Peripheral Manipulation, 3d ed.

Upon first glance, this edition of Peripheral Manipulation is not very different from the previous edition. Most of the descriptions of the evaluation and treatment techniques that encompass the majority of the book have not been changed. The author, however, has strengthened the information concerning many of the individual joints by including additional graphics and more information about this evaluation process. More importantly, new chapters have been added to emphasize the therapist's asessment of the patient, communication skills, and an overview ,of musculoskeletal disorders commonly treated by physical therapists.

This book presents the "Maitland concept of examination, treatment and assessment of passive movement." The author emphasizes that "assessment" is the most crucial aspect of this concept and cautions against learning the manual techniques without comprehending the need for continually assessing the patient, the treatment technique, and the patient's response to the treatment ,and without knowing how to perform this assessment.

Equally important to the concept is the ability of the therapist to communicate with the patient. The author devotes a chapte to this concept, stating that communication has generally been overlooked by manual therapists. the abilities to listen with an open mind and to believe the patient are skills that must be developed and that can have a significant impact on the success of the patient care program.

Another basic tenet of the Maitland concept that is presented in a new chapter is that selection and implementation of treatment techniques are not predicated upon a diagnostic classification. The chapter on musculoskeletal disorders presents an overview of the more common conditions seen by physical therapists, such as joint locking, hypermobility, and arthritis. This chapter emphasizes the importance of establishing the history and clinical signs and symptoms of the disorder and making certain that this aspect of the examination matches the more objective part of the examination.

As in previous editions, the author describes in great detail how to perform these mobilization techniques. He is consistent about describing the patient as "he" and the therapist as "she" in an atttempt to assist the reader with learning the techniques. The format of the book, plus the use of brief case studies, drawings, and figures, make this edition more readable and comprehensible.

This book would be best used as a textbook for physical therapy students, both in the baccalaureate- and postbaccalaureate-level programs. It will also serve experienced manual therapists as a reference book to strengthen their skills or as a quick reference to review a particular treatment technique. I recommend this book and believe it would be an asset to the professional library of physical therapists.

J Randy Walker, Jr, PhD, PT The University of Tennessee at Chattanooga Chattanooga, Tenn