Chronic Tendinopathy of the Achilles and Patellar Tendon. Part I: Histopathology and diagnostic means.

Vasileios Korakakis

Tendon pathology is very common among physiotherapy patients. Tendinopathy is a common disorder, where certain tendons, such as the Achilles and Patellar, are particularly vulnerable to degenerative pathology. Disorders of these tendons are often directed to chronicity and the successful management is difficult and long. The aim of this review is the research in the literature and the evaluation of the treatment procedures, but also the tracing of the elements that define molecularly and structurally tendinopathy. Despite etiology and pathogenesis of chronic tendinopathy are incompletely understood, histolopathological and biochemical evidence leads to a more degenerative, rather than inflammatory, appreciation of the nature of this condition. More specifically, structural abnormalities, increased celularity and neovascularisation, compose the image of an incorrect or a failed intrinsic tendon healing response.


Reliability of methods of evaluation of balance in children with cerebral palsy.

Georgia Iatridou, N. Aggeloulis, V. Gourgoulis, A. Kampas, I. Kandrali

The evaluation of balance in children with cerebral palsy (CP) it is an extremely difficult and complex procedure. Varied methods of balance evaluation are mentioned in the international literature, but almost none has any clinical utility in children with CP. The purpose of the present study was the application of three methods of evaluation of balance (BBS, TUG and BOTMP) in children with CP, as also their evaluation in with regard to reliability. Methodology: The reliability control of the tests was based on their successive application to twenty children with CP within the short period of one day and one week in order to substantiate their ability to produce the same results in a stable sample (test ? retest reliability). Additionaly, for the control of the reliability the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the coefficient of variation (CV) and the limits of agreement (LOA) of measures were calculated in different performances of the tests. Results: All methods (BBS, TUG and BOTMP) presented excellent reliability in all their applications and although the BOTMP method presented smaller reliability than the other two, it is not characterized as unreliable. Conclusions: The tests BBS, TUG and BOTMP are considered to be reliable and able to evaluate the balance of the child with CP.


Proprioceptive changes in the ankle joint after injury of the lateral ankle ligament

Savvas Spanos, I. Gantiafikas

The aim of the present review is to investigate the extent, that the injury due to sudden and forceful inversion of the lateral ankle ligament can disrupt the proprioceptive input from the joint. The researchers, in an effort to investigate if there is a proprioceptive deficit in the ankle joint after a lateral sprain, evaluated kinaesthesia,joint position sense and balance. Some performed injections of anaesthetics to check the percentage of contribution of the mechanoreceptors of the lateral ligament to proprioception, while others measured the activation time of the peroneal muscles during sudden inversion of the foot. The methods used have been shown to be valid and reliable, although some are considered to be subjective. The biggest problem of probably most studies is the small sample size. It is concluded that most studies agree that the injury of the lateral ankle ligament creates a proprioceptive deficit, that presents mostly as decreased balance ability, or decreased perception of motion of the joint at small speeds (<2o/sec). The input from the other receptors in the area strives to compensate for the deficit, but not adequately, something that leads to increased risk of reinjury in the joint.


Neuromuscular changes during aging

Theodora Plavoukou, S. Panagiotis, P. Sofroniadi, A. Spiradis

The aim of the present study is to review the current data concerning aging, the way it affects the muscle tissue and the proper therapeutic approach in order to deal with the age-related deficits. Information is focused on the effect of aging on the muscle cell, the nervous system, the muscle morphology and on the parameters of muscle function and functional ability. Generally, reductions take place at the basic cellular functions (protein synthesis, enzyme activities, mtRNA transcription, ROS), that cause an increase of catabolic and a decrease of anabolic cellular activities. Moreover, degenerative procedures of the nervous system take place (a decrease in the number of motor neurons, a decrease in nerve conduction velocity, neuromuscular junction degeneration), that cause changes at the muscle function and morphology. These procedures severely alter the parameters of muscle function (muscle strength, endurance, power), and set important limitations on the functional abilities of the elderly. Moreover, a report about the physiotherapist?s intervention is made, who, by means of exercise, contributes in the prevention and the partial rehabilitation of kinetic functional deficits and decelerates the degenerative processes.)