Fundamental Orthopedic Management for the Physical Therapist Assistant.

Shankman G. St Louis, Mo 63146, Mosby Year Book Inc, 1997, hardback, 336 pp, illus, $34.95 (with accompanying Student Workbook, paperback, 88 pp, $9.95).

Until recently, physical therapist assistants (PTAs) did not have textbooks or resource books written especially for them. Fortunately, this trend is beginning to change. In the preface, the author states that this text is intended to fill the long-neglected void in PTA education and will serve as a primary resource, supplemental guide, and valuable reference for PTAs interested in orthopedics.

The format for the textbook, which is divided into four sections, follows a logical sequence. Section 1, "Basic Concepts of Orthopedic Management," begins with a chapter on patient supervision skills, then proceeds to chapters covering flexibility, strength, endurance, and balance and coordination. Each chapter follows a similar format, providing a short basic science overview related to the topic followed by more in-depth material on practical applications.

Section 2, "Review of Tissue Healing," includes separate chapters on ligament, bone, cartilage, and muscle and tendon healing. These chapters are generally six to eight pages long and provide brief information on basic science, clinical application, and selected rehabilitation techniques.

Section 3, "Gait and Joint Mobilization," has a chapter devoted to each topic. These chapters are also relatively short and cover only the very basic concepts of normal and pathological movement. These chapters may be of limited value to the reader because additional resources would be needed to cover these topics at an appropriate depth.

Section 4, "Management of Orthopedic Conditions," consists of seven chapters, each dedicated to specific joints. These chapters tend to be more in-depth than previous chapters, covering mechanisms of injury, special testing, common injuries, general rehabilitation concepts, and some specific rehabilitation techniques. Fracture and surgical management are also included. Protocols are generally avoided.

The text is easy to read, due to the clear and concise writing style of the author. The illustrations are especially well done. The photographs and drawings are extensive and appropriately placed. Highlighted tables enable the reader to quickly identify important information.

Overall, this text should be a useful adjunct to orthopedics courses for PTAs. However, some instructors may find that the information is too superficial to be a primary text for a course covering gait, joint mobilization, and therapeutic exercise. Physical therapist assistants practicing in the area of orthopedics may find this text of interest, but again the content may not be extensive enough.

The student workbook is a very good review and self-assessment tool. The questions consist of true/false, multiple-choice, short-answer, essay, and clinical thinking applications. The questions are written at various levels of difficulty and include recognition, recall, analysis, and synthesis activities. The answers are provided in a section at the back of the workbook.

Tim Noteboom, PT, SCS, ATC
Regis University
Denver, Colo

Mr Noteboom is Instructor in the Physical Therapy Department. He is involved in teaching kinesiology, orthopedic, and sports medicine courses. He also instructs PTA students in electrical stimulation at Arapahoe Community College in Littleton, Colo.