper fibres are found to be overactivated leading to limited upward scapular rotation (Ludewig et al. 2004). Scapular taping is suggested as a method of improving both, muscular control and scapular position (Selkowitz et al. 2007, Hsu et al. 2009). The aim of this study is to explore the electromyographic activity of upper trapezius following the application of tape in patients with suspected subacromial impingement and anterior glenohumeral subluxation. Methods 9 women (mean age:34,7) with suspected subacromial impingement, 4 of which had co-existent anterior subluxation, and 7 healthy females (mean age:22) who served as controls, volunteered to participate in this pilot. Subjects were requested to perform abduction in the scapular plane with and without the a...

Introduction: In recent years, artificial intelligence is used in a variety of systems in the fie... more Introduction: In recent years, artificial intelligence is used in a variety of systems in the field of medicine. The time when the only asset of the doctor was the classic leather bag containing a few basic instruments such as the stethoscope belongs to the dustbin of history. Objectives: In this paper we attempt to objectify and modeling the postoperative pain of planned orthopedic surgery in the knee with the help of machine learning and artificial intelligence tools. The purpose of this modeling is to create an intelligent system of evaluation and assessment of postoperative pain and to answer the hypothesis, if the use as an objective parameter value as derived from the recording of somatosensory evoked potentials (SSEP) may affect the accuracy Methods: The used data were recorded from 52 patients who underwent elective surgery in the knee in the Orthopaedic Clinic of the University Hospital of Patras. Four to eight hours postoperatively, the patients were evaluated by the same ...

Introduction: The rotator cuff muscles have been showed to be the substantial dynamic stabilizers... more Introduction: The rotator cuff muscles have been showed to be the substantial dynamic stabilizers of the glenohumeral joint in multiple shoulder positions. The supraspinatus provides glenohumeral compression, abduction and generates a small external rotation (Reinold et al. 2009). The architectural characteristics of the supraspinatus usually involve in measuring parameters as thickness, width and cross sectional area (CSA) as important factors for the functionality during dynamic and static movements (Whittaker, et al. 2011; Han, et al. 2012). Objectives: The objective of this study was to evaluate the CSA of the supraspinatus muscle on the dominant and non- dominant shoulders in amateur tennis players using brightness mode ultrasonography, as prognostic factors to improve insights for physiotherapists and orthopaedic surgeons. Methods: Ultrasonography images from the supraspinatus CSA were recorded in 20 participants, 23-27 years of age, who were involved unprofessionally in tenni...

Physiotherapy, 2015

One of the most accepted footedness measure outcomes is the Waterloo Footedness Question-Revised ... more One of the most accepted footedness measure outcomes is the Waterloo Footedness Question-Revised (WFQ-R). The main advantage of WFQ-R against the other questionnaires of the same category is that it has been designed to assess both foot preference for mobilizing and stabilizing tasks. Therefore, it has been used in an extensive number of neurophysiology research and motor behavior research protocols.

Physiotherapy, 2015

Given the high incidence of low back pain (LBP) internationally, there is still debate on the imp... more Given the high incidence of low back pain (LBP) internationally, there is still debate on the impact of pain intensity and location (including back-associated leg pain) on perceived disability and life-functioning factors in younger or middle-aged adults, where occupation is of primary importance. Additionally, there is limited research in how these factors affect the Greek population.

Introduction: Spinal metastatic disease is very common in patients with cancer. The goals of ther... more Introduction: Spinal metastatic disease is very common in patients with cancer. The goals of therapy are pain control and functional preservation. Kyphoplasty and spondyloplasty are minimal invasive procedures that play a crucial role in the treatment of spinal metastatic spine disease. Aims/Objectives: We assess the quality of life, anxiety and depression in long term follow up, after kyphoplasties and spondyloplasties in thoracic and lumbar spinal metastatic fractures and lytic lesions with EuroQuol (EQ - 5D) and HADS instruments. Methods: One hundred-seven patients (60 men - 47 women, mean age: 62,4 years old) underwent 141 procedures. Patient-related outcomes EuroQuol (EQ - 5D) and HADS (Hospital Anxiety and Depression Scale) instruments, were assessed pre- and post-operatively and after 3, 12, 24 months, 3 years and 4 years follow up. Results: Mean EQ-5D and HADS scales significantly improved (32% and 41%) from pre- to post-treatment (P < 0.0001). This improvement being sust...

