Lower Extremity Injury Evaluation: An Interactive Approach. (Software).

Lower extremity injury evaluation: an interactive approach. Wiksten S, Barry B. Thorofare, NJ 08086, Slack Inc, 2001, CD-ROM, ISBN: 1-55642-428-0, $259. [System requirements: For PC: Pentium 100 processor or faster, Microsoft Windows '95 or later, 2X CD-ROM drive, 16 MB RAM, 1 MB (or higher) SVGA video card, 8-bit Sound Blaster-compatible sound card. For Macintosh: Power PC processor, Mac OS version 7.5 or later, 2X CD-ROM drive, 16 MB RAM.]

The purpose of this CD-ROM is to provide a supplement to traditional demonstration techniques used for injury examination. The CD video allows users to view real-life presentations of several special musculoskeletal tests of the lower extremity. The self-paced program consists of 6 regional components.

The areas of examination are the thoracic and lumbar spine, pelvic and sacral region, hip, knee, and ankle/foot. Within each area of examination, several special tests are available for review. The thoracic spine component consists of 3 special tests: rib compression test, slump test, and Kernig test. The lumbar spine section contains demonstrations of the straight leg raise, Milgram test, femoral nerve traction test, and Hoover test. The fabere (Patrick's) test, sacroiliac joint stress test, Gillet's sacral fixation test, squish test, and Gaenslen's test make up the content of the section on the pelvic/sacral region. Five tests are presented in the hip and groin region: Trendelenburg's test, Thomas test, 90-90 straight-leg-raise test, hip scouring, and the true leg-length discrepancy test. The knee section is the largest and consists of the varus-valgus stress test, anterior/posterior drawer, Lachman's test, pivot shift test, posterior sag, McMurray's test, Apley's compression/ distraction test, patellar apprehension, and Clarke's patellar grind test. The final section consists of the special tests for the ankle and foot and includes the Thompson test, anterior drawer, talar tilt, Tinel's sign, Feiss line, and neuroma compression test.

Each special test demonstration has 5 segments presented systematically. Real-life video and audio accompany each demonstration. After a special test is selected from the menu, segment 1 displays the position of subject, segment 2 displays the position of examiner, and segment 3 presents the examination procedure. The final 2 segments present positive test results and negative test results. The viewer has the capability to move back and forth between segments with ease. An optional screen within each special test provides anatomy review. Once chosen, the viewer is able to view a 3-dimensional rotating image of the joint at study. A zoom feature is available for a closer look at the anatomical structure. A nice characteristic of the positive test segment is an anatomical replication of the positive test, something that cannot be captured in a textbook.

Overall, this CD-ROM presents a good review of common musculoskeletal special tests. Although most tests are presented accurately, I would recommend more precision with the slump test and caution on the interpretation of a positive test results for Tinel's sign. Also, a recommended reading or reference section would be beneficial. A weakness in the maneuverability of the program is having to re-click for each segment. It would have been more efficient to put the subject position and tester position together in one segment. Otherwise, the program is easy to manage, even for the user who is not computer savvy. There is a minimal computer system requirement for loading this program. I believe that this CD-ROM would be beneficial for physical therapist or athletic training students.

Janice K Loudon, PT, PhD, SCS, ATC University of Kansas Medical Center Kansas City, Kan

Dr Loudon is Associate Professor in the physical therapy program at the University of Kansas Medical Center. She has over 17 years of clinical experience in orthopedics. Her research interest is the study of biomechanics and prevention of injuries in sports.