Dynamic Chiropractic - November 4, 1994, Volume 12, Issue 23

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Book Reviews

By Keith Innes, DC

Title: Orthopaedic Physical Therapy, 2nd edition Category: Doctor/student education Author: Edited by Drs. Robert Donatelli, Michael Wooden Publication: Hardcover, 778 pages Publisher: Churchill Livingstone Inc. (212) 206-5000

The Editors

Robert A. Donatelli, PhD, PT, OCS, and Michael J. Wooden, MS, PT, OCS, are faculty members and instructors in the department of rehabilitation medicine at the Emory University School of Medicine. Both are orthopaedic clinical specialists. Dr. Donatelli is national director of Sports Rehabilitation for the Physiotherapy Associates in Atlanta, Georgia, and Dr. Wooden is its research coordinator.

Dr. Donatelli is a well-published and respected lecturer throughout the world. He is an innovator and a perfectionist of his art. It is always refreshing to read his writings: they are open-minded, nondogmatic, and well-referenced. He is truly a leader in the field of orthopaedic physical therapy.

In 1989, Drs. Donatelli and Wooden collaborated on the first edition of the extremely valuable text, Orthopaedic Physical Therapy.

The Text

The second edition of Orthopaedic Physical Therapy has been increased from 599 pages to 778 pages; the addition of three new chapters; a completely rewritten and revised chapter on the hand and wrist; and the addition of five new contributing authors who are experts in their own fields.

The first edition of this text was a landmark text and one that every doctor or student who deals with the neuromusculoskeletal system should have purchased and read from cover to cover. The second edition improves upon this position significantly from the overall point of view.

The rewritten chapters, Chapter 10-12, are superb in all respects for anyone treating the upper extremity. The illustrations are concise and clear with text that adequately explains each maneuver.

Chapter 18, "Use of Lumbar Rotations in the Treatment of Low Back Pain," is a notably interesting chapter, providing the reader with some very old concepts and laws (Freyette's laws published by Freyette in 1954), and some state of the art research (Bogduk and Twomey, Clinical Anatomy of the Lumbar Spine, Churchill Livingstone Publisher). The rationales and treatments are well written and illustrated. However, the list of references is somewhat lacking, with no reference to the huge study by Kuo (517 patients), or Matthew's research on rotational manipulation and disc prolapse, nor is the recent article by Quon mentioned. All of the above articles were written prior to the writing of this revised edition.

Chapter 26, "Orthopaedic Problems in the Neurologic Patient," is a wonderful addition to this text. The list of 180-plus references is current and consistent with what is written in the chapter. Perhaps the chapter's only shortcoming is that it's much too short and should be expanded significantly in a future edition.

Chapter 27, "Soft Tissue Mobilization," is a much needed addition. I was particularly pleased to see the inclusion of Dr. Vladimir Janda's and the work of numerous others in this large chapter. The chapter is well illustrated so that the reader, even if if unfamiliar with soft tissue work, will glean the concepts and be able to put them to use almost immediately.

The text is organized into four major components: fundamental principles; the upper quarter; the lower quarter; and special considerations. The underlying theme of this text is that the patient's initial complaint may not be the causative factor of the lament, nor is it going to be the only area treated. In other words, the authors are advocating examining the entire individual and treating the cause not just the presenting signs and symptoms. Does this sound familiar?

Orthopaedic Physical Therapy, second edition, is a significant improvement over and above the excellent previous edition. I bought the first edition and read it cover to cover a number of years ago and enjoyed it immensely. Now that I have finished the second edition, I can convincingly recommend it to every doctor or student interested in quality health care that takes into consideration the body as a whole. If you only want to purchase one text this year and get the most for your money, then look no further: this is the one.

Innes Rating: 10

Stephen Savoie, DC

Title: The Chiropractic Theories, Principles & Clinical Applications, Third Edition Category: Doctor and student education Author: Robert A. Leach, AA, DC, FICC Publication: Hard cover, 401 pages, $49.00 Publisher: William & Wilkins

In this third edition, Dr. Leach continues to improve upon the first two editions. If you have not been one of those fortunate enough to have read either the previous editions, you have deprived yourself long enough. Dr. Leach has summarized in this one book what chiropractic truly is all about.

In his preface, Dr. Leach states, "This book is about a hope, a fear, and a future." If the knowledge accumulated in this third edition would be assimilated by the majority of our profession, it would be a bright future indeed. This work takes chiropractic theory out of the realm of dogma and brings it into the light of a scientifically grounded health care profession. In reading the various chapters, all extremely well referenced, you begin to appreciate how much work has already been completed to demonstrate the efficacy of what chiropractors do for the benefit of patients. The many theories are discussed with both pros and cons presented without bias or emotional overlay.

The third edition has several new chapters which reflect the changes in research terminology: Segmental Dysfunction Hypothesis; Soft Outcome Measures of Dysfunction; Hard Outcome Measures of Dysfunction; Facilitation Hypothesis and Developing Chiropractic Scientist/Practitioners. The chapters on outcome measures, both hard and soft, is very informative regarding procedures we use, or should use, on a daily basis and their validity. Several of the outcome questionnaires available are also discussed and referenced.

There is also good clinical correlation regarding the theories and the type of clinical problems seen in a chiropractic office. Dr. Leach has provided a number of algorithms for both evaluation and treatment. These provide a ready visual reference for the practicing chiropractic to use in the office.

This is a textbook that everyone interested in the advancement of the chiropractic profession should read and reread. The material Dr. Leach presents should be required reading in all of our chiropractic colleges. As Dr. Leach notes in the book, this shouldn't be viewed as an end but as a beginning. His work, it is hoped, will inspire increased development of "practitioner/scientists" in chiropractic. Without reservation, I rate this book a 10.

Savoie Rating: 10