Muscles: Testing and Function With Posture and Pain, ed 5 (with Primal Anatomy CD-ROM).

Muscles: Testing and Function With Posture and Pain, ed 5 (with Primal Anatomy CD-ROM) Kendall FP, McCreary EK, Provance PG, et al. Baltimore, MD 21201, Lippincott Williams & Wilkins, 2005, hardcover (with CD-ROM), 512 pp, illus. ISBN: 0-7817-4780-5, $74.95.

The fifth edition of this classic text has had a makeover. Colorful headers top every page. Blocks of text are enhanced by colored rifles and subtitles. Terms are bolded. Even the tables look brighter with colored grid lines. This fresh appearance has been aided by the extensive reorganizing of material started in the third edition, and continued in the fourth and, now, the fifth edition.

Except for the first 2 chapters, "Fundamental Concepts" and "Posture," the remaining 5 chapters are organized by body region: head and face; neck; trunk and respiratory muscles; upper extremity and shoulder girdle; and lower extremity. The material within the body region chapters now has the general order of innervations, joints, range of motion, muscle length tests, muscle strength tests, painful conditions, case studies, corrective exercises, and references. Many of the line drawings, photographs, and even blocks of text will be familiar to experienced Kendall users. With the consolidation of chapters and the reordering of contents in this edition, however, the material proceeds sequentially and concisely, as it never has before. The chapter structure, along with the subject line in the header on every page, also makes it easy to navigate through this edition.

Creating sections within the body region chapters has led to a more thorough development of topics. For example, in the chapter on the lower extremity, the muscle length testing of the hip now groups together hamstring length tests, the Ober and modified Ober tests, and hip flexion length tests and also covers the possible errors in performing these tests. The detail provided, along with additional clarifying photographs, has made this section more robust. Similarly, the section structure within chapters allows for a more meaningful grouping of topics. Length and strength testing of abdominal muscles in the trunk chapter are enhanced with the inclusion of the "classic Kendall" analysis of muscle actions in the curl-up sit-up position with knees bent versus legs extended and held down.

In the fifth edition, the term "Classic Kendall" refers to color-coded text boxes that convey interesting information that can be obtained only from the unique opportunities of a long physical therapy career. But truly, nothing could be more classic Kendall than the chapter sections on manual muscle strength testing. The strength-testing techniques are skillfully demonstrated in photographs, clarified in drawings, and expertly described in the text. The vintage but still relevant photographs have guided generations of clinicians.

Despite the familiarity of the photographs, drawings, tables, and text, the visual and organizational enhancements in the fifth edition make it clear that this is not your old clinical instructor's Kendall. Anyone who requires further convincing just needs to spend time with the accompanying Primal 3D CD-ROM. Seven body regions are represented, with an average of 22 screens for each region. The images begin with the bones for the region and each successive screen layers on more anatomy: ligaments, muscles, arteries, veins, and nerves. All images can be rotated 360 degrees. The software will crosshatch and identify any point on the image clicked by the cursor. Such an engaging and interactive form of instruction might help students retain more information the first time they learn anatomy, as well as help clinicians review the anatomy of specific body regions.

In general, when it comes to the relationships between pain and altered posture, muscle length, and strength, the underlying evidence is at the level of a case study or case series, with all the limitations in reliability and validity that come along with that level of evidence. This does not mean that the recommendations in this text are not reliable, valid, or useful, but it does mean that therapists seeking to base their practice on more systematic forms of evidence should welcome further studies testing the influential ideas presented in this book. In addition, there could be an argument that more material would have been better placed in the "Classic Kendall" or "Historical Notes" text and photograph boxes, or omitted altogether. For instance, the directions on how to fabricate a vintage rigid body jacket to treat scoliosis are an example of the former, and the terms "bowlegs" and "knocked-knees," the latter.

The fifth edition of Muscles: Testing and Function With Posture and Pain, is an excellent choice to guide the postural analysis and muscle length and strength testing of another generation of physical therapist students. Clinicians will find this easy-on-the-eyes, reorganized reference to be a more convenient resource to use than previous editions. This fifth edition would be an excellent choice for any physical therapy department library. It can be anticipated, however, that the book and CD-ROM will spend little time sitting on the library shelf.

Debra Coglianese, PT, DPT, OCS, ATC 

Massachusetts General Hospital 

Boston, Mass

Dr Coglianese is a Senior Physical Therapist with a practice at the MGH Charlestown Health Center. She is a lecturer for the Comprehensive Case Course at the MGH Institute of Health Professions.

[System requirements for CD-ROM: For PC: Windows98/Me/2000/XP. For Macintosh: Mac OS 8.6-9.2, OS 10 with "Classic Environment."]