Fundamental orthopaedic management for the physical therapy assistant.
Author: Harman, Bronwyn
Pub Date: 11/01/2011
Publication: Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 New Zealand Society of Physiotherapists ISSN: 0303-7193
Issue: Date: Nov, 2011 Source Volume: 39 Source Issue: 3
Accession Number: 288538006
Full Text: Fundamental Orthopaedic Management for the Physical Therapy Assistant Garry Shankman, Robert Manske 2011 Elsevier, St Louis, Third Edition. Soft Cover. ISBN 978-0-323-05669-4

This text serves as a timely reminder to refresh in our minds the definition of a physical therapist assistant, which according to the American Physical Therapy Association is a " technically educated health care provider who assists the physical therapist (as cited in Shankman & Manske, 2011, p. 13). There is a subtle difference in this definition compared to that provided by the Physiotherapy New Zealand, which states that a physiotherapy assistant is "a person employed to assist a physiotherapist to provide physiotherapy services in a safe effective and efficient manner" (Physiotherapy New Zealand, 2005, p. 4). The difference is that this latter definition does not include the expectation that the physiotherapy assistant is technically educated. The reason for this is that there is no formal training provided for a physiotherapy assistant in New Zealand.

The text is divided into six parts, the first of which covers basic concepts of orthopaedic management and is followed by a review of tissue healing and then a section on common medications used in orthopaedics. The second half covers biomechanics, joint mobilisation and the management of conditions by region, followed by a section covering rheumatological conditions, pain, orthotics and prosthetics. Each section incorporates a reasonable amount of detail and in parts, uses terminology that is perhaps more suited to the level of understanding expected of an undergraduate student with phrases such as, "prostaglandins and thromboxanes are lipid derived powerful and important mediators of inflammatory reactions," (Shankman & Manske, 2011, p. 115).

The content on joint mobilisation explains how to mobilise a joint and includes a description of the grades of joint mobilisation. It also indicates that a high velocity thrust is not a technique used by the physical therapy assistant. The sections that cover different regions explain in detail specific mobilisation procedures or tests for those areas. For example in the section on management of the ankle and foot, there are instructions on how to mobilise the talus anteriorly. These are complete with photos demonstrating the technique and in the knee region there are instructions on how to perform the anterior drawer to assess the integrity of the anterior cruciate ligament. The task of assessing ligamentous stability seems incongruous with the New Zealand Physiotherapy Assistant Guidelines which state that tasks that are excluded from physiotherapy assistant duties are, " assessing clients, interpreting findings" or "making a diagnosis" (Physiotherapy New Zealand, 2005, p. 7).

The suitability of this text therefore appears to be geographically dependent according to the level of training provided to the physical therapy assistant. For this reason it is perhaps a more appropriate text for the physical therapy assistant in the United States or Canada as the level of training they undergo is almost to degree level in some regions.


Physiotherapy New Zealand (2005): The physiotherapy assistant. Retrieved 15th August, 2011, from

Shankman G, Manske R (Eds.) (2011): Fundamental orthopaedic management for the physical therapy assistant (Third ed.). St. Louis: Elsevier.

Bronwyn Harman, MPNZ, PG Dip Health Science, Adv Dip Phys, Lecturer, Department of Physiotherapy, Auckland University of Technology
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