Physical Therapy of the Shoulder, ed 4.

Physical Therapy of the Shoulder, ed 4

Donatelli RA, ed. St Louis, MO 63146, Churchill Livingstone Inc, 2004, hardcover (with CD-ROM*), 588 pp, illus, ISBN: 0-443-06614-0 $79.95.

Four editions within a span of 15 years attest to the work ethic of the editor and to the credibility and usefulness of this text, which is written for the rehabilitation professional who specializes in the care of people with shoulder girdle pathology and dysfunction. With 7 new chapters, 35 contributors (including 12 new authors) present up-to-date methods of examination, intervention techniques, and surgical procedures.

The text is divided into 5 sections: "Mechanics of Movement and Evaluation," "Neurologic Considerations," "Special Considerations," "Treatment Approaches," and "Surgical Considerations." A CD-ROM complements the text, providing visual and audio excerpts of an examination of a patient as well as fresh cadaver slides, a link to an electronic image collection, and animated movement of the glenohumeral joint and scapula.

A strong feature of this new edition is the first chapter, which gives an overview of APTA's Guide to Physical Therapist Practice (Guide). As a result, all of the cases presented throughout the text are now written in Guide language, something that should aid physical therapists who want hints about one way to use the Guide. Other chapters in section 1 present anatomy and mechanics, the shoulder in throwers, and differential soft-tissue diagnosis. The anatomy and mechanics chapter is well organized and accurate and includes 7 fresh cadaver slides in addition to the color plates the were present in previous editions. Descriptors of theoretical normal glenohumeral arthrokinematic movements, however, are absent. In their chapter, "Throwing Injuries," Cooper and colleagues present new information on the etiology, evaluation, and treatment of throwing injuries to the shoulder. Their chapter also includes appendixes that can further assist practitioners who work with throwing athletes. Finally, the diagnosis chapter has been improved by presenting a more evidence-based approach to the understanding and application of tests and measures.

The neurologic section contains 5 chapters that cover the interrelationship of the spine, rib cage, and shoulder (a completely rewritten chapter); neural tissue evaluation and treatment; thoracic outlet syndrome (TOS); brachial plexus lesions; and the shoulder in hemiplegia (another completely rewritten chapter). All chapters in this section contain interesting cases that illustrate application of principles, but I was disappointed in the lack, or balance, of evidence provided with regard to neural tissue work and the Edgelow protocol for examination and treatment of TOS.

Impingement, frozen shoulder, rotator cuff pathology, and viscera-related shoulder pain are discussed in the "Special Considerations" section. The chapter on frozen shoulder is noteworthy for its extensive narrative review of the literature on treatment outcomes; however, the chapter does not have a critical appraisal of the literature cited, so readers should be cautious in how they interpret and use the authors' findings.

Section 4 includes chapters on manual therapy techniques, muscle length and manual muscle testing (which includes electromyographic [EMG] data for manual strength testing) and shoulder exercises, and myofascial treatment. A small portion of the manual therapy chapter, which discussed evidence for the use of manual techniques, was good to see. It seems to me, however, that the information on muscle length and strength tests is out of place and might better fit in the diagnosis chapter. The EMG data that were presented appear to validate our understanding of manual muscle tests, which is reassuring. For years, many in our profession have been asking those who use myofascial treatments to validate their work. Unfortunately, validation of myofascial work is missing from our literature, including this text. At the least, the authors in this 2004 edition should have acknowledged that there is little or no evidence for the use of myofascial treatments. The final section contains 4 extensive chapters covering shoulder instability and total shoulder replacements (which are new chapters), rotator cuff repairs, and shoulder girdle fractures.

Despite a few minor criticisms, I found this book to be well organized and well written, making it a comfortable read. Numerous illustrations, photos, line drawings, radiographs, and tables complement the text. In addition, each chapter concludes with many up-to-date references. Finally, the CD-ROM can be used as a teaching tool for examination techniques and contains images that can be easily downloaded into a PowerPoint presentation, a feature that faculty might want to use. I would recommend this text to educators who teach musculoskeletal material and any practitioner who has a caseload that includes a variety of problems related to the shoulder girdle.

Gordon J Alderink, PT, PhD

Grand Valley Slate University

Grand Rapids, Mich

Dr Alderink is Associate Professor in the Physical Therapy Department, where he teaches kinesiology, biomechanics, orthopedics, and research methods. His also is Director of Academic Research at the Mary Free Bed Hospital Motion Analysis Center; a laboratory that performs gait analyses to help manage patients with orthopedic or neurological pathologies.

[Note: The system requirements for the CD-ROM are: PC: Windows 98 or higher, Pentium II processor, 233 MHz or higher, at least 64 MB RAM (128 MB recommended), 30 MB hard-disk space, 8x or faster CD-ROM drive, 800 x 600 resolution monitor and QuickTime 6 or higher. Macintosh: Apple PowerPC 166 MHz or higher, Mac OS version 9.0 or later as well as the features described above.]