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Doody's Review ServiceReviewer: Daryl Lawson, PT, DSc (Elon University)
Description: This book uses case-based presentations of musculoskeletal disorders to help physicians understand and write effective physical therapy prescriptions, what takes place during physical therapy, and how physical therapists fulfill prescriptions. Each case is followed from the physician's examination to the physical therapy evaluation and treatment.
Purpose: The purpose is to help musculoskeletal physicians understand the physical therapy process once a prescription is written. The training of medical students, nurse practitioners, physician assistants, osteopaths, physiatrists, and residents offers little time for understanding the role of physical therapy. A book explaining this role for those in disciplines unfamiliar with physical therapy is needed.
Audience: The target audience is physiatrists, orthopedists, rheumatologists, neurologists, family practitioners, physician assistants, physical therapists, occupational therapists, residents, and students. It would be helpful to medically trained clinicians who refer patients for physical therapy.
Features: The book uses a consistent format for the 34 case presentations, beginning with a physician's examination and concluding with the physician's impression of the case and plan, one aspect of which is a referral to physical therapy. The next section in each case is a physical therapy examination, subjective and objective, including ROM, joint play, special tests, MMT, neurodynamic testing, tight tender points/soft tissue restrictions, posture and ergonomics. This is followed by the assessment and the plan, including manual therapy, modalities, and a home exercise program. Each case ends with a orthopedic rehabilitation prescription that is filled out to reflect the plan of care. The book has good photos of therapeutic exercise for each case that demonstrate the prescribed exercise and give the referring practitioner an idea of what their patients may be doing in physical therapy. It also provides a basic outline of a physical therapy examination and prescription based on the findings of the evaluation. It would have been helpful to introduce the target audience to the grading scale of MMT, ROM, neurodynamic testing, joint play, and ergonomics, since all of these concepts may be outside their training. The cases offer no evidence-based treatment based on the evaluation. Some of the findings on the evaluation are inconsistent with the exercises presented (e.g. Achilles tendon stretch picture when ankle ROM is the norm). The physical therapy examinations lack any outcome surveys or functional tests which would be important information for referring practitioners. Finally, the physical therapy assessment uses ICD-9 diagnostic language instead of incorporating the International Classification of Functioning, Disability, and Health (ICF) which is the preferred diagnostic code for physical therapy.
Assessment: This book may be useful to current or future referring practitioners. It gives some insight into a physical therapy evaluation, treatment, and prescription. It would not be appropriate for physical therapy students, physical therapist assistants, or physical therapists. A more comprehensive book on physical therapy evaluations and treatment that are evidence-based would be more appropriate for them.