Evangelos Pappas

University of Wollongong | UOW · Illawarra Health and Medical Research Institute

Objectives To estimate the financial burden of anterior cruciate ligament (ACL) reconstructions in amateur football (soccer) players in Australia over a single year, including both direct and indirect cost. Methods Available national direct and indirect cost data were applied to the annual incidence of ACL reconstructions in Australia. Age-adjuste...

Despite emerging research questioning the long-term effect of purposeful heading on players' brain health, heading-related perspectives and behaviours of stakeholders in amateur football in Australia (a country without heading guidelines) remain unknown. This study aimed to explore current heading-related perspectives and behaviours of football sta...

Background Patellofemoral pain (PFP) is a common knee disorder that causes persistent pain, lower self-reported function and quality of life. People with PFP also present with altered psychological factors, which are associated with higher levels of pain and dysfunction. Mindfulness-based interventions (MBI) generally consist of meditative practice...

Objectives To explore the usage and awareness of the FIFA 11 + (11 + ) across multiple stakeholders involved with amateur football. Methods Coaches, players, non-coaching staff and medical personnel in New South Wales (NSW), Australia, were invited to complete a cross-sectional online survey, which was disseminated using a targeted email to two Fo...

Background The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomecha...

SYNOPSIS: Current injury-specific return-to-performance rehabilitation programs are not comprehensive, lack intensity, and need better tailoring to the demands of sport. The vast number of rehabilitation and return to sport protocols also reflects a lack of consensus about what the best program looks like, which hinders beginning practitioners from...

Objective: Examine longitudinal changes in trunk, hip, and knee kinematics in maturing boys during an unanticipated cutting task. Design: Prospective cohort study. Setting: Biomechanical laboratory. Participants: Forty-two high-school male basketball, volleyball, and soccer athletes. Assessment of risk factors: Trunk, hip, and knee range-o...

Objectives The primary aim of this study was to compare injury rates pre- and post- COVID-19 lockdown in sub-elite football (soccer) players by analysing the full season and the first month of each season between 2018-2020. Secondary aims were to describe the incidence, location and type of injuries and to compare injuries by age group and sex. De...

Background Despite knee extensor and flexor strength reportedly being associated with injury risk, including rupture of the anterior cruciate ligament in girls, there is limited evidence for the longitudinal changes in lower extremity strength. Purpose To investigate the sex-specific relationship with longitudinal changes of knee extensor and flex...

Objectives To systematically evaluate the literature and estimate the prevalence, incidence, and burden of gradual-onset knee injuries in team ball-sports. Design Systematic review with meta-analysis. Method Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, SPORTDiscus, SCOPUS) were searched from inception to June 2021. Cohort studies of te...

Objectives To determine the direct and indirect costs of injuries in sub-elite footballers in New South Wales (NSW), Australia, stratified by injury location, type, sex and age groups. Design Descriptive epidemiological study. Methods A de-identified insurance database containing three seasons (2018–2020) of football injuries in NSW was used to d...

Background Not all anterior cruciate ligament (ACL) injuries are preventable. While some ACL injuries are unavoidable such as those resulting from a tackle, others that occur in non-contact situations like twisting and turning in the absence of external contact might be more preventable. Because ACL injuries commonly occur in team ball-sports that...

Objectives To systematically review the literature on the effects of ankle supports on lower extremity biomechanics during functional tasks. Design Systematic review with meta-analysis. Methods Eight electronic databases were searched from inception to July 2019. Studies of biomechanical outcomes during functional tasks that used a within-partici...

Background Most people who suffer an anterior cruciate ligament (ACL) injury search for information online. Objectives Summarise the proportion of webpages on ACL rupture management that present evidence-based information. Design Content analysis. Methods We examined webpage information on ACL ruptures identified through (1) Google searches usin...

Synopsis: Social marketing is successful at tackling global health threats and social change but has not been fully explored in sports injury prevention contexts. The social marketing mix (product, price, place, and promotion) can help create exercise-based injury prevention programs with high-value propositions that will be relevant to their impl...

Introduction: Extremity dominance is one of the intrinsic factors that have been identified for ankle sprains. Electromechanical delay (EMD) is an integral part of the peroneal motor response and, therefore, substantial in preventing ankle sprains. This study aimed to investigate the effect of laterality on EMD times before and after fatigue. Met...

