Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation.

Neumann DA. St Louis, MO 63146, Mosby Inc, 2002, hardcover, 619 pp, illus, ISBN: 0-8151-6349-5, $54.95.

This text begins by explaining core biomechanical principles, then approaches the body regionally, as do a host of competing kinesiology texts. This approach is supremely logical, and Dr Neumann, a respected physical therapy educator, writes clearly and economically. What sets the work apart from others I've read and used, both in teaching students and in keeping myself current, is its integration of narrative text and hundreds of priceless illustrations. According to the introduction, Neumann and the illustrator, Elisabeth Rowan, worked together for the better part of a decade to devise a way of showing human movement in a systematic, three-dimensional framework. The illustrations permit readers to emulate this framework and to begin to analyze complex problems.

The book presents a systematic way to analyze osteokinematics and arthrokinematics and provides the basic information that students need to apply their physics background, especially vector analysis, to solve problems in human movement. The text and closely matched illustrations consistently illuminate complex topics in normal and pathological movement. I paid special attention to topics that perennially confound newcomers to the field, such as shoulder girdle and subtalar movement, pathokinesiology of the wrist and hand, or the rationale for teaching lifting techniques. Neumann's explanations and discussions are reasoned, clear, and bolstered with recent references to the biomechanical literature. Diagrams reinforce the narrative by showing the anatomical and functional relationships between the skeleton and joint structures and the important forces produced actively or passively in muscles and other soft tissues.

The explanations and diagrams that illustrate arthrokinematics are especially impressive. Readers can easily visualize simultaneous roll and glide at joint surfaces and appreciate their functional significance.

The text also includes numerous radiographs and photographs that address analytic concepts and help those clinicians who are palpating relevant anatomy. Although the text does not provide the extensive road maps to palpation that are so useful to beginning therapists, this a small criticism of a work that otherwise covers human movement analysis in great detail.

Each chapter contains numerous "special focus" sections. These range from clinical examples to illustrative movement problems that the reader can perform and experience personally. I initially thought that these sections interrupted and distracted the reader from the flow of the text. After spending time with this valuable volume, however, I've concluded instead that they take advantage of content areas that integrate or cut across concepts that the author develops throughout the book.

I wish that my physical therapist and occupational therapist students had access to this text when I taught biomechanics. Kinesiology, including biomechanics, is an indispensable foundational science for physical therapists. Armed with knowledge of physiology and what the founders of our profession called "functional anatomy," a therapist, at a minimum, should be able to evaluate the claims and the reasonableness of any therapeutic protocol. At best, they can create and personalize rehabilitation programs to address any patient's particular mix of biomechanical assets and deficits. Neumann's text provides ground-level knowledge to help young therapists move toward this ideal and a wealth of detail that can revitalize the practice of experienced clinicians.

David M Thompson, PT, MS
University of Oklahoma Health
Sciences Center
Oklahoma City, Okla

Mr Thompson was formerly a faculty member in physical therapy at the University of Oklahoma Health Sciences Center, where he taught biomechanics and wrote a textbook chapter on the rehabilitation of people with transfemoral amputations. He is currently a doctoral student in biostatistics.