Spinal and Extremity Manipulation: the Basic Skill Set for Physical Therapists.

Wainner RS, Flynn TW, Whitman J. San Antonio, TX 78234, Manipulations Inc, 2001, CD-ROM, ISBN: 0-9714792-1-6, $59.95. [Minimum System Requirements: Pentium 166-MHx or higher, Windows 95 or later, 16 MB RAM.]

The purpose of this CD-ROM is to demonstrate specific mobilization techniques for the extremities and the spine. The authors included brief video clips and written instructions to help the user perform the techniques. The authors also introduce the user to evidence-based practice and summarize the evidence for the effectiveness of manual technique for each joint.

The content of this CD-ROM is easy to access. The disk opens automatically to the "Main Menu" screen, where users simply click on a joint on a schematic of the human skeleton to view a video clip of the mobilizations and manipulations for that joint. Each mobilization or manipulation technique includes a written description of patient position, hand placement, and the direction in which the force is applied.

The "Main Menu" screen includes several useful headings: "Examining the Evidence," "Evidence Summaries," "Search Strategy and Engines," and "Teaching Tools." The authors present their definition of evidence-based practice in "Examining the Evidence," which helps users to understand their frame of reference as they present evidence supporting manual therapy for the extremities and the spine. "Evidence Summaries" includes a summary of the literature and a reference list for each of the joints covered on the CD-ROM. The section for the lumbar spine and sacroiliac joint also includes interactive Web addresses for several online publications.

The authors provided an excellent and useful service to all users when they included the section "Search Strategy and Engines." This section includes the interactive description of the process that the authors used to gather the supporting evidence about manual therapy, which allows the user to duplicate their search and remain current in the literature. The CD-ROM hotlinks (via Microsoft Internet Explorer) to 3 literature databases: PEDro--the Physiotherapy Evidence Database, PubMed (MEDLINE), and the Cochrane Review Groups Database.

The quality of the video, however, could be better, because the video clips are very short and tend to become blurry when they are running. In addition, the clips must be run several times in order to appreciate the application of the technique. It would have been useful if the authors had also included a statement about the indications for using each technique.

Overall, this is a valuable CD-ROM for the experienced or beginning manual therapist. It provides a good literature review concerning the use of manual therapy and adequately depicts a number of mobilization and manipulation techniques for each extremity and spinal joint.

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

Dr Walker is UC Foundation Associate Professor and Head of the Physical Therapy Program and is Director of the School of Rehabilitation Professions. His area of clinical expertise is musculoskeletal dysfunction, and he teaches several courses in the physical therapy curriculum related to this topic, including goniometry and muscle testing.