Please cite this article in press as: Moutzouri M, et al. What is the effect of sensori-motor tra... more Please cite this article in press as: Moutzouri M, et al. What is the effect of sensori-motor training on functional outcome and balance performance of patients' undergoing TKR? A systematic review. Physiotherapy (2015), http://dx. Abstract Objectives Total knee replacement (TKR) has a beneficial effect on patients' functional ability; however, incidence of falls and deficits on proprioception are not restored even 1-year after surgery. Early and intensive exercise post-TKR has received limited endorsement in the literature. The aim of this review was to systemically identify and critically appraise clinical studies investigating the effect of sensori-motor training on functional and balance performance in TKR patients. Data sources The electronic databases Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro and the register of current controlled trials were searched up to September 2014. Review methods Two independent reviewers used predefined inclusion and exclusion criteria to identify all eligible articles. Eligible articles were summarized and critically reviewed, using the PEDro scale. Results Two hundred and seventy six articles were screened, six were included. The studies, presented the results of 409 patients (269 intervention, 140 control). A range of rehabilitation protocols were defined by components of proprioception, postural control, balance perturbation and coordination. All studies supported the use of sensori-motor training as an additional element in patients' rehabilitation protocols. Clinical performance-based tests (more than relevant patient-reported measures) showed that functional ability and balance were improved compared to controls. The robustness of evidence was compromised because most of the studies were underpowered. Conclusions Limited robust (Ia) evidence supports the equal effectiveness of functional rehabilitation program as a functional rehabilitation enhanced with sensori-motor elements in patients post-TKR. However, dose-response parameters of exercise eliciting improvement warrant further investigation.

BMC Musculoskeletal Disorders, 2008

Background: Mulligan's mobilisation techniques are thought to increase the range of movement (ROM... more Background: Mulligan's mobilisation techniques are thought to increase the range of movement (ROM) in patients with low back pain. The primary aim of this study was to investigate the application of the Mulligan's Sustained Natural Apophyseal Glide (SNAG) technique on lumbar flexion ROM. The secondary aim was to measure the intra-and inter-day reliability of lumbar ROM employing the same procedure.

Rehabilitation Research and Practice, 2016

Background. We need to understand more about how DNF performs in different contexts and whether i... more Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). However, no differences were found within and between the therapeutic groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in the tested muscles&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

British Journal of Medicine and Medical Research, 2017

World Journal of Orthopedics, 2016

To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists... more To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ (2) tests. The survey was divided into three subsections; PTs&amp;amp;amp;amp;#39; attitudes on LBP assessment, patients&amp;amp;amp;amp;#39; attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low (&amp;amp;amp;amp;lt; 10%) and 8 statements demonstrated high (&amp;amp;amp;amp;gt; 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a &amp;amp;amp;amp;quot;privilege&amp;amp;amp;amp;quot; which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as &amp;amp;amp;amp;quot;executers&amp;amp;amp;amp;quot;, being unable to interfere with treatment plan, possibly implying lack of autonomy. Although similarities on history taking methods and on patients&amp;amp;amp;amp;#39; attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.

Physiotherapy Research International, 2016

Journal of Sport Rehabilitation, 2016

Elastic bandages are commonly used in sports to treat and prevent sports injuries. To conduct a s... more Elastic bandages are commonly used in sports to treat and prevent sports injuries. To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic and sports injuries prevention and rehabilitation. We searched the following electronic databases: MEDLINE, CINAHL, SPORTDiscus, EMBASE and Physiotherapy Evidence Database (PEDro), with key words &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;elastic bandaging&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; in combination, respectively, with (1) first aid, (2) sports injuries, (3) orthopedic injuries and (4) sports injuries prevention and rehabilitation. Research studies were selected based upon the use of the term &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;elastic bandaging&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were English, peer-reviewed clinical trials on the effects of elastic bandaging for orthopedic injuries prevention and rehabilitation. Twelve studies met the above criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were critically analyzed using the PEDro scale. The studies in this review fell into two (2) categories: studies in athletes (N=2) and non-athletes (N=10). All included trials had moderate-to-high quality, scoring (≥5 on the PEDro scale). The PEDro scores for the studies in athletes and non-athletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher to moderate methodological quality clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of the elastic bandaging could not be confirmed.

