Closed Kinetic Chain Exercise: a Comprehensive Guide to Multiple-Joint Exercises. (Reviews of books, computer software, and videotapes are written by invitation).

Closed Kinetic Chain Exercise: A Comprehensive Guide to Multiple-Joint Exercises Ellenbecker TS, Davies GJ. Champaign, IL 61825-5076, Human Kinetics, 2001, hardcover, 126 pp, illus, ISBN: 0-7360-0170-0, $32.

This book provides a comprehensive, practical, and applicable guide to closed chain kinetic exercise for the lower and upper extremities. It contains 8 chapters that progress from basic definitions to practical applications in testing and training. It compares open and closed kinetic chain exercises and uses research in the literature and scientific principles as the basis for exercise choice and progression.

Chapter 1 outlines the essential concepts and defines the terms that are often used to describe open and closed kinetic chain exercise. The authors address the gray area of moveable yet fixed kinetic exercise such as riding a bike where the foot remains fixed on the pedal and the pedal and foot moves through space.

Chapters 2 and 3 focus on the biomechanics and physiology of closed kinetic chain exercise. These chapters address anterior and posterior shear plus compression for the knee joint as well as patella tracking. The authors present a variety of research to promote the reader's thought process as well as to encourage readers to use research when they are developing rehabilitation programs. For example, the authors use a table from Fleming and colleagues (Fleming BC, Beynnon BD, Renstrom PA, et al. The strain behavior of the anterior cruciate ligament during stair climbing: an in vivo study. Arthroscopy. 1999;15:185-191) that compares shear forces on the anterior cruciate ligament generated by a number of open and closed chain exercises. Using the tennis serve as an example, the authors describe the sequencing within a kinetic link and integrate this information into their discussion of the total arm strength and total leg strength principles.

In chapter 4, the authors make a comparison between closed and open kinetic chain exercise as they relate to functional activity. The authors dismiss the

myth that closed kinetic chain exercises are more functional by using the example of running, an exercise that is predominantly (90%-95%) an open kinetic chain exercise. They also refute the assumption that closed chain exercise always provides muscular co-contraction at a joint to increase stability. Testing protocols and their algorithms are accompanied by easy-to-follow descriptions that allow practitioners to reproduce the criteria.

Chapters 5 and 6 address using closed kinetic chain exercises in rehabilitation and conditioning programs for the lower extremity and upper extremity, respectively. The authors cite numerous relevant clinical research articles to help the clinician, which supports the formation of an appropriate and safe program. A progressive rehabilitation program is promoted using the foundation of functional testing as progression criteria.

A series of closed kinetic chain exercises are presented in chapters 7 and 8. Each exercise is presented with exercise name, start position, exercise action, purpose, the primary muscles used, indications, contraindications, and sometimes suggestions for proper performance. The descriptions are easy to read, and the illustrations that accompany each exercise help the clinician apply the content of these 2 chapters in clinical practice quickly and easily.

Overall, this book is easy to read, and it provides a good scientific basis for using closed chain exercise as a component of a rehabilitation or conditioning program. It also provides easy-to-apply progressions and testing. To enhance learning, the book offers ample examples, tables, and illustrations that any fitness consultant or rehabilitation clinician can incorporate into the practice setting.

Rose L Smith, PT, MEd, SCS, ATC
University of Cincinnati
Cincinnati, Ohio

Ms Smith is Assistant Professor in the Department of Rehabilitation Sciences and Adjunct Instructor in the Athletic Training Program, and Health Alliance rehabilitation specialist for University of Cincinnati Athletic Department.