Essentials of Physical Medicine and Rehabilitation: Review and Self-Assessment.

Silver JK, Frontera WR, eds. Philadelphia, PA 19107, Hanley & Belfus Inc, 2003, paperback, 367 pp, illus, ISBN: 1-56053-437-0, $39.95.

This book serves as a self-assessment tool that presents information on 145 topics in physical medicine and rehabilitation (PMR). Each topic is presented in its own "chapter" that consists solely of a group of 5 or 10 multiple-choice questions, followed by the correct answers on the next page. The authors' answers include their rationale and diagrams, photographs, charts, and graphs to support their selection. The book is written for physicians in preparation for their PMR board examinations and is designed as a companion to the main text Essentials of Physical Medicine and Rehabilitation (Hanley & Belfus, 2002), written by the same authors. The information, however, is presented in a study-guide format that might not be detailed enough for this book to be used as a reference on its own. If this book is used as a self-assessment tool in conjunction with the main text, it meets its intended purpose.

The various authors cover many of the major topics in the areas of PMR. The book is logically divided into 2 sections. The first section, "Musculoskeletal Disorders," consists of 91 chapters on topics such as adhesive capsulitis, glenohumeral instability; rheumatoid arthritis of the hand, thoracic outlet syndrome, and shin splints. The second section, "Rehabilitation," consists of 54 chapters on topics such as cancel chronic fatigue syndrome, headaches, repetitive strain injuries, and stroke.

The information appears to be mostly accurate and up-to-date, but the authors do not provide references to support their "correct answers." The addition of current references would definitely strengthen the text. For example, in chapter 72, "Shin Splints," the author notes that the "primary muscles involved in shin splints are the flexor digitorum longus and soleus." (p172) A "wrong answer" according to the author would he the "tibialis anterior and soleus" and tire "tibialis anterior and tibialis posterior." Leading authorities, such as Janet Travell, have argued that these muscle combinations, which are listed as "wrong responses," are involved in "shin splints." The rationale that the authors provide for their answer choice is that the "tibialis posterior muscle origin is more posterior" A more thorough chapter would make the authors' decisions on correct responses more clear to the reader.

The fact that references for the information are not provided is a major weakness in a stand-alone text. In addition, the authors of chapter 13, "Biceps Tendinitis," presented special tests, such as Speed's test, based on clinical judgments without giving adequate consideration to the reliability or validity of the measurements.

This hook is intended to serve as a self-study for someone who already understands the basic information about the PMR topics that it covers. The book is different from other books on the market because it is a simple review test for the reader. The book's multiple choice questions are easy to complete and do provide general feedback on the reader's basic understanding of PMR topics.

The diagrams, illustrations, radiographic films, charts, and photographs effectively complement the text. These numerous figures definitely help clarify the authors' key points mad rationale.

I would not recommend this book as air independent text, but it may be a useful complement to the full text. This study guide may be beneficial for physical therapists who are trying to assess their knowledge of the PMR field. As it is written, however it is does not stand alone as an independent text because the information provided is incomplete, and it lacks the appropriate references to justify the answer choices.

Ricardo A Fernandez, PT, OCS 

Northwestern University

The Feinberg School of Medicine 

Chicago, Ill

Mr. Fernandez is Assistant Professor/Clinician in the Department of Physical Therapy and Human Movement Sciences and specializes in orthopedic rehabilitation of patients with shoulder and knee dysfunction.