Disability and Rehabilitation 2011 33 1776 84, Sep 1, 2011

ABSTRACT The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES... more ABSTRACT The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES-I) in community-dwelling seniors in Greece. For cross-cultural adaptation, the back-translation procedure was utilised by four bi-lingual translators. For validation, 89 community-dwellings (50 males, 39 females) aged 61-90 years old (mean: 72.87 ± 6.04) completed four questionnaires adapted into Greek; two instrument specific ones, FES-I and Confidence in Maintaining Balance (CONFbal), and two generic Questionnaires, Short-form Health Survey (SF-36v2) and General Health Questionnaire (GHQ30). Additionally, three functional/balance tests were compared against the FES-I. All questionnaires and measurements were repeated after 7-10 days to explore repeatability. Content validity was achieved as all participants found the questionnaire appropriate and comprehensible. Validity of the FES-I yielded moderate to strong correlations with CONFbal (r = 0.694, p&lt;0.01), three SF-36 subscales (r ranging between 0.560 and 6.55, p&lt;0.01), GHQ30 (r = 0.584, p&lt;0.01) and one functional test (r = 0.638, p&lt;0.01 for Timed Up and Go test). FES-I&#39;s test-retest reliability (ICC:0.951, SEM: 1.79, SDD:20.44%, r = 0.950) and internal consistency (Cronbach&#39;s α = 0.925) were excellent, and responsiveness across fallers and non-fallers yielded a large effect size (0.89), indicating good discriminant validity. The Greek FES-I was valid, reliable, comprehensible and acceptable for the sample tested and may thus, be used in cross-cultural rehabilitation research and practice.

Journal of Rehabilitation Medicine Official Journal of the Uems European Board of Physical and Rehabilitation Medicine 2013 45 177 185, Jan 16, 2013

To identify potential subgroups amongst patients with non-specific low back pain based on a conse... more To identify potential subgroups amongst patients with non-specific low back pain based on a consensus list of potentially discriminatory examination items. Exploratory study. A convenience sample of 106 patients with non-specific low back pain (43 males, 63 females, mean age 36 years, standard deviation 15.9 years) and 7 physiotherapists. Based on 3 focus groups and a two-round Delphi involving 23 health professionals and a random stratified sample of 150 physiotherapists, respectively, a comprehensive examination list comprising the most &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;discriminatory&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; items was compiled. Following reliability analysis, the most reliable clinical items were assessed with a sample of patients with non-specific low back pain. K-means cluster analysis was conducted for 2-, 3- and 4-cluster options to explore for meaningful homogenous subgroups. The most clinically meaningful cluster was a two-subgroup option, comprising a small group (n = 24) with more severe clinical presentation (i.e. more widespread pain, functional and sleeping problems, other symptoms, increased investigations undertaken, more severe clinical signs, etc.) and a larger less dysfunctional group (n = 80). A number of potentially discriminatory clinical items were identified by health professionals and sub-classified, based on a sample of patients with non-specific low back pain, into two subgroups. However, further work is needed to validate this classification process.

Journal of Rehabilitation Medicine Official Journal of the Uems European Board of Physical and Rehabilitation Medicine 2012 44 851 857, 2012

Objective: To investigate the inter-tester reliability of a nonspecific low back pain examination... more Objective: To investigate the inter-tester reliability of a nonspecific low back pain examination procedure, for sub-classifying non-specific low back pain. Design: Reliability study. Participants: Thirty patients with non-specific low back pain (12 males, 18 females, mean age 27.7 years, standard deviation 10.3) and 7 physiotherapists (raters). Methods: Based on a health professionals' consensus via focus groups and a Delphi servey, an examination procedure was developed comprising 206 items discriminatory for nonspecific low back pain, 108 of which were from the History (clinical questions) and 98 from the Physical Examination (clinical tests) section. Utilizing this procedure, each patient was examined by a blinded pair of raters. Results: Moderate to excellent agreement was obtained in 125 (61%) items (77 History and 48 Physical Examination items), 47 of which obtained substantial or excellent agreement (kappa>0.61), 37 moderate agreement (kappa between 0.41 and 0.6), and 41 excellent percentage agreements. Poor reliability (kappa < 0.41) was yielded in the remaining 81 items (31 History and 50 Physical Examination items). Conclusion: Satisfactory reliability was obtained in nearly two-thirds of History and half of the Physical Examination items on a non-specific low back pain assessment list generated through consensus agreement. These findings provide clinicians and researchers with valuable information regarding which items are considered reliable and can be utilized in non-specific low back pain patient evaluation/assessment procedures, classification attempts and clinical trials.

