Maitland's vertebral manipulation, ed 7.

Maitland G, Hengeveld E, Banks K, English K, eds. Philadelphia PA 19103, Elsevier Butterworth Heinemann, 2005, paperback, 496 pp, illus, ISBN: 0-7506-8806-8, $84.

[Minimum system requirements for CD-ROM: Windows: Windows 98, 2000, NT, ME, or XP operating system or the Mac OS 9.1+ operating system, 126 MB RAM, 1024 x 768 pixel screen resolution, millions of colors. Quick Time 6 is required to view the video clips.]

This is the seventh edition of Geoff Maitland's classic text. This edition's text is identical to the sixth edition that was published in 2000, except that photographs have replaced the line drawings and a CD-ROM is included.

Throughout the book, key concepts are highlighted for emphasis. This feature allows the reader to quickly and easily reference important information later on. The book consists of 15 chapters, 5 appendixes, a bibliography, and an index. References are also cited throughout the text. As in earlier editions, a glossary is placed in the beginning of the text so that the reader will be clear about what they are reading. The first chapter serves as an introduction to the concepts. The second chapter is written from the physician's viewpoint and touches on those patients who may have nonmusculoskeletal pathology and the indications or contraindications for manipulative therapy. The third chapter, simply titled, "Communication," is one of the reasons why this text is considered a classic.

The fourth chapter examines the importance and relevance of "assessment." The fact that this is a dynamic and cooperative process is emphasized. The fifth chapter is unique because the physical therapist's prognosis--not the medical prognosis--is the focus. The "assessment and reassessment" of the patient is integral to developing a prognosis, as is keeping an open mind.

Patient examination is the focus of the sixth chapter. The "subjective" and physical examination processes and specific tests are reviewed. More important, the planning of the examination relative to establishing a hypothesis is discussed at great length. The principles, selection, and application of techniques are covered in the next 3 chapters. The thought process that a clinician should perform when selecting a technique is described through graphs, as well as in the text. The authors emphasize that signs and symptoms will dictate the treatment choice, not the diagnostic label. This chapter is where the line drawings were replaced by still photos. The reader can now visualize more clearly how the physical examination procedures are performed.

Specific examination and treatment techniques for the regions of the cervical spine to the intercoccygeal regions make up the content of chapters 10 through 14. The photos that illustrate the various procedures are clear and numerous and allow the reader to see more accurately the hand contacts and the therapist's and patient's positions. For each of the regions, specific "subjective" and "objective" data are stressed as appropriate. Body charts are used along with case histories as teaching tools. Chapter 15, "Examples of Treatment," provides 24 case histories. This is one of the more valuable sections of the book, as the reader can connect the material in the text to actual patients.

The CD-ROM is extremely user friendly. The menu has been arranged so that each region of the spine is categorized identically to the text. There are additional menus for "Neurodynamics," "Passive Physiological Intervertebral Movement," "Pre-Manipulative Vertebral Artery Testing," and "Grade V Manipulations." There is an extensive and impressive collection of video clips. The menus, along with their drop-down boxes, are easily navigated. The videos clearly display the treatment and evaluative procedures. The clips can be paused at any time to allow the viewer to examine the different hand holds used, therapist and patient positions, and the direction of force. Upon selection of an item from the menu, a slide appears that describes what will be shown in the demonstration. This slide can be referred to while watching a clip to remind the viewer what they are viewing. The CD-ROM is video only. A nice addition would have been to include the relevant special tips that can be found in the book, along with the demonstrations. The video clips are best used while reading the text to add to the written descriptions and still photographs. The video clips are a great resource for therapists with experience in Maitland's approach to refine their techniques.

Although the seventh edition of Vertebral Manipulation contains the same text as the sixth edition, the inclusion of the photographs and CD-ROM makes this edition more clear and concise. These changes greatly enhance this edition, and I would recommend this text to any therapist, regardless of expertise level.

Jeff Yaver, PT, PhD, is a clinical specialist, Kaiser Permanente Medical Center, Manteca, Calif.

[DOI: 10.2522/ptj.2007.87.1.120]