The Monash Musculoskeletal Research unit has multiple randomised clinical trials underway evaluating education, exercise, shockwave therapy and injection therapy. This includes the use of technology to deliver interventions; for example, via multimedia internet websites supported by telerehabilitation. Novel user-informed education interventions are being developed based on the experiences of patients and clinicians. Many of these projects involve international collaborations that aim to develop wearable sensor technology to monitor exercise quality and adherence.
Selected clinical projects:
- The efficacy of load and time under tension in Achilles tendinopathy rehabilitation: a factorial randomised trial (with collaborators at University of Queensland & La Trobe University)
- The reliability and validity of assessing exercise fidelity during calf exercise using easily accessible telerehabilitation technology (with collaborators from the Information Technology faculty, Monash University)
- Developing a user-informed tendinopathy education intervention (with collaborators at Queen Mary, University of London)
- Internet-based management of rotator cuff tendinopathy with remote physiotherapist led support: a pilot and feasibility randomised controlled trial
- Feasibility and outcomes of a novel progressive rehabilitation program including hopping among runners with Achilles tendinopathy (with collaborators at Queen Mary, University of London)
- Heel lifts versus calf muscle eccentric exercise for Achilles tendinopathy: a randomised controlled trial (with collaborators at La Trobe University)
Selected clinical publications, reviews, commentaries and editorials:
- Malliaras, P., Understanding mechanisms to improve exercise interventions in tendinopathy. Physical Therapy in Sport, 2017. 27: p. 50-51.
- Mallows, A J., et al., Cognitive and contextual factors to optimise clinical outcomes in tendinopathy BJSM Online, 2017
- McAullife, S., et al., Central sensitisation in different tendinopathies: are we comparing apples and oranges? BJSM online, 2017
- Malliaras, P., et al., Achilles and patellar tendinopathy loading programmes. Sports medicine, 2013. 43(4): p. 267-286.
- Malliaras P, Cook J, Purdam C, Rio E. (2015) Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations. J Orthop Sports Phys Ther. 45(11):887-898.
- Goom, T. S. H., et al., Proximal Hamstring Tendinopathy: clinical Aspects of Assessment and Management, Journal of Orthopaedic & Sports Physical Therapy, 2016
- Boesen, A.P., et al., Effect of high-volume injection, platelet-rich plasma, and sham treatment in chronic midportion achilles tendinopathy: a randomized double-blinded prospective study. Am J Sports Med, 2017. 45(9): p. 2034-2043.
- Littlewood, C., et al., Development of a self-managed loaded exercise programme for rotator cuff tendinopathy. Physiotherapy, 2013. 99(4): p. 358-362.
- Littlewood, C., et al., Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy: a pilot randomised controlled trial. Physiotherapy, 2014. 100(1): p. 54-60.
- Malliaras, P., J.R. Palomino, and C.J. Barton, Infographic. Achilles and patellar tendinopathy rehabilitation: strive to implement loading principles not recipes. Br J Sports Med, 2018: p. bjsports-2017-098615.
A/Prof Malliaras is Co-Director of the MOnash musculoskeleTal collaboratION (MOTION), a Monash University based initiative that includes an international and multidisciplinary group of researchers. The primary focus of MOTION is to progress understanding of the mechanisms of tendinopathy disease to inform development of effective management strategies. The MOTION laboratory at Monash University (Peninsula Campus) integrates imaging, biomechanics and neurophysiological techniques to improve understanding of tendinopathy pain and pathology mechanisms.
Selected laboratory projects:
- Investigation of load-dependency of motor cortex function, maximal voluntary contraction and pain changes following isometric exercise in tendinopathy (collaboration with physiology department, Monash University)
- Lower limb kinematics and kinetics and Achilles tendon tissue stiffness during submaximal continuous hopping among people with Achilles tendinopathy and controls (Collaboration with University of Western Sydney)
- Validation of accelerometer-based assessment of exercise fidelity and repetitions during standing and seated calf raise exercise (Collaboration with University of the Sunshine Coast)
- Comparison of load-cell and accelerometer-based assessment of motor output variability during knee extension and ankle planter flexion constant force tasks among people with patellar and Achilles tendinopathy (Collaboration with University of the Sunshine Coast)
- Is conditioned pain modulation altered among people with Achilles tendinopathy compared with controls?
- Does shockwave therapy have a conditioned pain modulation effect and is this dose dependent? (Collaboration with the University Medical Centre Groningen)
- The effect of load intensity, load rate and time under tension on healthy Achilles tendon tissue volume and stiffness: in vivo and modelling studies (collaboration with Oxford University and the University of Salford)
Selected laboratory publications:
- Malliaras, P., et al., Patellar tendon adaptation in relation to load-intensity and contraction type. J Biomech, 2013. 46(11): p. 1893-1899.
- Malliaras, P., J.L. Cook, and P. Kent, Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. Journal Sci Med Sport, 2006. 9(4): p. 304-309.
- Malliaras, P., et al., Prospective study of change in patellar tendon abnormality on imaging and pain over a volleyball season. British journal of sports medicine, 2006. 40(3): p. 272-274.
- Malliaras, P., J.L. Cook, and P.M. Kent, Anthropometric risk factors for patellar tendon injury among volleyball players. British journal of sports medicine, 2007. 41(4): p. 259-263.
- Malliaras, P., et al., Achilles tendon Doppler flow may be associated with mechanical loading among active athletes. Am J Sports Med, 2008. 36(11): p. 2210-2215.
- Scholes, M., et al., Men with unilateral Achilles tendinopathy have impaired balance on the symptomatic side, Journal of Science and Medicine in Sport, 2017
- Ooi, C. C et al., A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players, Journal of Science and Medicine in Sport, 2015
- Pearson, S. J., et al., Immediate and Short-Term Effects of Short- and Long-Duration Isometric Contractions in Patellar Tendinopathy, Wolters Kluwer Health, Inc., 2018