Purpose Of the most commonly encountered clinical sign in shoulder patients is loss of muscular c... more Purpose Of the most commonly encountered clinical sign in shoulder patients is loss of muscular control around scapula. One of the muscles which is subject to electromyographic (EMG) alterations is trapezius. Especially its upper fibres are found to be overactivated leading to limited upward scapular rotation (Ludewig et al. 2004). Scapular taping is suggested as a method of improving both, muscular control and scapular position (Selkowitz et al. 2007, Hsu et al. 2009). The aim of this study is to explore the electromyographic activity of upper trapezius following the application of tape in patients with suspected subacromial impingement and anterior glenohumeral subluxation. Methods 9 women (mean age:34,7) with suspected subacromial impingement, 4 of which had co-existent anterior subluxation, and 7 healthy females (mean age:22) who served as controls, volunteered to participate in this pilot. Subjects were requested to perform abduction in the scapular plane with and without the a...

Introduction: In recent years, artificial intelligence is used in a variety of systems in the fie... more Introduction: In recent years, artificial intelligence is used in a variety of systems in the field of medicine. The time when the only asset of the doctor was the classic leather bag containing a few basic instruments such as the stethoscope belongs to the dustbin of history. Objectives: In this paper we attempt to objectify and modeling the postoperative pain of planned orthopedic surgery in the knee with the help of machine learning and artificial intelligence tools. The purpose of this modeling is to create an intelligent system of evaluation and assessment of postoperative pain and to answer the hypothesis, if the use as an objective parameter value as derived from the recording of somatosensory evoked potentials (SSEP) may affect the accuracy Methods: The used data were recorded from 52 patients who underwent elective surgery in the knee in the Orthopaedic Clinic of the University Hospital of Patras. Four to eight hours postoperatively, the patients were evaluated by the same ...

Introduction: The rotator cuff muscles have been showed to be the substantial dynamic stabilizers... more Introduction: The rotator cuff muscles have been showed to be the substantial dynamic stabilizers of the glenohumeral joint in multiple shoulder positions. The supraspinatus provides glenohumeral compression, abduction and generates a small external rotation (Reinold et al. 2009). The architectural characteristics of the supraspinatus usually involve in measuring parameters as thickness, width and cross sectional area (CSA) as important factors for the functionality during dynamic and static movements (Whittaker, et al. 2011; Han, et al. 2012). Objectives: The objective of this study was to evaluate the CSA of the supraspinatus muscle on the dominant and non- dominant shoulders in amateur tennis players using brightness mode ultrasonography, as prognostic factors to improve insights for physiotherapists and orthopaedic surgeons. Methods: Ultrasonography images from the supraspinatus CSA were recorded in 20 participants, 23-27 years of age, who were involved unprofessionally in tenni...

Physiotherapy, 2015

One of the most accepted footedness measure outcomes is the Waterloo Footedness Question-Revised ... more One of the most accepted footedness measure outcomes is the Waterloo Footedness Question-Revised (WFQ-R). The main advantage of WFQ-R against the other questionnaires of the same category is that it has been designed to assess both foot preference for mobilizing and stabilizing tasks. Therefore, it has been used in an extensive number of neurophysiology research and motor behavior research protocols.

Physiotherapy, 2015

Given the high incidence of low back pain (LBP) internationally, there is still debate on the imp... more Given the high incidence of low back pain (LBP) internationally, there is still debate on the impact of pain intensity and location (including back-associated leg pain) on perceived disability and life-functioning factors in younger or middle-aged adults, where occupation is of primary importance. Additionally, there is limited research in how these factors affect the Greek population.

Introduction: Spinal metastatic disease is very common in patients with cancer. The goals of ther... more Introduction: Spinal metastatic disease is very common in patients with cancer. The goals of therapy are pain control and functional preservation. Kyphoplasty and spondyloplasty are minimal invasive procedures that play a crucial role in the treatment of spinal metastatic spine disease. Aims/Objectives: We assess the quality of life, anxiety and depression in long term follow up, after kyphoplasties and spondyloplasties in thoracic and lumbar spinal metastatic fractures and lytic lesions with EuroQuol (EQ - 5D) and HADS instruments. Methods: One hundred-seven patients (60 men - 47 women, mean age: 62,4 years old) underwent 141 procedures. Patient-related outcomes EuroQuol (EQ - 5D) and HADS (Hospital Anxiety and Depression Scale) instruments, were assessed pre- and post-operatively and after 3, 12, 24 months, 3 years and 4 years follow up. Results: Mean EQ-5D and HADS scales significantly improved (32% and 41%) from pre- to post-treatment (P < 0.0001). This improvement being sust...