Peter Malliaras

Monash University (Australia) · Department of Physiotherapy

Although a number of studies attempt to classify human fatigue, most models can only identify fatigue after fatigue has already occurred. In this paper, we propose a novel time series approach to forecasting wearable sensor data and associated fatigue progression during exercise. The proposed framework consists of spatio-temporal attention-based Tr...

Objective: To identify and describe the psychological and psychosocial constructs and outcome measures used in tendinopathy research. Design: Scoping review. Literature search: We searched the PubMed, EMBASE, Scopus, Web of Science, PEDro, CINAHL, and APA PsychNet databases on July 10, 2021, for all published studies of tendinopathy population...

Objectives To confirm what impairments are present in runners with Achilles tendinopathy (AT) and explore the variance of AT severity in an adequately powered study. Design Case-control study. Setting Two private physiotherapy clinics in Australia and Spain. Participants Forty-four recreational male runners with AT and 44 healthy controls matche...

The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load...

Background Nine core domains for tendinopathy have been identified. For Achilles tendinopathy there is large variation in outcome measures used, and how these fit into the core domains has not been investigated.Objective To identify all available outcome measures outcome measures used to assess the clinical phenotype of Achilles tendinopathy in pro...

Background Load management is considered an important factor for prevention and treatment of Achilles tendinopathy. However, little attention has been given to monitoring daily load objectively in this population. Objectives We aimed to explore patterns in proxies of daily load derived from a six-axis inertial measurement unit (IMU) over a one-wee...

Background Patellar tendinopathy (PT) is common and debilitating for jumping athletes. Intriguingly, despite its high prevalence and many research studies, a causal explanation for PT presence remains elusive. Objective Our objective was to investigate whether landing biomechanics among jumping athletes are associated with PT and can predict onset...

Tendinopathies affecting the upper and lower extremity are a common musculoskeletal presentation to primary care health professionals, including allied health. The etiology of tendinopathies varies depending on the area affected and the condition can affect adolescents through to older adults. However, tendinopathies are generally considered to dev...

Objectives The aims of this scoping review were to (1) determine the frequency and types of behavior change techniques (BCTs) and education utilized in trials investigating exercise interventions for rotator cuff related shoulder pain (RCRSP); (2) subcategorize the BCTs and education found in the trials to summarize all behavior change approaches r...

Background Understanding plantarflexor muscle impairments among individuals with Achilles tendinopathy (AT) may help to guide future research and inform clinical management of AT. Therefore, the aim of this review is to evaluate plantarflexor muscle impairments among individuals with AT and whether plantarflexor muscle function changes following re...

Background: Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6 and 16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degrees of success. In recalcitrant cases, surgery is oft...

Background Musculoskeletal physiotherapy practice rapidly adopted telehealth during the COVID-19 pandemic, providing a unique opportunity to evaluate the experiences and attitudes of people who would not usually engage with these services. Methods A sequential mixed-methods study recruited people with musculoskeletal pain conditions accessing Aust...

Introduction Achilles tendinopathy (AT) is a common and disabling musculoskeletal condition. First-line management involving Achilles tendon loading exercise with, or without, other modalities may not resolve the problem in up to 44% of cases. Many people receive injections. Yet there are no injection treatments with demonstrated long-term efficacy...

Objective User-independent recognition of exercise-induced fatigue from wearable motion data is challenging, due to inter-participant variability. This study aims to develop algorithms that can accurately estimate fatigue during exercise. Methods A novel approach for wearable sensor data augmentation was used to generate (via OpenSim) a large corp...

This study aimed to determine test-retest reliability of ankle plantar flexor neuromuscular properties in healthy people to improve understanding of additional measurement and analysis procedures that may be used in outcome assessment. Ten healthy participants (age 29.60 ± 5.36 years) volunteered. Isometric torquemax, rate of torque development (RT...

Objectives To compare the efficacy of inertial flywheel and heavy slow resistance training in reducing pain and improving function in patellar tendinopathy. Design Randomised clinical trial. Methods Fourty two participants (1 woman, 41 men) with longstanding (>3 months) patellar tendinopathy were randomised into inertial flywheel resistance (N =...

Background . Achilles tendinopathy (AT) is common, and can be traumatic or insidious in onset and short-lasting or persistent in nature. Factors influencing the experience of pain are poorly understood; little is known about mechanisms driving pain and the response (or lack of) to rehabilitation. Despite this, there is a growing body of evidence su...

Background One potential reason for disparate outcomes of exercise for Achilles tendinopathy is poor knowledge about whether exercise parameters (i.e. different exercise doses) influence outcome. Whether parameters that are important for tendon adaptation influence clinical outcomes in Achilles tendinopathy has not been investigated. Therefore, thi...

Nous avons réalisé une étude observationnelle explorant les pratiques des kinésithérapeutes français dans la prise en charge des douleurs d'épaule liées à la coiffe des rotateurs.

BACKGROUND Care delivered by physiotherapists aims to facilitate positive health behaviors by patients (e.g. adherence to exercise). However, research suggests that behavioral interventions are frequently omitted from care. Hence, better understanding of strategies that can be used by physiotherapists to support patients to engage in positive behav...