PurposeSpinal sagittal balance is associated with back pain and quality of life. Enhancing understanding of the clinical factors associated with sagittal balance is essential for guiding the development of effective non-operative treatment. We aimed to evaluate the associations between spinal sagittal balance and potentially modifiable clinical fac...

Background Knee extensor and flexor strength are associated with injury risk, including rupture of the anterior cruciate ligament. However, the longitudinal changes in lower extremity strength with maturation have been under-investigated. Objective To investigate the longitudinal changes of knee extension and flexion strength associated with matur...

Background Proximal stability has been proposed as a contributor to athletic knee injuries. However, it is unclear if this is supported by current evidence. Objective Examine the association between proximal stability and future athletic knee injuries Design Systematic review, meta-analysis and best-evidence synthesis. Setting Amateur to elite a...

Background Young female athletes involved in high-speed cutting and change-of-direction sports are particularly susceptible to anterior cruciate ligament (ACL) injuries. Little is known if maturational changes in cutting technique contribute to the increased injury risk. Objective To examine longitudinal changes in cutting kinematics in female ath...

Background Not all ACL injuries are preventable. The epidemiology of non-contact ACL injuries is not known. Objective To estimate the incidence and proportion of non-contact to total ACL injuries by sex, age, sport, participation level, and exposure type. Design Systematic review, meta-analysis and meta-regression Setting Team ball-sports (socce...

The anterior cruciate ligament (ACL) plays an important role in stabilizing translation and rotation of the tibia relative to the femur. Individuals with ACL deficiency usually demonstrate alterations in gait characteristics. Evidence indicates that walking speed, alterations in kinetics and kinematics on the ACL deficient limb, and inter-limb asym...

Despite increased awareness of the multifactorial nature of Hamstring Strain Injury (HSI), the role of running biomechanics remains unclear. The aim of this systematic review was to investigate whether an association exists between running biomechanics and HSI. Five databases were searched from inception to January 2021. Eligibility criteria includ...

Objective Young female athletes involved in high-speed cutting and change-of-direction sports are particularly susceptible to anterior cruciate ligament (ACL) injuries. Little is known if maturational changes in cutting technique contribute to the increased injury risk. Our objective was to examine longitudinal changes in cutting kinematics in fema...

Inertial Measurement Units (IMUs) are promising alternatives to laboratory-based motion capture methods in biomechanical assessment of athletic movements. The aim of this study was to investigate the validity of an IMU system for determining knee and trunk kinematics during landing and cutting tasks for clinical and research applications in sportin...

Inertial Measurement Units (IMUs) are a promising alternative to laboratory-based motion-capture methods for the biomechanical assessment of athletic movements. The aim of this study was to investigate the validity of an IMU system for determining knee and trunk kinematics during landing and cutting tasks in sporting populations. Twenty-seven parti...

[Purpose] The sagittal shape of the spine is associated with back-pain, balance and quality of life. We developed, evaluated and report the responses of a graphical tool to assess sagittal spine shape knowledge (literacy). [Participants and Methods] Two hundred and fifty adults were randomly assigned, in a cross-sectional crossover study, to free-h...

Objective To investigate whether intensive supervised rehabilitation following ACL reconstruction leads to superior self-reported function and sports participation compared to less supervised rehabilitation. Design Systematic review and meta-analysis. Data sources We performed electronic database searches in several key databases and trial regist...

PurposeThe purpose of this study is to examine the association between the development of articular cartilage pathology and knee rotation after single-bundle anterior cruciate ligament (ACL) reconstruction. Methods Seventeen patients that underwent single-bundle ACL reconstruction and did not have any cartilage lesions at the time of surgery based...

Background Biofeedback is used to optimise muscle activation patterns in people with neck pain. Objectives To evaluate the safety and efficacy of electromyographic and pressure biofeedback on pain, disability and work ability in adults with neck pain. Design Systematic review and meta-analysis. Methods We searched key databases and trial registr...

Objective To investigate predictors of low back and lower extremity musculoskeletal injury in a cohort of Naval cadets. Design Prospective Cohort Study Methods 545 Naval cadets (Males, n = 394, 72%) were followed-up over eight months. Nine variables were investigated as predictors: history of musculoskeletal symptoms in the last 12 months, ankle...

Introduction Numerous studies have focused on the anteroposterior stability after anterior cruciate ligament (ACL) reconstruction, with less emphasis on rotational stability. It has been hypothesized that bone patella tendon bone (BTB) autograft for ACL reconstruction restores knee rotation closely to normal due to its comparable fiber orientation...

