Therapeutic modalities for musculoskeletal injuries, ed 2.

Therapeutic Modalities for Musculoskeletal Injuries, ed 2

Denegar CR, Saliba E, Saliba S. Champaign, IL 61825, Human Kinetics, 2006, hardcover, 312 pp, illus, ISBN: 0-7360-5582-7, $56.

This evidence-based text on modalities is written specifically for inclusion in an athletic training curriculum. The student-friendly book uses a similar format for each of the 16 chapters, along with multiple tables and illustrations to complement the text. Each chapter begins with objectives, followed by a case scenario illustrating the relevance of the material presented. The end of each chapter contains a summary of the major points, a list of optional learning resources, and a peer-reviewed reference list. Although the athletic training student is the target audience, this text may be of interest to other health care professionals who treat athletes of all ages, from professional to recreational.

Chapters 1 to 7 provide a comprehensive foundation for the application of modalities in the rehabilitative process. First, the book addresses the legalities of modality usage within athletic training; then, it deals with the psychological aspects of an injury. It covers the perspective of the athlete coping with an injury, but it also discusses how the athletic trainer can encourage the athlete's participation in the treatment program. The next 5 chapters present a comprehensive continuum for using modalities within the healing constraints of inflammation. Pain is addressed from the acute and chronic perspective. In addition, the role of the neuromuscular system is a major focus area in the beginning of the initial evaluation of the injury. The modality continuum ends with outcome methods to validate modality usage.

Chapters 8 to 13 cover the different modalities used by athletic trainers. Chapter 8 focuses on the use of superficial application of heat and cold. The chapter presents the basics of energy transfer, thermal changes, tissue effects, and indications and contraindications for the common methods of heat and cold application as well as for cryokinetics and contrast therapy.

The next 2 chapters focus on electrical stimulation. Chapter 9 deals with electrical terms, types of waveforms and generators, and electrode placement; chapter 10 deals with the clinical application of electrical stimulation for acute and chronic pain, neuromuscular re-education, wound healing, and drug delivery with iontophoresis. Chapter 11 covers the deep heating modalities: ultrasound and diathermy. The generation of ultrasound and diathermy is described and treatment parameters are provided, using terminology commonly associated with each modality. The nonthermal and thermal application of ultrasound is described, and the potential uses of diathermy are outlined. The nonthermal application of US and diathermy for bone healing is addressed.

Chapter 12 outlines the history, types, characteristics, biological effects, and recommended uses of lasers. A minimal comparison is made to light-emitting devices. The modality chapters end with a general presentation on the mechanical modalities, including massage techniques, mobilization, traction, and intermittent compression. A brief description and discussion on the efficacy of manual therapies is included. Applications of cervical and lumbar traction using manual and mechanical means are presented. The indications and contraindications are outlined for each of the different modalities in these chapters.

Chapter 14 ties the previous chapters together with the development of a plan of care that integrates the modalities throughout the phases of healing after an acute injury. A plan of care for persistent pain is addressed in chapter 16. The chapter emphasizes the importance of identifying the source of the pain so that the patient may be referred to another health care provider if necessary. The authors address biofeedback and regaining volitional neuromuscular control throughout the phases of healing in chapter 15.

This modality text describes the foundation that an athletic trainer needs to incorporate modalities into practice. The most commonly used modalities in the athletic training setting are addressed, along with their application throughout the healing continuum. By presenting the material not only from an evidence perspective but through outcome measures, the authors promote the validity of modality use. This text is applicable to any health care professional who uses modalities to treat athletes.

RL Smith, PT, DPT, SCS, ATC, is Assistant Professor-Clinical, University of Cincinnati, College of Allied Health Sciences, Cincinnati, Ohio.

[DOI: 10.2522/ptj.2007.87.2.232]