Background: Rotator cuff related shoulder pain (RCRSP) is a common and disabling cause of shoulder pain contributing to great socio-economic costs. Conservative management is recommended as first line treatment, with studies performed in the United Kingdom (UK), Belgium, Netherlands and Australia finding practice generally consistent with guideline...

Background Rotator cuff related shoulder pain (RCRSP) knowledge is an important contributor to compliance with clinical practice guidelines and providing best practice care. However, there are no validated instruments for measuring health literacy levels among people with RCRSP. This study aimed to design a valid and reliable instrument to measure...

The Achilles tendon (AT) may experience changes in dimensions related to fluid flow under load. The extent to which fluid flow involves redistribution within or flow out of the tendon is not known and could be determined by investigating volume changes. This study aimed to synthesize data on immediate and long-term effects of loading on tendon volu...

Objective The primary aim was to assess whether men who have insertional Achilles tendinopathy (IAT) have altered endogenous modulation of painful stimuli, and secondarily if they exhibit unaffected-side pressure hyperalgesia. Methods Using a cross-sectional design, we recruited men with unilateral IAT and asymptomatic men as controls matched for...

Achilles tendon (AT) stiffness is an important property of both human locomotor performance and injury mechanics. Freehand 3-D ultrasound (3-DUS) is a promising method for measuring stiffness of the Achilles tendon, particularly the free AT (2–6 cm proximal to calcaneus), which is commonly injured. The aim of this study was to investigate the test–...

Objectives To investigate if self-reported pain with single leg heel raise (SLHR) or single leg hop (SLH) are concurrently valid to assess midportion (MPAT) or insertional Achilles tendinopathy (IAT) symptom severity, compared to the VISA-A. Additionally, if SLHR or SLH pain accounts for VISA-A variability, and if they are associated with psycholog...

Objective: This systematic review aimed to synthesize current evidence on contributing factors influencing outcome following exercise management for Achilles tendinopathy (AT). Data sources: Databases (PubMed, Embase, and Cochrane Library) were searched from inception to February 2020. Study selection: Studies investigating factors (e.g., age,...

Purpose. There is an emerging body of literature describing psychological associations with lower limb tendinopathies. The literature suggests that those experiencing a lower limb tendinopathy are likely to experience varying degrees of kinesiophobia, depression and catastrophisation. These studies have typically been confined to one lower limb ten...

Objective Tendinopathy is often a disabling, and persistent musculoskeletal disorder. Psychological factors appear to play a role in the perpetuation of symptoms and influence recovery in musculoskeletal pain. To date, the impact of psychological factors on clinical outcome in tendinopathy remains unclear. Therefore, the purpose of this systematic...

Background Patient education is recommended in clinical practice guidelines for rotator‐cuff‐related shoulder pain (RCRSP), yet there are no guidelines for clinicians. A gap in the current literature relates to patients' perspectives. Aims The aim of this study was to explore the experiences and perspectives of people with RCRSP about education fo...

Background: One potential reason for disparate outcomes of exercise for Achilles tendinopathy is poor knowledge about whether exercise parameters (i.e. different exercise doses) influence outcome. Whether parameters that are important for tendon adaptation influence clinical outcomes in Achilles tendinopathy has not been investigated. Therefore, th...

Background: Rotator cuff-related shoulder pain (RCRSP) is a common and disabling musculoskeletal condition. Internet-based and telerehabilitation delivery of recommended care may improve access to care and improve adherence and outcomes. Objective: The primary aim of this pilot randomized controlled trial was to assess the feasibility of a 12-week...

Objectives: To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy. Methods: This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Aust...

Background: Most knowledge regarding conservative management for lower limb tendinopathy (LLT) is for persistent symptoms, with less known about conservative management of acute LLT. Sub‐optimal management of acute LLT is detrimental in many regards, not least the likely conversion to persistent symptoms. Objectives: To synthesise existing literatu...

BACKGROUND Rotator cuff–related shoulder pain (RCRSP) is a common and disabling musculoskeletal condition. Internet-based and telerehabilitation delivery of recommended care may improve access to care and improve adherence and outcomes. OBJECTIVE The primary aim of this pilot randomized controlled trial was to assess the feasibility of a 12-week i...

Background: Modifying variables in exercise prescription can produce specific effects on Achilles tendinopathy outcomes. This study aims to determine the feasibility of conducting an adequately powered randomised trial in the future to assess the efficacy of different load intensity and time-under-tension exercise parameters for improving pain and...

Aim to compare the effectiveness and harms of higher exercise dose, including higher exercise load and/or higher volume, with lower exercise dose (lower load and/or lower volume) in people with rotator cuff tendinopathy Design Systematic review (PROSPERO: CRD42017077478) Data sources CENTRAL, MEDLINE, EMBASE, CINAHL from inception to March 2019....

