Fundamental Orthopedic Management for the Physical Therapist Assistant, ed 2.

Fundamental Orthopedic Management for the Physical Therapist Assistant, ed 2 Shankman GA. St Louis, MO 63146, Mosby Inc, 2004, paperback, 565 pp, illus, ISBN: 0-323-02002-X, $39.95.

When I first looked at Fundamental Orthopedic Management for the Physical Therapist Assistant, I wondered whether it might be too much of a good thing, perhaps overwhelming to the student physical therapist assistant (PTA). After spending more time with the book I realized that, far from being overwhelmed, the PTA would be delighted and grateful to have so much information available in one book.

The book is most obviously intended for student PTAs studying orthopedic physical therapy. The book, however, brings together material from many areas, including kinesiology, general medicine, and exercise science, and so it could be a part of several courses in the PTA curriculum.

Part I, covering chapters 1 through 7, is entitled "Basic Concepts of Orthopedic Management." Chapter 1 discusses basic concepts of communication with patients and with members of the rehabilitation team. Chapter 2 discusses the PTA's role in the ongoing examination of the patient, briefly covering procedures commonly used in orthopedic physical therapy. Chapter 3 contains a concise review of physical agents. Chapters 4 through 7 cover basic science and its practical application in exercise programs addressing deficits of flexibility, strength, endurance, and balance and coordination. These chapters are packed with information that should help the PTA bring an informed and thoughtful approach to the implementation of exercise routines.

Part II (chapters 8 through 13) reviews tissue healing. Chapter 8 starts with a review of structure and function of connective tissue. Chapters 9 through 13 outline the healing process in ligaments, bones, cartilage, muscle, and neurovascular tissues, along with the practical implications of the healing process in physical therapy interventions.

Part III contains a single chapter (chapter 14) that deals with pharmacology. This section is brief and focuses on antibiotics and anti-inflammatory medications and their use in orthopedics. Part IV (chapters 15 and 16) covers the fundamentals of gait and basic concepts of joint mobilization. The chapter on gait, though brief, is comprehensive. It covers terminology, muscle action, gait deviations, and use of assistive devices. Part V, "Biomechanical Basis for Movement," presents definitions of mechanical terms and concepts along with examples of their practical application in physical therapy.

The core of the book is in part VI (chapters 18 through 24). These chapters are organized by region of the body, dealing with specific orthopedic diseases, soft-tissue injuries, and fractures of the spine and pelvis, foot and ankle, knee, hip, shoulder, elbow, and wrist and hand. For each diagnosis, the pathology and examination procedures are briefly explained. When applicable, a brief explanation of pertinent surgical procedures is provided. Rehabilitation guidelines avoid specific protocols, instead they use criterion-based rehabilitation programs. The programs are practical and easy to understand.

Consistent use of learning tools helps readers to understand and integrate the material. Each chapter starts with an outline, learning objectives, and list of key terms. Review questions at the end of each chapter reinforce its content and provide scenarios for the application of critical thinking. The publisher's Web site, which has an image collection and links to many other Web sites, adds another aspect to the educational opportunities provided by this book.

Throughout the text, Shankman makes a point of referencing documents of the American Physical Therapy Association (APTA). In chapter 2, "The Role of the Physical Therapist Assistant in Physical Assessment," he applies language consistent with the Guide to Physical Therapist Practice to the role of the PTA in physical assessment and modification of the physical therapy plan of care. He also references A Normative Model of Physical Therapist Assistant Education and the House of Delegates policy Direction and Supervision of the Physical Therapist Assistant. The book focuses throughout on the unique status and role of the PTA, consistent with APTA guidelines.

This is an outstanding book. It is most appropriate as a textbook for use in PTA education programs. It would also be an excellent resource for PTAs who are working in clinics and are hoping to improve their knowledge of orthopedic management. Physical therapists looking for more understanding of the expected knowledge base and potential role of the PTA in orthopedic physical therapy also may find it helpful.

Catherine Walls, PT, OCS 

Mount Auburn Physical Therapy OAssociates

Watertown, Mass

Ms Walls is a physical therapist specializing in the management of patients with orthopedic disorders.