Clinical Cases in Physical Therapy, ed 2.

Clinical Cases in Physical Therapy, ed 2 Brimer MA, Moran ML, eds. Philadelphia, PA 19106, Butterworth-Heinemann Inc, 2004, paperback, 223 pp, illus, ISBN: 0-7506-7394-X, $29.95.

Physical therapists are continually learning--from their patients, from their colleagues, from published research. One way that therapists communicate with one another is through case presentations. The first edition of Clinical Cases in Physical Therapy was published in 1995. Since that time, the American Physical Therapy Association has developed the Guide to Physical Therapist Practice (Guide) to define appropriate clinical practice. The goal of this second edition is to provide real-life examples of how therapists use the Guide for patient care.

Forty-six cases are presented that encompass the diverse nature of physical therapy--orthopedics, geriatrics, clinical education, home health, neurology, occupational health, hand therapy, pediatrics, cardiac rehabilitation, prosthetics, ethics, respiratory therapy, and wound care. Each case begins with learning objectives. These objectives identify proper utilization of services and represent the clinical expertise of the case's author. For example, case 9 presents a 15-year-old cross-country runner with anterior thigh and hip pain, who was referred to a physical therapy clinic by her coach. The objectives for this case include analyzing her training schedule, differentiating between a bone scan and radiograph, and comparing the physiological effects produced by aquatic closed-chain and open-chain exercises.

Following the learning objectives, the results of examination and evaluation of the patient are given. The diagnosis is classified according to Preferred Physical Therapist Practice Patterns[SM] in the second edition of the Guide. In the case of the 15-year-old runner, she is given the diagnosis of Practice Pattern 4E (Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation). The reader is then presented with several questions to stimulate further thought and enhance clinical decision making. For example, in this case, the reader is asked to consider what information was provided by the squat test. The case author then goes on to explain that the unilateral squat demonstrates the patient's ability to control knee flexion eccentrically and represents a sport-specific skill that is needed during the shock absorption phase of running.

After the evaluation, the intervention is outlined, and the outcome of the case is presented. Each case concludes with a discussion and references from peer-reviewed literature. Within these sections, the reader is presented with questions about the case, and the author provides responses that support the decision. The editors of this book recognize that case presentations should not only document unusual cases but also justify how we evaluate, treat, and prognosticate for those patients that we see every day.

Apart from the valuable sharing of clinical expertise, this text provides a different framework for understanding our patients and our practice. In the Appendix, the cases are. organized by the Preferred Physical Therapist Practice Patterns from the Guide. For example, Practice Pattern 5B (Impaired Neuromotor Development) was shown in case 28, which looked at a 22-month-old child with severe hypotonia and global developmental delay. One of the purposes of the Practice Patterns and the Guide is to help our profession develop a common language for communication, while recognizing that there is no recipe for patient care.

This text is suitable both for the clinician who is beginning professional practice and the seasoned clinician. Because the scope of the cases is so broad, the new practitioner will be exposed to the range of issues and patients that they will see as their careers progress. For the seasoned clinician, this text offers a glimpse into other specialties and illustrates how another physical therapist might treat the same patient in a different manner and also have a positive outcome.

Maggie Fillmore, PT, DPT, FAAOMPT, OCS 

Kaiser Permanente Medical Center

Oakland, Calif

Dr Fillmore is a physical therapist specializing in orthopedics and pediatrics. She is a clinical faculty member for the Kaiser Fellowship in Advanced Orthopedic Manual Therapy.

[Note: Charles Ciccone, PT, PhD, Editor for Evidence in Practice and Reviews, wrote a foreword for this book. He did not participate in the review process for this book.]