Ilias Kallistratos

Background: Tibial bone stress injury (TBSI) with associated bone marrow edema (BME) is a common and clinically challenging condition in athletes, often requiring prolonged load restriction and delayed return to sport. Evidence for adjunctive interventions that improve both symptoms and MRI-derived recovery remains limited. The aim of this study was to investigate whether adding Functional Magnetic Stimulation (FMS) to standardized rehabilitation improves pain, function, and MRI-derived outcomes over 16 weeks in athletes with MRI-confirmed TBSI. Materials and Methods: Forty athletes with Fredericson grade 2–3 TBSI were randomized to FMS plus rehabilitation (n = 20) or rehabilitation alone (n = 20). Both groups completed a 4-week load-based rehabilitation program, while the FMS group additionally received eight 30 min FMS sessions at 40 Hz. Outcomes were assessed at baseline, 4 weeks, and 16 weeks. The primary outcome was activity-related pain (NPRS), while secondary outcomes included lower-limb function (LEFS-GR), BME extent, and Fredericson grade. Continuous outcomes were analyzed using two-way mixed ANOVA, whereas Fredericson grade was analyzed using an ordinal generalized estimating equation model. The level of statistical significance was set at p < 0.05. Results: Groups were comparable at baseline. Significant group × time interactions favored FMS for NPRS, F(2, 76) = 12.46, p < 0.001, η²p = 0.247; LEFS-GR, F(1.08, 41.09) = 81.56, p < 0.001, η²p = 0.682; and BME extent, F(1.44, 54.85) = 49.33, p < 0.001, η²p = 0.565. At 16 weeks, the FMS group showed lower NPRS scores, higher LEFS-GR scores, and lower BME extent than controls. Fredericson grade also showed a significant group × time effect, Wald χ²(2) = 20.38, p < 0.001. The FMS group had significantly lower cumulative odds of classification in a higher Fredericson grade at 4 weeks (OR = 0.045, 95% CI: 0.012–0.163, p < 0.001), whereas the corresponding difference at 16 weeks remained directionally favorable but did not reach statistical significance (OR = 0.033, 95% CI: 0.001–1.029, p = 0.052). Conclusions: The addition of FMS to load-based rehabilitation was associated with greater clinical and functional improvements, greater reductions in BME extent, and a more favorable longitudinal trajectory in MRI severity classification than rehabilitation alone in athletes with TBSI. However, because the study did not include a sham-FMS condition and participants could not be blinded, the self-reported pain and functional outcomes should be interpreted cautiously. FMS may represent a useful adjunct to structured rehabilitation, although sham-controlled and longer-term studies should determine its effects on return-to-sport progression and recurrence risk.

Introduction: Ankle dorsiflexion is essential for efficient movement, athletic performance, and injury prevention. Restricted dorsiflexion alters lower-limb biomechanics and increases injury risk. Therapeutic approaches such as stretching, eccentric training, and joint mobilisation are commonly applied to restore function. This systematic narrative review synthesises current evidence on the effectiveness of ankle joint mobilisation for improving dorsiflexion range of motion (DF-ROM) and explores its potential impact on athletic performance. Methods: In August 2025, a structured and systematic literature search was conducted in PubMed/MEDLINE, the Cochrane Library, and selected grey literature databases. Studies eligible for inclusion comprised randomised controlled trials (RCTs) and pilot RCTs investigating manual therapy interventions directed at the ankle joint. The methodological quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: Eleven studies involving 423 participants met the inclusion criteria. Manual therapy interventions were generally associated with improvements in DF-ROM and functional outcomes across trials, despite considerable heterogeneity in intervention dosage, participant characteristics, comparator conditions, and outcome measures. In contrast, evidence linking DF-ROM improvements to direct athletic performance outcomes (e.g., jumping, agility, return-to-sport) was more limited and inconsistent across studies. The magnitude and consistency of effects varied across studies, with some evidence suggesting a dose–response relationship favouring longer treatment durations. Combined protocols integrating manual therapy with strengthening or balance training tended to demonstrate superior outcomes compared with exercise alone. Conclusions: Manual therapy may contribute to improvements in ankle dorsiflexion and selected functional outcomes, particularly when integrated with exercise-based rehabilitation; however, conclusions should be interpreted with caution due to between-study variability. Future large-scale, sport-specific RCTs with long-term follow-up are needed to establish optimal treatment protocols and confirm the long-term effectiveness of these interventions.

