Papers by Antonis Angoules
Journal of Frailty, Sarcopenia and Falls, 2019
Objective: Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseas... more Objective: Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseases are related to increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and postmenopausal women and women with rheumatic diseases. Methods: Two hundred fifty seven women were included in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. Results: Height was decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical significance was found among POST HEALTH and POST OST women. Conclusions: Jumping mechanography can be proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.
Journal of Novel Physiotherapies, 2016
Cardiac rehabilitation is a long-term plan of care that is based on the motivation of patients to... more Cardiac rehabilitation is a long-term plan of care that is based on the motivation of patients to attend rehabilitation. The purpose of the review was to synthesize existing evidence on motivational methods to attend outpatient cardiac rehabilitation; in order to create an evidence-based strategy addressing patient education, psychologic issues and guide healthcare professional action.
World Journal of Orthopedics, 2015
Osteitis pubis (OP) is a debilitating overuse syndrome characterizing by pelvic pain and local te... more Osteitis pubis (OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to
Journal of Novel Physiotherapies, 2015
Journal of Novel Physiotherapies, 2014
British Journal of Medicine and Medical Research, 2015
Objective: Hippotherapy or Equine Assisted Therapy (EAT) is an alternative therapeutic treatment ... more Objective: Hippotherapy or Equine Assisted Therapy (EAT) is an alternative therapeutic treatment which is based on the special benefits of horse riding. The purpose of the herein review is to investigate the efficacy of this method for the treatment of several dysfunctions affecting the musculoskeletal system. Materials and Methods: International literature was thoroughly studied, with special focus on indications and therapeutic effectiveness of this method in injuries and diseases of musculoskeletal interest. Results: EAT seems to contribute positively to spasticity reduction, following spinal cord injuries (SCIs) and affects the overall patients’ quality life. It also acts positively on the prevention of falls in Review Article Angoules et al.; BJMMR, 8(4): 289-297, 2015; Article no. BJMMR.2015.451 290 the elderly. Less evidence exists on the usefulness of this method in scoliotic curvature reduction in children with cerebral palsy (CP) and in treatment of Low back Pain (LBP). Conclusion: Hippotherapy improves muscle strength, balance and coordination of movement and it also contributes to relaxation and control of posture. Thus, it seems that as a supplementary method, accompanying other individualized therapeutic approaches, it can address a number of problems of the musculoskeletal system. More and well-designed studies are needed to draw firm conclusions about the benefits and the indications of the method.
OBJECTIVE: A number of non-operative treatment protocols have been proposed in the literature for... more OBJECTIVE: A number of non-operative treatment protocols have been proposed in the literature for lumbar stenosis. However, the available primary research describes inadequately the employed protocol. This causes diffi culties in distinguishing which interventions are more effective in reducing symptoms. METHODS: We reviewed existing studies in order to promote the construction of an evidence-based strategy for non-operative treatment rehabilitation of lumbar stenosis patients. Randomized controlled trials describing insuffi ciently the non-operative treatment rehabilitation protocols were excluded since the results may not direct this review towards a favorable treatment plan. RESULTS: A protocol has been outlined to inform the clinician and to elucidate the effectiveness of non-operative treatment through randomized controlled trials. The results of this study indicate that a comprehensive exercise and manual therapy protocol is more effective in reducing symptoms than a less intensive exercise program. CONCLUSIONS: A comprehensive non-operative treatment comprising of fl exion exercises, manual therapy and treadmill exercises appears to be more benefi cial in reducing symptoms than a less vigorous program comprising of fl exion exercises, treadmill training and home exercise.
Clinical Orthopaedics & Related Research, 2009
Although acute management of pelvic fractures and their long-term functional outcome have been wi... more Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic implications. We analyzed the factors predisposing a pelvic injury to develop malunion/nonunion, the clinical presentation of these complications, and the efficacy of the reported operative protocols in 437 malunions/nonunions of 25 clinical studies. Treatment of these demanding complications appeared effective in the majority of the cases: overall union rates averaged 86.1%, pain relief as much as 93%, patient satisfaction 79%, and return to a preinjury level of activities 50%. Nevertheless, the patient should be informed about the incidence of perioperative complications, including neurologic injury (5.3%), symptomatic vein thrombosis (5.0%), pulmonary embolism (1.9%), and deep wound infection (1.6%). For a successful outcome, a thorough preoperative plan and methodical operative intervention are essential. In establishing effective evidence-based future clinical practice, the introduction of multicenter networks of pelvic trauma management appears a necessity. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
World Journal of Orthopedics, 2017
Intersection syndrome is a rare sports overuse injury occurring through friction at the intersect... more Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis. Clinical examination provides with the necessary information for diagnosis, still magnetic resonance imaging scans and ultrasonography may assist in diagnosis. Treatment consists mainly of rest, use of a thumb spica splint, analgetic and oral nonsteroidal anti-inflammatory drugs and after 2-3 wk progressive stretching and muscle strengthening. Should symptoms persist beyond this time, corticosteroid injections adjacent to the site of injury may be useful. In refractory cases, surgical intervention is warranted.
