Positional Release Technique: from a Dynamic System Perspective. (Reviews).

Positional Release Technique: From a Dynamic System Perspective Deig D. Woburn, MA 01801-2041, Butterworth-Heinemann Inc, 2001 hardcover, 248 pp, illus, ISBN: 0-7506-7225-0, $59.95.

This book offers the reader a comprehensive explanation of positional release technique (PRT). The reader is introduced to the underlying concepts of the technique, its mechanics, and finally its practical application. The author's thoroughness is evident throughout the book and would certainly be appreciated by any reader wishing to know about PRT.

The book is divided into 3 parts. The first part, "Conceptual Model and Methodology," provides an extremely extensive background on PRT. This groundwork allows the reader to understand the origin and philosophy of PRT. The author describes where PRT lies in the spectrum of manual therapy. The tenets of this technique, which stress patient-centered and whole-person approaches, are also explained. The theoretical foundations are covered in detail with numerous references. Unfortunately, none of these references are published studies of PRT effectiveness; relatively few are primary, peer-reviewed sources; and some are theoretical precepts published over 50 years ago.

The initial section also includes a thorough review of the history of indirect techniques, including functional technique, Jones strain-counterstrain, orthobionomy, and exaggeration technique. Overall concepts of examination and evaluation as well as treatment are presented in a general manner. Unconventional physical and emotional patient responses to treatment are outlined, and the rationale behind the responses are explained to the reader.

The first part offers an exhaustive amount of unproven background as a logical basis for PRT, and it stops short of providing the reader with any sound evidence behind the use of the technique. The author, however, recognizes the lack of outcome studies and the definite need for further research involving indirect techniques such as PRT.

Part 2 covers 3 areas of application: muscular, joint, and isometrics. For each application, the author provides an introduction with detailed specifics of examination and intervention procedures. Comprehensive explanations of individual techniques, which are illustrated very well by accompanying photographs and anatomical diagrams, are included in this part. The author suggests using these diagrams for patient education purposes. Several chapters in the second part end with a summary that effectively recaps the preceding chapter.

In the third part useful case studies are presented. All but 1 of the 8 case studies were written by students in a postprofessional program and are followed by commentary from the author. Part 3 describes practical application of the technique to the reader.

For the physical therapist or other practitioner interested in learning PRT, this book provides a clear explanation of the intervention procedures. The author provides an interesting discussion of the concepts and theories behind PRT. Assessment, which emphasizes the mind-body connection in patients, is described along with an extensive theoretical basis. The descriptions and the well-executed illustrations provide an easy-to-follow guide to the implementation of numerous specific techniques. In the midst of the in-depth list of references, the lack of direct research providing any strong evidence of the efficacy of PRT is a weakness that should not be overlooked by the reader.

Karen Maloney Backstrom, PT, MS, OCS
University of Colorado Health
  Sciences Center
Denver, Colo

Ms Backstrom is an Assistant Professor in the Physical Therapy Program and coordinator of the orthopedic curriculum. Her clinical activities occur within the CU Physical Therapy Faculty Practice.