Background: Although alterations in posture, flexibility, and motion control of the lumbar spine are associated with low back pain, the underlying interplay between genetic and environmental influences on these traits remains unclear. The aim of this study is to investigate the extent to which genetics and the environment influence lumbar lordosis...

Objective: To determine if neuromuscular deficits in trunk and hip-related function are risk factors for athletic knee injuries. Design: Aetiology systematic review with meta-analysis. Literature search: Six online databases (MEDLINE, Web of Science, EMBASE, CINAHL, Scopus and SPORTDiscus) searched until April 2019. Study selection criteria:...

Purpose: To investigate the effect of different sit-stand workstations on lumbar spine kinematics, lumbar muscle activity and musculoskeletal pain. Materials and methods: Thirty-two office workers were randomised to one of three sit-stand workstations (Group 1 , ratio of minutes spent sitting to standing each hour at work was 40:20, n=8; Group 2, 3...

The aim of this study is to develop a new pattern recognition-based method to model and discriminate gait dynamics disparity between anterior cruciate ligament (ACL) deficient (ACL-D) knee and contralateral ACL-intact (ACL-I) knee in patients with unilateral ACL deficiency by using kinematic features and neural networks. Thereby the capabilities of...

The anterior cruciate ligament (ACL) possesses the function of stabilizing the knee joint through limiting anterior tibial translation and controlling tibial rotation. Patients with unilateral ACL deficiency often demonstrate alterations of knee kinematics, kinetics and gait patterns in the deficient side in comparison to the unaffected contralater...

Despite the increase in the number of Ironman competitions worldwide, thousands of athletes have been joining Ironman experience but only a few studies have been published on the effects of this competition on postural control. This study aims to investigate the ability to maintain a static posture in three different positions before and after an I...

The anterior cruciate ligament (ACL) is one of the most important structures of the knee joint which plays a significant role in controlling knee joint stability. Patients with unilateral ACL deficiency often show alterations of their gait patterns in the deficient side in comparison with the unaffected contralateral side. Gait analysis is widely u...

Interventions (or assessment of risk factors) We defined injuries as overuse,subjective, non-traumatic or soft tissues.Multiple variables were measured throughout the season and pooled in 5 categories: external and internal load, mental state, heart rate variability and neuromuscular function. We also engineered multiple features from the training...

Introduction Driving performance, as assessed using a driving simulator, after distal radius fracture has not been previously studied. Our aims were to undertake a pilot study to assess feasibility via: (i) acceptability of driving simulation for this assessment purpose, (ii) recruitment and retention, (iii) sample size calculation. Preliminary eva...

http://link.springer.com/article/10.1007/s00167-019-05807-6 Editorial Above-normal weight is a worldwide public health problem and an important risk factor for cardiovascular diseases and premature death [6]. Complications generated by overweight/obesity are estimated at $75 to $117 billion per annum in the United States [7]. In this context, regul...

Plantar heel pain is a common musculoskeletal foot disorder that can have a negative impact on activities of daily living and it is of multifactorial etiology. A variety of mechanical factors, which result in excessive load at the plantar fascia insertion, are thought to contribute to the onset of the condition. This review presents the evidence fo...

Background: Professional dance is a physically demanding career path with a high injury prevalence, yet an ingrained culture of hiding or pushing through injuries. Developing better knowledge surrounding the cultural beliefs and behaviors related to injury reporting is critical to understand their incidence and burden. Therefore, the aim of this s...

The anterior cruciate ligament (ACL) plays an important role in controlling knee joint stability. The literature provides conflicting information on whether patients with ACL deficiency exhibits gait adaptations. The aim of this study is to investigate if the use of neural networks with a new pattern recognition-based method can differentiate gait...

Ferreira, AS, de Oliveira Silva, D, Ferrari, D, Magalhães, FH, Pappas, E, Briani, RV, Pazzinatto, MF, and de Azevedo, FM. Knee and hip isometric force steadiness are impaired in women with patellofemoral pain. J Strength Cond Res XX(X): 000-000, 2019-The purposes were as follows: to compare knee extension and hip abduction force steadiness and maxi...

Background: Orthopaedic physical therapists (PTs) who perform manual therapy are at high risk for wrist and hand pain. Studies that examine the magnitude, scope and causes of wrist and hand pain are needed so that prevention programs can be developed. Objectives: The objective of this study was to determine the magnitude, scope, and impact of wr...

