Therapeutic Exercise: Foundations and Techniques, 2nd ed.

Therapeutic Exercise: Foundations and Techniques, 2nd ed By Kisner C, Colby LA. Philadelphia, PA 19103, FA Davis Co, 1990, paperback, 714 pp, illus, $37.95

The authors state that the purpose of this book is to provide an instructional tool for entry-level physical therapists and a reference book for practicing professionals to use in the clinic. Written in an outline format instead of in the usual paragraph style, the book is tightly packed with information that can easily be used as a reference in designing treatment plans based on the evaluation of patients with musculoskeletal problems.

The book is divided into three parts. The first section is devoted to general concepts and techniques. Basic approaches to evaluation and assessment are discussed in addition to guidelines for treatment program development. Descriptions of the rationale for and techniques of therapeutic exercise (eg, range-of-motion exercise, resistance exercise, and stretching) are clear and concise. The authors identify the Norwegian philosophy of joint mobilization as the foundation for the chapter on peripheral joint mobilization.

Section 2 provides information on the application of various therapeutic techniques to the specific regions of the body. Each stage of the soft tissue repair process and guidelines for treatment essentials to be considered during each stage are clearly discussed. This section contains--for each body region to be treated--a review of anatomy, joint mechanics, muscle action and function, and information on the management of common musculoskeletal lesions and surgical problems. This practical, readable reservoir of information probably would be the section most often used by clinicians.

The third section provides information on therapeutic exercise used in such special areas as obstetrics, chest physical therapy, management of obstructive and restrictive pulmonary conditions, and aerobics. One chapter covers critical analysis of exercise and fitness programs. According to the authors, a significant portion of this secion is new information that is based on recent research in the basic sciences. The chapters follow the same concise outline format used throughout the book and enhance the book's value as a clinical reference.

This section edition differs from the first edition primarily because of revisions and additions to information on the response of soft tissue to injury, on approaches to neck and back care, on the use of isokinetics, and on the management of surgical and cardiopulmonary conditions.

The authors emphasize an integrated approach that consists of three major consecutive steps: (1) evaluation to identify problems, (2) establishments of realistic goals based on the problems, and (3) selection of a plan for care to meet the goals. Each chapter begins with a list of objectives that helps the reader anticipate the content and focus on specific information. The book is well-organized, and the information flows easily, in a straight-forward manner.

Adding to the book's value as a quick reference is a 9-page glossary with well-defined terminology and a 21-page index. The body of the text is sufficiently referenced, with an ample number of sources listed at the end of each chapter. The book has some photographs and charts, and line drawings complement the text nicely. Positions for exercise are clearly portrayed. The illustrations in the chapter on peripheral joint mobilization are very clear in their depiction of hand placement and angle of glide.

I would certainly recommend this book for entry-level therapists, in addition to therapists who are returning to clinical practice and those who are in general practice. Even the clinician who has considerable experience working with patients with musculoskeletal problems and who would appreciate more advanced levels of information would probably find in this book the inspiration to create new treatment approaches to common clinical problems.

Joan M Knapp