Background: Vision is a key sensory system for postural regulation; however, the effects of degraded visual input and complete visual occlusion on static balance are not fully understood. The aim of the present study was to compare postural control during single-leg stance under two reduced-vision conditions (eyes open in darkness vs. complete visual occlusion) in healthy young adults and examine the potential influence of sex and mild visual deficits. Materials and Methods: This within-subject laboratory study included 42 healthy young adults (21 males, 21 females; mean age 20.67 ± 0.48 years). Participants performed three valid 20 s single-leg stance trials on a force platform under two visual conditions: eyes open in darkness and complete visual occlusion using an opaque mask. The order of conditions was randomized and counterbalanced, and the mean value of the three valid trials under each condition was used for analysis. Postural sway outcome variables included CoP Area, Oscillation Width, Oscillation Height, Total Displacement, and Mean Velocity. A two-way mixed-design ANOVA examined the effects of visual condition and sex. Additional mixed ANCOVA analyses were performed using body weight as a covariate to verify whether the sex-related findings remained after adjustment for body weight. Exploratory subgroup analyses based on mild visual deficits were performed using independent-samples t-tests. Results: No significant overall main effect of visual condition was observed for any postural sway variable (all p > 0.05). However, a significant condition × sex interaction was found for CoP Area (F(1,40) = 9.910, p = 0.003, η²p = 0.199), indicating different response patterns between males and females across conditions. Significant main effects of sex were also found for Total Displacement (F(1,40) = 9.212, p = 0.004, η²p = 0.187) and Mean Velocity (F(1,40) = 9.090, p = 0.004, η²p = 0.185), with males showing higher values overall. The sex-related findings for CoP Area, Total Displacement, and Mean Velocity remained significant after adjustment for body weight. No significant sex effects were found for Oscillation Width or Oscillation Height, and no significant differences were observed between participants with and without mild visual deficits in either condition (all p > 0.05). Conclusions: Altered visual input did not produce a uniform overall effect on postural sway during single-leg stance in healthy young adults. Instead, the findings indicate a more differentiated pattern, with a sex-specific response for CoP Area and overall sex-related differences in Total Displacement and Mean Velocity that were not explained by body weight. Mild visual deficits were not associated with significant balance alterations under the present experimental conditions. These findings support a more nuanced interpretation of postural regulation under reduced visual input and highlight the importance of considering individual characteristics, particularly sex, in balance assessment.

Background: Restricted ankle dorsiflexion is common in basketball athletes and has been associated with altered lower-limb mechanics and reduced athletic performance. Although ankle joint mobilization is widely used to improve mobility, its effects on athletic performance remain unclear. The aim of this study was to examine whether adding posterior ankle joint mobilization to a structured exercise-based program incorporating eccentric strengthening and stretching improves ankle mobility and athletic performance in basketball athletes with restricted dorsiflexion. Primary outcomes were dorsiflexion range of motion (DF-ROM) and the Weight-Bearing Lunge Test (WBLT); secondary outcomes included jump performance, hop tests, Reactive Strength Index, Fatigue Index, and maximal isometric strength. Methods: In this randomized controlled trial, 38 basketball athletes (mean age 21.26 ± 2.52 years) with unilateral restricted ankle dorsiflexion were randomly allocated to an exercise-only group (n = 19) or to an exercise plus talocrural mobilization group (n = 19). The intervention lasted 5 weeks, with assessments performed at baseline, post-intervention, and at a 3-month follow-up. Results: Both groups improved ankle dorsiflexion; however, greater gains were observed in the intervention group for both dorsiflexion range of motion (DF-ROM; interaction p < 0.001; mean difference [MD] = 3.52° post-intervention and MD = 5.17° at follow-up) and the Weight-Bearing Lunge Test (WBLT; interaction p < 0.001; MD = 1.39 cm and MD = 1.34 cm, respectively). The intervention group showed superior improvements in countermovement jump and Triple Hop Test performance (both p < 0.001), as well as a small but statistically significant advantage in the Single Hop Test (p = 0.015). No between-group differences were found for the 6 m timed hop test, Reactive Strength Index, Fatigue Index, or maximal isometric strength (p > 0.05). Conclusions: Adding ankle joint mobilization to an eccentric strengthening and stretching program produced greater improvements in dorsiflexion and jump performance than exercise alone, without affecting speed, reactive ability, or maximal strength. Ankle mobilization may be a useful adjunct for improving functional mobility and selected performance outcomes in basketball athletes.

Background and Objectives: Lumbar disk herniation with radiculopathy (LDHR) is a prevalent neuromusculoskeletal condition characterized by nociceptive and neuropathic pain components. Manual therapy (MT) is commonly used in its management, whereas Functional Magnetic Stimulation (FMS) represents an emerging modality with limited evidence in radiculopathy. The aim of this study was to examine the short-term effects of combining MT with FMS compared with MT alone on pain intensity, neuropathic pain features, neural mechanosensitivity, and functional disability in individuals with chronic LDHR. Materials and Methods: Forty adults with MRI-confirmed unilateral LDHR were randomly allocated to an MT + FMS group or an MT-only group. Both groups received ten treatment sessions over three weeks. Outcomes included lumbar and leg pain intensity (NPRS), functional disability (RMDQ), neuropathic pain symptoms (S-LANSS), and straight leg raise (SLR) range of motion. Measurements were obtained at baseline and at week 3. Group and time effects were examined using a two-way mixed ANOVA with significance set at p < 0.05. Results: Significant group × time interactions were observed for all outcomes (p < 0.01), indicating greater improvements in the MT + FMS group. Reductions in lumbar and leg pain, disability, and S-LANSS scores exceeded established MCID thresholds, while SLR gains surpassed published MDC values, reflecting both statistical and clinical relevance. Only the MT + FMS group improved below the neuropathic pain diagnostic cutoff (S-LANSS < 12). Conclusions: The findings of this trial suggest that incorporating FMS into a manual therapy program may provide additional short-term clinical benefits for individuals with chronic LDHR. Further research with larger samples, longer follow-up periods, and mechanistic assessments is needed to confirm these preliminary results and to better understand the underlying mechanisms.