Following an anterior cruciate ligament (ACL) injury, patients are often reassured that timely surgery followed by intensive physiotherapy will “fix their knee”. Not only does this message create a false perception of uncomplicated return to sport (RTS), it also ignores the large body of evidence demonstrating a high RTS re-injury rate following AC...

Background: There is increasing evidence that motor imagery performance (MIP) is impaired in conditions that have a component of movement dysfunction. However, MIP has not been investigated in people with chronic anterior cruciate ligament (ACL) deficiency who experience limited disability and function at high levels. Hypothesis: This study had...

Background Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking....

Background: Long-term gait adaptations after anterior cruciate ligament reconstruction (ACLR) have been reported. However, it is still unclear if they persist more than 4 years after surgery and if they are affected by gait speed. Research question: To investigate differences between groups, legs and walking speeds for ankle, knee and hip joint mom...

Purpose: To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. Methods: In this randomized trial, 32 football players (18-23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 e...

Background:: There is evidence that frontal plane knee joint motion plays a crucial role in the pathogenesis of knee osteoarthritis, yet investigation of individuals with chronic anterior cruciate ligament-deficient (ACLD) knees remains sparse. Purpose:: To investigate (1) if individuals with chronic ACLD knees demonstrate higher biomechanical m...

Objective: The primary objective of this study was to compare the long-term (1-year follow-up) effects of the McKenzie method and motor control exercises on trunk muscle thickness in people with chronic low back pain (LBP) and a directional preference. Design: Randomized controlled trial. Setting: A secondary public health facility in Sydney,...

The purpose of this study was to systematically review the literature and synthesise the evidence on injury rates and characteristics in recreational, elite student, and professional dancers. Five online databases were searched from inception to January 2018 and screened by two independent reviewers. Primary research studies were eligible for inclu...

Background:: It is well accepted that there is a higher incidence of repeat anterior cruciate ligament (ACL) injuries in the pediatric population after ACL reconstruction (ACLR) with autograft tissue compared with adults. Hamstring autograft harvest may contribute to the risk for repeat ACL injuries in this high functional demand group. A novel me...

Background: Crepitus is a common clinical feature of knee osteoarthritis. However, the importance of crepitus in the overall clinical presentation of individuals with knee osteoarthritis is unknown. Objective(s): (A) To compare function, pain and quality of life between individuals with knee osteoarthritis with and without crepitus; (B) to compa...

Repetition of jumps in dance and sport training poses a potential injury risk, however non‐contact landing injuries are more common in athletes than dancers. This study aimed to compare the lower limb stiffness characteristics of dancers and athletes during drop landings to investigate possible mechanisms of impact‐related injuries. Kinematics and...

Objectives To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. Design Prospective cohort study. Setting We used family-linked longitudinal data from the Norwegian HUNT study collected...

Severo-Silveira, L, Dornelles, MP, Lima-e-Silva, FX, Marchiori, CL, Medeiros, TM, Pappas, E, and Baroni, BM. Progressive workload periodization maximizes effects of Nordic hamstring exercise on muscle injury risk factors. J Strength Cond Res XX(X): 000-000, 2018-This study aimed to investigate the effect of 2 different Nordic hamstring exercise (NH...

Purpose The purpose of the study is to determine the effectiveness of semi-active and active robotic hip and knee arthroplasty on post-operative patient-reported outcomes of function, pain, quality of life and satisfaction with surgery. Methods PubMed, Medline, Embase and CENTRAL were searched. Included were comparative studies investigating the e...

Objective(s): To investigate whether the presence of knee crepitus is associated with the occurrence of total knee replacement (TKR), quality of life and deficits in physical function at long-term. Methods: Setting - This observational study uses longitudinal data (up to 4-year follow-up) from the Osteoarthritis Initiative (OAI). Participants -...

Objective: (s): The aim of this study was threefold: (i) To compare the amplitude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls; (ii) To compare the amplitude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls; (iii) To investigate the associatio...

Background: Two-dimensional (2-D) analysis is commonly used to quantify frontal plane kinematics of the trunk and lower extremity. However, there are conflicting results regarding the reliability and validity of these measurements. Objective: To synthesize the current literature to determine whether 2-D analysis is a reliable and valid method of...

Background: Low back pain is a highly prevalent and disabling musculoskeletal disorder. Physical activity is widely used as a prevention strategy for numerous musculoskeletal disorders; however, there is still conflicting evidence as to whether physical activity is a protective or risk factor for low back pain or whether activity levels differ bet...