Book Review: Prohealth Systems Orthopaedic Texts

A couple months ago, we were sent some samples of orthopaedic texts to review. Having come from a program where no real orthopaedic text books were issued, we were very interested in the opportunity to see what Prohealth had to offer. Given our backgrounds now as residency-trained therapists, we also can add some additional perspective on what is essential for orthopaedic texts. The books included in our review are: Muscle Manual, Spinal Manual, Extremity Manual, Orthopaedic Conditions, Physical Medicine, and Physical Assessment.

The Muscle Manual is an equivalent of what the famous Florence Kendall presented in her texts. However, the Muscle Manual offers much more than Kendall in other areas. Not only does this book include origin, insertion, action, innervation, blood supply, muscle strength test, or muscle length test, the book also offers anatomic variations, common injuries, palpation technique, trigger point referral, methods to strengthen and stretch the muscle. These additions have pretty significant clinical implications. Now with all that being said, in our opinion the book is lacking in detail of the muscle attachment sites. The importance of this is debatable as with all the anatomical variations, the need for exact specifications for each muscle (i.e. "the anterolateral surface of the proximal portion...") may be less significant.

The next couple books go hand in hand: Spinal Manual and Extremity Manual. These probably compare with most of the orthopaedic text books on the market that schools are aware of. Each book is divided into joint-based sections (i.e. cervical spine, shoulder, etc). At the beginning of each sections, there is a review of anatomy, kinesiology, ROM, MMT and exam flow for the joint. The section then leads into a breakdown of each common pathology for the joint. These breakdowns include: basic information, classification, demographics, history, physical exam findings, a multi-disciplinary treatment approach, and prognosis. This can be beneficial considering how often we are asked about different treatment approaches for each pathology (acupuncture, medications, diet and botanicals, etc. As we move towards a more connected health care system, this will be essential in providing our patients the best care. The books also contain an opening that includes a breakdown of how subjective histories should be taken, how to analyze articles, systems review, differential diagnosis, gait cycle, and more. These inclusive text books can be extremely beneficial for those trying to figure out proper exam flow and may be good references for the boards or OCS exam. Unfortunately, these texts are lacking in movement analysis. Like most orthopaedic text books, a pathological approach is taken that primarily involves treating the symptomatic tissues, not the cause of the symptomatic tissue. Leaving out subjects like Sahrmann's movement impairment syndromes or other methods of movement analysis prevents many from treating the original cause of the problem. However, these texts would still stand as excellent references for a condition and possibly various evidence-based treatment approaches.

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Prohealth also offers an Orthopedic Conditions text which is packed with useful information regarding assessment, diagnosis, and management of Orthopedic conditions. Under each diagnosis section, information is included on history, physical exam, differential diagnosis, special tests, diagnostic imaging, and laboratory tests. Having the imaging and laboratory tests included in the diagnosis is extremely helpful. For example, when reading about the scaphoid fracture, Dr. Vizniak includes an X-ray, T1 MRI, and T2 MRI images to show the differences between each image. At the end of the book, he includes a Key Movement Patterns (KMP) section outlining common movement patterns that occur in response to poor posture or pain. It is not as in depth as a Sahrmann type movement impairment syndromes, but it is a great quick guide to assessing for movement dysfunction. We can honestly say that the Orthopedic Conditions book is an excellent evidenced informed guide to helping manage musculoskeletal conditions.   

For more specific treatment techniques, the Physical Medicine text may prove useful. The book includes a joint-by-joint breakdown of various treatments and assessments. Methods of mobilization, manipulation, MET's, STM, strengthening and stretching are included for each joint. Additionally, taping, electrotherapy, acupuncture, and nutrition are covered. This may prove useful as a reference for those looking for a taping technique, a suggestion for herbal supplements, different manual techniques and more. While no substitute can be made for actual practice and learning with the instructor of manual techniques, this book allows one to review the various methods of treatment and assessment with ease. The Physical Assessment book is useful for various examination techniques and special tests. It includes images, descriptions and diagnostic accuracy for the tests.

While these texts may not represent the movement towards a kinesiopathology approach for physical therapy, they definitely play a role as references for the clinic for specific pathologies, assessment, treatment, and anatomy in general. The global approach each text provides in developing the clinical reasoning of the reader can be an incredible component to the growth of a professional. Additionally, each book has links to videos on the website that provides an alternative learning method and supplementary information. Check out on the website for more information for these books.