Orthopaedic Clinical Examination: An Evidence - Based Approach for Physical Therapists, 1st ed.
|Article Type:||Book review|
|Subject:||Books (Book reviews)|
|Publication:||Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2005 New Zealand Society of Physiotherapists ISSN: 0303-7193|
|Issue:||Date: Nov, 2005 Source Volume: 33 Source Issue: 3|
|Topic:||NamedWork: Orthopaedic Clinical Examination: An Evidence - Based Approach for Physical Therapists, 1st ed. (Book)|
|Persons:||Reviewee: Cleland, Josh|
Orthopaedic clinical examination: an evidence-based approach for
physical therapists. First edition. Josh Cleland (2005) Icon Learning
Systems, Carlstadt, New Jersey. ISBN 1-929007-87-6. Soft cover, 515
pages. RRP NZ$123.75.
The foreword by Assoc Professor Lt. Col Robert S. Wainner contains the essential message and purpose of the book "... the purpose of this book is to give clinicians a rich depository of information on operational definitions and associated diagnostic properties for the most important tests and measures in a framework that can be used to drive clinical decision-making in orthopaedic clinical practice." In the opinion of this reviewer, the book meets its objectives handsomely. It is well written, comprehensive, and richly illustrated with photographs and high quality drawings from Frank H Netter MD, all in full colour.
The book begins with an introduction to key concepts in diagnostics such as reliability (inter- and intra-examiner) with the associated kappa and ICC statistics, and diagnostic accuracy values (sensitivity, specificity, likelihood ratios, clinical prediction rules, pre- and post-test probability). Chapter 2 surveys and presents up-to-date methods of searching, evaluating and analysing the literature for evidence on diagnostic tests. Chapters 3 through 12 focus on the clinical tests in common use for the temporomandibular joint, cervical spine, thoracolumbar spine, sacroiliac joint region, hip and pelvis, knee, foot and ankle, shoulder, elbow and forearm, the wrist and hand, in sequence. Each chapter deals with a region or structure and follows a consistent format with sections on osteology, arthrology, ligaments, muscles, nerves, examination: history, reliability of the clinical examination, diagnostic utility of the clinical examination and a comprehensive list of references. One minor irritation is that the author describes the provocation tests as tests for dysfunction. Provocation tests only assess pain, not dysfunction.
This book is a careful compilation of evidence regarding clinical musculoskeletal tests available at the time of writing, although there are certain data items that have not been included such as the diagnostic accuracy characteristics of the extension-rotation test for lumbar facet joint pain. It will date and I expect a second edition as soon as the current printing is sold. My one serious criticism of the material is the author studiously avoids any judgement on the clinical value of tests, apparently preferring to provide the reader with the means and task of such judgements. This is a legitimate approach of course, and may increase its appeal, since it does not challenge practitioners advocating and using tests with poor reliability and/or diagnostic utility characteristics. This reviewer however, is left with the question: "... and so..?"
In summary, this book sets the standard for new reference texts aiming to embrace an evidence-based approach to diagnostics. It should become a standard text for undergraduate and postgraduate courses in physiotherapy and musculoskeletal medicine. A must buy for clinicians and teachers of manual therapies and musculoskeletal medicine.
Mark Laslett, NZRP, PhD, Dip.MT, Dip.MDT
|Gale Copyright:||Copyright 2005 Gale, Cengage Learning. All rights reserved.|