Rehabilitation of Movement Theoretical basis of clinical practice
1
Physiotherapy August 1999/vol 85/no 8 517 Book reviews 517 W B Saunders, (Philadelphia) 1997 (ISBN 0 7020 2157 1) 598 pages by Judith Pitt-Brooke MSc MCSP Cert Ed, with Heather Reid MMed Sci MCSP Cert Ed, Jane Lockwood MSc MCSP and Kate Kerr Phd BA MCSP £26.95 Physiotherapy like many other professions has its sects, gurus and apostles. This is particularly true of musculoskeletal physiotherapy. Different approaches come into and go out of fashion and it is all too easy to lose sight of the big picture This book will come as a godsend to those physiotherapists who want to take stock of their approach to clinical practice and who strive to deliver evidence-based care. There are 15 chapters, which are divided into three sections. Eleven contributors including the editors wrote the text and there are numerous cross-references, which help to unify the diverse subject matter. The editors have done a good job in harmonising the work of their contributors, which is presented in a clear and concise style. Each chapter adopts the format of a content list, a list of chapter objectives, the factual matter of the chapter and finally a summary section. The factual sections all contain clinical examples, practical tips and practical tasks, which work well to place the theory into a practical and clinical context. The first section deals with the factors that influence movement. These include the musculoskeletal requirements for movement and the physiology of motor control. The two chapters which stand out in this section are the ones by Louis Gifford. The chapter on neurodynamics is clear and succinct in its description of how movement affects the nervous system. The key message of this chapter is that the mechanistic approach which physiotherapists have adopted towards pathoneural dynamics should give way to a more ‘biological’ based system of clinical reasoning. This ties in with Louis Gifford’s chapter on pain, which in addition to reviewing the physiological mechanisms of pain, argues the need for physiotherapists to appreciate fully the importance of mental and emotional issues. Gifford states the need for physiotherapists to ‘recognise that the atmosphere they create during therapy is biological and is the key to successful outcome’. This chapter raises some fundamental questions regarding the way that physiotherapists deal with pain conditions. In the final section of the book on ‘Contemporary therapeutic approaches to clinical practice’ the chapter dealing with ‘Application of the cognitive behavioural approach’ reinforces this message. In addition the section covers among other things exercise, neuromuscular techniques, and ergonomics. The chapter which stands out in this section is the one by Kevin Banks who reviews the use of passive techniques. For the uninitiated, this chapter succeeds where even sections of G D Maitland’s seminal works fail, that is, it provides a clear and unambiguous description of what therapeutic passive movement is all about and how it should be delivered. The book’s middle section is devoted to ‘Examination; assessment and measurement techniques’. It adequately addresses the subjects of clinical reasoning, clinical measurement and gait analysis. For undergraduate physiotherapists who need to assimilate and integrate a broad spectrum of clinical knowledge, this book should be at the top of their ‘must read’ list. For those qualified physiotherapists who strive to adhere to evidence-based practice and who acknowledge the need for an expansive and comprehensive approach to musculoskeletal problems, then this book should be at the top of their ‘should read’ list. Philip Newton MCSP Rehabilitation of Movement Theoretical basis of clinical practice Below: The subdivisions of the gait cycle as shown in ‘Rehabilitation of Movement’ Stance right Swing left Stance left Swing right Initial double limb stance Single limb stance Terminal double limb stance Swing Double limb stance
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Transcript of Rehabilitation of Movement Theoretical basis of clinical practice
Physiotherapy August 1999/vol 85/no 8
517
Book reviews
517
W B Saunders, (Philadelphia)1997 (ISBN 0 7020 2157 1) 598 pages
by Judith Pitt-Brooke MSc MCSP Cert Ed, with Heather Reid MMed Sci MCSP Cert Ed, Jane Lockwood MSc MCSPand Kate Kerr Phd BA MCSP £26.95Physiotherapy like many other professions has its sects, gurus and apostles. This is particularly true of musculoskeletalphysiotherapy. Different approaches come into and go out offashion and it is all too easy to lose sight of the big picture Thisbook will come as a godsend to those physiotherapists who wantto take stock of their approach to clinical practice and who striveto deliver evidence-based care.
There are 15 chapters, which are divided into three sections.Eleven contributors including the editors wrote the text andthere are numerous cross-references, which help to unify thediverse subject matter. The editors have done a good job inharmonising the work of their contributors, which is presentedin a clear and concise style. Each chapter adopts the format of acontent list, a list of chapter objectives, the factual matter of thechapter and finally a summary section. The factual sections allcontain clinical examples, practical tips and practical tasks, whichwork well to place the theory into a practical and clinical context.
The first section deals with the factors that influencemovement. These include the musculoskeletal requirements for movement and the physiology of motor control. The twochapters which stand out in this section are the ones by LouisGifford. The chapter on neurodynamics is clear and succinct inits description of how movement affects the nervous system. Thekey message of this chapter is that the mechanistic approach
which physiotherapists have adopted towards pathoneuraldynamics should give way to a more ‘biological’ based system ofclinical reasoning.
This ties in with Louis Gifford’s chapter on pain, which inaddition to reviewing the physiological mechanisms of pain,argues the need for physiotherapists to appreciate fully theimportance of mental and emotional issues. Gifford states theneed for physiotherapists to ‘recognise that the atmosphere theycreate during therapy is biological and is the key to successfuloutcome’. This chapter raises some fundamental questionsregarding the way that physiotherapists deal with painconditions.
In the final section of the book on ‘Contemporary therapeuticapproaches to clinical practice’ the chapter dealing with‘Application of the cognitive behavioural approach’ reinforcesthis message. In addition the section covers among other thingsexercise, neuromuscular techniques, and ergonomics. Thechapter which stands out in this section is the one by Kevin Bankswho reviews the use of passive techniques. For the uninitiated,this chapter succeeds where even sections of G D Maitland’sseminal works fail, that is, it provides a clear and unambiguousdescription of what therapeutic passive movement is all aboutand how it should be delivered.
The book’s middle section is devoted to ‘Examination;assessment and measurement techniques’. It adequatelyaddresses the subjects of clinical reasoning, clinicalmeasurement and gait analysis.
For undergraduate physiotherapists who need to assimilateand integrate a broad spectrum of clinical knowledge, this bookshould be at the top of their ‘must read’ list. For those qualifiedphysiotherapists who strive to adhere to evidence-based practiceand who acknowledge the need for an expansive andcomprehensive approach to musculoskeletal problems, then this book should be at the top of their ‘should read’ list.
Philip Newton MCSP
Rehabilitation of MovementTheoretical basis of clinical practice
Below: The subdivisions of the gait cycle as shown in‘Rehabilitation of Movement’
Stance rightSwing left
Stance leftSwing right
Initial doublelimb stance
Singlelimb stance
Terminal doublelimb stance
Swing Doublelimb stance