Emergency Medicine: Open Access, 2014
Hip pain in children is a diagnostic challenge for every practitioner in emergency medicine and f... more Hip pain in children is a diagnostic challenge for every practitioner in emergency medicine and for any other doctor or health professional, facing this common symptom. Diagnosis may vary from innocent conditions such as Transient Synovitis (TS), also mentioned as "irritable hip", to hazardous for the child health diseases like Septic Arthritis (SA). Differential diagnosis includes a wide spectrum of pathological conditions, some of which require urgent investigation and treatment. Trauma, Legg-Calvé-Perthes disease, Slipped Femoral Capital Epiphysis (SFCE), arthritis, transient synovitis, joint sepsis, osteomyelitis and rarely primary or metastatic bone tumors, may be the cause of hip pain in a limping child [1,2]. A prompt and accurate diagnosis is vital for the child's health.
Cases Journal, 2008
Background Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, charact... more Background Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, characterised by both benign and malignant tumours affecting multiple systems. Case presentation We present a 47-year-old female patient with thigh pain that was diagnosed with Cowden syndrome 20 years ago and developed multiple and different skeletal metastases which became resistant to radio-chemotherapy. A percutaneous plate fixation of the distal femur with an intralesional excision and cementoplasty of the metastasis was performed initially. This was combined with a cemented total hip arthroplasty using an Exeter long revision stem and a cementoplasty of the femoral canal for the proximal lesions. Conclusion A meticulous approach to her complex metastatic disease resulted in successful palliative prophylactic reconstructive surgery that improved her quality of life, allowing her independent pain free walking for 12 months.
Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation ... more Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation who received an artificial joint. Materials and Methods. 22 patients (18 men, 4 women), 24-65 years old (mean: 42), who had undergone above-the-knee joint amputation and underwent evaluation of proprioception using joint reposition in a predetermined angle of 15 ∘ knee flexion. The measurements were applied using a conventional goniometer to both amputated and healthy knees. The last ones were used as internal control. All patients performed an active knee flexion from hyperextension to 15 ∘ in a closed kinetic chain in order to evaluate proprioceptive sensation of the knee joint using the joint position sense (JPS) method during specific controllable circumstances very close to normal gait. Results. JPS at 15 ∘ flexion for the amputated knee was calculated to be equal to 13.91 (SD = ±4.74), and for the healthy side it was equal to 14.15 (SD = ±2.61). No statistically significant differences were detected between the amputated and the healthy limb (> 0.05). Conclusions. The proprioceptive information of the stumps did not appear to be affected significantly after thigh amputation and application of artificial prosthesis when JPS at 15 ∘ was evaluated. It seems that these patients compensate the loss of the knee sensory receptors via alternative mechanisms.
Purpose. To evaluate anterior-posterior knee laxity using two different autografts. Material-Meth... more Purpose. To evaluate anterior-posterior knee laxity using two different autografts. Material-Methods. 40 patients, (34 males and 6 women), 17-54 years old (mean: 31), were included in the present study. Group A (4SHS = 20) underwent reconstruction using four-strand hamstrings, and group B (BPBT = 20) underwent reconstruction using bone-patellar tendon-bone autograft. Using the KT-1000 arthrometer, knee instability was calculated in both knees of all patients preoperatively and 3, 6, and 12 months after surgery at the ACL-operated knee. The contralateral healthy knee was used as an internal control group. Results. Anterior-posterior instability using the KT1000 Arthrometer was found to be increased after ACL insufficiency. The recorded laxity improved after arthroscopic ACL reconstruction in both groups. However, statistically significant greater values were detected in the bone-patellar tendon-bone group, which revealed reduction of anteroposterior stability values to an extent, where no statistical significance with the normal values even after 3 months after surgery was observed. Conclusions. Anterior-Posterior instability of the knee improved significantly after arthroscopic ACL reconstruction. The bone-patellar tendon-bone graft provided an obvious greater stability.