Objective Synthesize evidence regarding effectiveness of progressive and resisted or non-progressive and non-resisted exercise compared with placebo or no treatment, in rotator cuff related pain. Data sources English articles, searched in Cochrane CENTRAL, MEDLINE, EMBASE and CINAHL databases up until May 19, 2020. Methods Randomized controlled t...

Background An acute Achilles tendon rupture (ATR) is a long-lasting and devastating injury. Possible biological augmentation to promote and strengthen tendon healing after an ATR would be desirable. Purpose To determine whether the application of a platelet-rich plasma (PRP) injection in nonsurgically treated ATRs may promote healing and thereby i...

Background: Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6%-16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degree of success. In recalcitrant cases, surgery is often th...

Background: Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6%-16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degree of success. In recalcitrant cases, surgery is often th...

Background: Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6%-16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degrees of success. In recalcitrant cases, surgery is often t...

Background Achilles tendinopathy (AT) is a common and often persistent musculoskeletal disorder affecting both athletic and non-athletic populations. Despite the relatively high incidence there is little insight into the impact and perceptions of tendinopathy from the individual’s perspective. Increased awareness of the impact and perceptions aroun...

Background: Achilles tendinopathy (AT) is a common and often persistent musculoskeletal disorder affecting both athletic and non-athletic populations. Despite the relatively high incidence there is little insight into the impact and perceptions of tendinopathy from the individual's perspective. Increased awareness of the impact and perceptions arou...

Objectives To explore whether homogeneous subgroups could be discriminated within a population of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis. Design Cross-sectional. Setting Research laboratory. Participants Fifty-three recreational runners (15 males,...

Objective To describe general practitioner's (GP's) current management of rotator cuff related shoulder pain (RCRP) in Australia and identify if this is consistent with recommended care and best available evidence. The secondary aim was to determine if GP management of RCRP changed over time. Methods Data about management of RCRP by Australian GPs...

PURPOSE/HYPOTHESIS: Achilles tendinopathy (AT) is a common, persistent, and often disabling disorder of the lower extremity. Current tendon rehabilitation paradigms often emphasize strength training and may not be adequately addressing other muscle-tendon impairments beyond strength deficits. There is emerging evidence that descending motor pathway...

Background: Clinical practice guidelines recommend non-surgical care in the management of rotator cuff tendinopathy prior to considering imaging or surgery. However, this requires effective education to promote adherence to treatment. Objectives: To explore expert shoulder clinician's experiences with managing rotator cuff tendinopathy including...

Background Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe heel lifts. Although adherence is challenging, there i...

Background: The absence of any agreed-upon tendon health-related domains hampers advances in clinical tendinopathy research. This void means that researchers report a very wide range of outcome measures inconsistently. As a result, substantial synthesis/meta-analysis of tendon research findings is almost futile despite researchers publishing busil...

We aimed to establish consensus for reporting recommendations relating to participant characteristics in tendon research. A scoping literature review of tendinopathy studies (Achilles, patellar, hamstring, gluteal and elbow) was followed by an online survey and face-to-face consensus meeting with expert healthcare professionals (HCPs) at the Intern...

Background High Volume Injection (HVI) show promising results in the treatment of chronic midportion Achilles tendinopathy (AT). HVI consists of a large volume of saline with a small amount of corticosteroid and local anaesthetic. Objective To determine the effect of corticosteroid in HVI in AT. Methods A total of 28 men (18 to 59 years) with chr...

Objectives: To examine the feasibility of recommended education and exercise supplemented by a hopping intervention implemented based on self-reported pain over 12 weeks for recreational runners with Achilles tendinopathy. Design: Single cohort feasibility study. Setting: One private physiotherapy clinic in Melbourne, Australia. Participants:...

Background Running is a popular form of physical activity with many health benefits. However, the incidence and prevalence of running-related injuries (RRIs) is high. Biomechanical factors may be related to the development of RRIs. Objective This systematic review synthesizes biomechanical risk factors related to the development of RRIs in non-inj...

Co-existence of Plantaris tendinopathy (PT) in patients with mid-Achilles tendinopathy (Mid-AT) is of clinical significance. This study aims to describe the MRI-based pathological characteristics of co-existing PT and Mid-AT. One-hundred MRI studies of patients diagnosed with Mid-AT were retrospectively analysed by an experienced musculoskeletal ra...

Objectives: To determine whether two-dimensional video analysis could discriminate running kinematics between recreational runners with and without a running-related knee injury. Design: Case-control. Setting: Research laboratory. Participants: Forty-two recreational runners (5 male-13 female injured; 7 male-17 female non-injured). Running-r...

Introduction The aim of this study was to compare running kinematics between recreational runners with and without running-related knee injury using two-dimensional video analysis. Materials and methods Forty-two recreational runners (18 injured, 24 non-injured) participated in the study. The injured group consisted of runners with anterior or lat...

Introduction The aim of this study was to explore whether homogeneous subgroups could be classified within the running kinematics of a group of recreational runners with a running-related injury (RRI). Materials and methods Fifty-three recreational runners (15 males, 38 females) with an RRI ran on a treadmill at preferred speed. Digital videos wer...