Introduction: Postural control is a crucial ability for producing functional movement, and it has been shown to help with both injury prevention and sports performance. In this context, there has been an increasing interest in the connection between balance and somatotype; however, the evidence remains inconsistent. Materials and Methods: In this study, 18 healthy and active university students took part (3 men and 3 women for each somatotype). They were asked to stand on one leg, the dominant one, for 15 seconds. During this time, the center of pressure movement was recorded through the Wii Balance Board paired with the BrainBLoX software. From these measurements, mediolateral and anteroposterior displacement variables were obtained and later analyzed using non-parametric tests. Results: Through the analysis, no statistically significant differences were found between somatotypes or genders (all p > 0.05). Descriptive medians showed slightly lower mediolateral sway ranges in endomorphs. Conclusions: Although this study, given its nature as a pilot study, did not find any significant associations between balance and somatotype, it demonstrated the viability of using low-cost tools in exploratory research. The observed trends are hypothesis-generating at best and require confirmation in larger samples.

This is a literature review covering the intricate and two-way association between gait disorders and executive functioning deficits in individuals with neurological disorders. The review begins by defining executive functions, followed by a discussion of its fundamental components (inhibition, working memory, cognitive flexibility), and finally, the neural foundation of EF is outlined, focusing on the frontal lobes and related brain networks. A typology of neurological gait disorders (e.g., Parkinsonian, hemiplegic, ataxic) is then described, which is then correlated with their respective etiologies. The cognitive-motor interference model of gait-executive functions interaction and the shared neural resource theories are explored as frameworks explaining the phenomenon, and the dual-task paradigm as a methodological instrument is considered specifically. In the review, the authors examined how this interaction manifests in neurological diseases, including Parkinson's, stroke, and multiple sclerosis, and noted the peculiarities and mechanisms in each instance. Lastly, the clinical implications of this interaction on everyday functioning, risk of falls, and quality of life are addressed, along with what they mean regarding rehabilitation approaches, with a particular focus on integrated motor-cognitive interventions, including dual-task training and novel technologies (e.g., exergaming, virtual reality).

Introduction: Rett syndrome is a rare neurodevelopmental condition with a complicated genetic basis that primarily affects girls and does not manifest clinical signs in early infancy. Stereotypical hand movements, decreased gross motor and postural responses, muscle tone disorders, hypersensitivity, and heart dysfunctions are a few of the clinical characteristics. Following the loss of skills, scoliosis, respiratory issues, and convulsions manifest. The minority is concerned about the syndrome's association with autism. Trofinetide is the primary medical treatment; the other treatments are still in the experimental stage. Physical therapy is the primary method of enhancing these children's quality of life in a few ways due to the assault on different bodily systems. Aim: The research's objective is to outline the current body of information regarding Rett syndrome and to enumerate the issues raised by the body of available literature. Method: Using the primary keyword "Rett syndrome," an English-language search was conducted in the Google Scholar, PubMed, and SpringerLink databases. Thirty-six papers of all kinds over the previous five years that satisfied the requirements were chosen. Findings: The treatment is still in its experimental phase, and physiotherapy makes a significant contribution given the wealth of clinical features and impacts on many body systems. Discussion: The differential diagnosis of the condition is as challenging as its refining due to its intricacy. Since physiotherapy follows the standard protocol and its treatment is in an evolutionary stage, it makes sense that more research in all areas is required.

Background/Objectives: Childhood obesity appears to be an alarmingly growing global threat. Current evidence has shown that obesity can be successfully managed with interventions targeting movement skills, motor coordination and physical activity. However, data concerning physiotherapy practice are limited. We aimed to assess the impact of therapeutic exercise on the 6-minute walk test (6-MWT) in obese children and adolescents. Methods: A total of 31 obese children and adolescents (BMI > 30 kg/m²), 18 males and 13 females, aged from 8 to 18 years, were enrolled. Two study groups were formed: the control group (Group A), comprising ten children; and the intervention group (Group B), comprising 21 children. Daily exercise habits were obtained via interview; anthropometric data (weight, height and BMI) were recorded; and 6-MWT parameters, blood pressure and oxygen saturation (SaO₂) were assessed before and after a 4-month intervention program consisting of breathing and aerobic exercises. Results: There was a statistically significant increase in 6-minute walk distance (+43.34, p < 0.001) and an improvement in body weight (p < 0.01), blood pressure (p < 0.01) and oxygen saturation (p < 0.03) in Group B after the 4-month training program. Conclusions: All results highlight the potential of physical exercise in clinical practice to improve functional status and achieve weight loss. Future randomized controlled trials, including individualized therapeutic exercise programs in larger samples of obese children, are much anticipated.