Journal of Trauma & Treatment, 2014
JFSF | December 2019 | Vol. 4, No. 4 | 116-121, 2019
Objective: Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseas... more Objective: Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseases are related to
increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and
postmenopausal women and women with rheumatic diseases. Methods: Two hundred fifty seven women were included
in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic
drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy
postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean
age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the
measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in
Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. Results: Height was
decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST
HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical
significance was found among POST HEALTH and POST OST women. Conclusions: Jumping mechanography can be
proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the
clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.
HORMONES 2017, 16(4):429-439, 2017
World J Orthop 2019 February 18; 10(2): 71-80, 2019
Cuboid fractures due to the particular bone anatomy and its protected location in
the midfoot are... more Cuboid fractures due to the particular bone anatomy and its protected location in
the midfoot are rare, and they are usually associated with complex injuries of the
foot. Clinical examination to diagnose these fractures should be detailed and the
differential diagnosis, especially in the case of vague symptoms, should include
the exclusion of all lateral foot pain causes. Conventional radiographs do not
always reveal occult fractures, which can be under diagnosed especially in
children. In this case, further investigation including magnetic resonance imaging
or scintigraphy may be required. The treatment of these injuries depends on the
particular fracture characteristics. Non-displaced isolated fractures of the cuboid
bone can be effectively treated conservatively by immobilization and by avoiding
weight bearing on the injured leg. In the case of shortening of the lateral column
> 3 mm or articular displacement > 1 mm, surgical management of the fracture is
mandatory in order to avoid negative biomechanical and functional
consequences for the foot and adverse effects such as arthritis and stiffness as
well as painful gait. In this review, an update on diagnosis and management of
cuboid fractures is presented.
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Papers by Antonis Angoules
increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and
postmenopausal women and women with rheumatic diseases. Methods: Two hundred fifty seven women were included
in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic
drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy
postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean
age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the
measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in
Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. Results: Height was
decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST
HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical
significance was found among POST HEALTH and POST OST women. Conclusions: Jumping mechanography can be
proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the
clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.
the midfoot are rare, and they are usually associated with complex injuries of the
foot. Clinical examination to diagnose these fractures should be detailed and the
differential diagnosis, especially in the case of vague symptoms, should include
the exclusion of all lateral foot pain causes. Conventional radiographs do not
always reveal occult fractures, which can be under diagnosed especially in
children. In this case, further investigation including magnetic resonance imaging
or scintigraphy may be required. The treatment of these injuries depends on the
particular fracture characteristics. Non-displaced isolated fractures of the cuboid
bone can be effectively treated conservatively by immobilization and by avoiding
weight bearing on the injured leg. In the case of shortening of the lateral column
> 3 mm or articular displacement > 1 mm, surgical management of the fracture is
mandatory in order to avoid negative biomechanical and functional
consequences for the foot and adverse effects such as arthritis and stiffness as
well as painful gait. In this review, an update on diagnosis and management of
cuboid fractures is presented.
increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and
postmenopausal women and women with rheumatic diseases. Methods: Two hundred fifty seven women were included
in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic
drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy
postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean
age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the
measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in
Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. Results: Height was
decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST
HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical
significance was found among POST HEALTH and POST OST women. Conclusions: Jumping mechanography can be
proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the
clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.
the midfoot are rare, and they are usually associated with complex injuries of the
foot. Clinical examination to diagnose these fractures should be detailed and the
differential diagnosis, especially in the case of vague symptoms, should include
the exclusion of all lateral foot pain causes. Conventional radiographs do not
always reveal occult fractures, which can be under diagnosed especially in
children. In this case, further investigation including magnetic resonance imaging
or scintigraphy may be required. The treatment of these injuries depends on the
particular fracture characteristics. Non-displaced isolated fractures of the cuboid
bone can be effectively treated conservatively by immobilization and by avoiding
weight bearing on the injured leg. In the case of shortening of the lateral column
> 3 mm or articular displacement > 1 mm, surgical management of the fracture is
mandatory in order to avoid negative biomechanical and functional
consequences for the foot and adverse effects such as arthritis and stiffness as
well as painful gait. In this review, an update on diagnosis and management of
cuboid fractures is presented.