#MyPTArticleOfTheMonth – what is Mireille Landry reading?

Mireille Landry has a BScPT from Queen’s University, an MSc from the University of Toronto, a Diploma in Sport Physiotherapy from Sport Physiotherapy Canada, and is a Registered International Sports Physical Therapist through the International Federation of Sports Physical Therapy. She has broad clinical expertise in cardiorespiratory, musculoskeletal and exercise physiotherapy in acute care, private practice and ambulatory care settings. As an Academic Lead in the Department of Physical Therapy at the University of Toronto, Mireille is involved in student teaching in various capacities and across units in the curriculum. She enjoys splitting her time between teaching, clinical care, and providing physiotherapy support and on-field management for sporting events. Mireille has travelled and worked at many national and major games supporting amateur athletes, including the 2016 Paralympic Games in Rio de Janeiro, Brazil.

Mireille has recently read two articles to inform her teaching and clinical work.

Oldham JR, et al. Efficacy of tandem gait to identify impaired postural control after concussion Med Sci Sports Exerc 2018;50(6):1162-8

This study evaluated the diagnostic test accuracy and minimal detectable change of three field tests for concussion: the Tandem Gait Test, Balance Error Scoring System, and Modified Balance Error Scoring System. 76 National Collegiate Athletic Association student athletes, 38 acutely after concussion and 38 controls, were evaluated at two time points using the field tests and the reference standard for concussion evaluation (Concussion Assessment, Research, and Education Consortium Clinical Study Core Protocol). The Tandem Gait Test had higher sensitivity and specificity than both the Balance Error Scoring System and Modified Balance Error Scoring System. Tandem Gait Test time increased after concussion, but there was no difference in the number of errors recorded for the Balance Error Scoring System and Modified Balance Error Scoring System. Mireille says: “this study is interesting as the field tests were assessed at baseline and acutely after concussion, so we can determine how a concussion affects performance on each of the tasks. The results are useful for physiotherapy as, in addition to being more accurate than the other field tests, the Tandem Gait Test is easier to administer. It’s important to note that the Tandem Gait Test was performed in a quiet environment within 48 hours of the concussion, so we can’t extrapolate the results to a sideline concussion assessment.”

Esculier J-F, et al. Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain? A randomised clinical trial. Br J Sports Med 2018;52(10):659-66

Recreational running is a popular activity and patellofemoral pain is among the most common reasons why runners seek physiotherapy management. This randomised controlled trial compared three 8-week rehabilitation programs on symptoms and functional limitations of recreational runners with patellofemoral pain. All groups received education on symptom management and training modifications. One group received the education program alone (education), the second received an exercise program in addition to education (exercises), and the third received gait retraining in addition to education (retraining). The trial was well-designed and -reported, scoring 8/10 on the PEDro scale. There were not between-group differences for the primary outcome (Knee Outcome Survey of the Activities of Daily Living Scale) after the intervention – the mean difference between the education and exercise group was 0.7 (95% confidence interval -6.0 to 7.4) and the mean difference between the education and retraining group was -3.4 (-10.4 to 3.5). Mireille says: “adding exercises or gait retraining did not provide additional benefits compared to education alone. Empowering runners with self-management strategies on symptoms and training loads should be a priority of treatment in runners with patellofemoral pain syndrome.”

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