Preface

Movement is an integral part of human experience. Functional movement is necessary for participation in all aspects of life, including activities of daily living, work, occupation, avocation, and sport. This philosophy is evident in the new Vision Statement that was adopted by the American Physical Therapy Association House of Delegates in June 2013:

In the 7 years since the last edition of the textbook, the focus of rehabilitation has become increasingly related to human movement. The editors and authors who have contributed to this textbook have been on this path for years. Together, we offer decades of highly variant experience in order to produce a textbook that offers a movement-based, functional perspective to the treatment of musculoskeletal dysfunction and injury. The art and science of caring for a patient or client is rooted in evidence-based practice, but requires knowledge of foundational sciences, application of theory, as well as skill, creativity, and innovation; however, above all we believe, it relates to movement. Several areas within the current 31-chapter edition have been expanded to best reflect the contemporary practice of physical therapy including clinical decision-making, algorithmic thinking, the neuromuscular scanning examination, functional movement screening, and the essentials of functional exercise.

The purpose of this text is to provide a comprehensive guide to assist practitioners in the design, implementation, and progression of rehabilitation programs for patients with musculoskeletal dysfunction. This includes dysfunction that occurs due to imbalance, overuse, injury, as well as postoperatively. It is intended for use in musculoskeletal intervention courses that teach students the application of theory, decision-making in therapeutic interventions, and rehabilitation progressions. However, it is equally well-suited for the practicing physical therapist looking for novel ideas for therapeutic interventions. The contributing authors have attempted to use our collective expertise, creativity, and knowledge to produce a textbook that encompasses many aspects of musculoskeletal rehabilitation and positively affects approaches to intervention, with a focus on function!

Organization

The text is divided into the same five parts as the previous edition. In Part 1: The Foundations of the Rehabilitation Process a revised chapter has been provided (Chapter 1) that summarizes The Guide to Physical Therapist Practice, as well as the important skill of clinical decision-making, highlighted by the use of algorithmic thinking. The other two chapters on tissue healing (Chapter 2) and the Neuromuscular Scan Examination (Chapter 3) complete the foundational concepts portion of the text that provides the basis for each of the upcoming sections. Very little time is spent on the process of examination in musculoskeletal practice, as the focus of this text is intervention.

Part 2: Treating Physiologic Impairments During Rehabilitation provides in-depth information about the general impairments that may need to be addressed throughout all phases of rehabilitation. These chapters include information about the management of pain (Chapter 4); an updated chapter on posture and function (Chapter 5); muscle performance (Chapter 6); endurance and aerobic capacity (Chapter 7); mobility and range of motion (Chapter 8); and neuromuscular function (Chapter 9). Each of these introductory chapters highlights both methods for managing impairments described in the subsequent chapters, as well as new “clinical pearl” boxes to highlight the authors experience with regard to interventions.

Part 3: The Tools of Rehabilitation provides the reader with an overview of rehabilitation “tools” that can be used during the rehabilitation of many types of patients or clients. It provides the reader with detailed information on how each tool can be applied throughout the rehabilitation process in order to achieve high-level outcomes that are functionally relevant. The tools of rehabilitation covered in this part include: plyometric exercise (Chapter 10); open- and closed-kinetic chain interventions (Chapter 11); proprioceptive neuromuscular facilitation techniques (Chapter 12); joint mobilization (Chapter 13); postural stability and balance interventions (Chapter 14); core stabilization training (Chapter 15); aquatic therapy (Chapter 16); functional movement screening (Chapter 17); functional exercise and progressions (Chapter 18); and the essentials of functional exercise interventions, including a novel exercise prescription and progression matrix (Chapter 19). Of note are the updated chapters on functional movement screening and functional intervention, reflecting paradigm shifts in practice.

The fourth part of the text uses a regional approach to address specific application of intervention throughout the body. Part 4: Interventions for Specific Injuries builds upon the varied information presented in Part 3, by offering applications of techniques and interventions related to common overuse, traumatic, and postoperative musculoskeletal dysfunction. Included are detailed rehabilitation suggestions for conditions common to the shoulder complex (Chapter 20); the elbow (Chapter 21); the wrist, hand, and digits (Chapter 22); the groin, hip, and thigh (Chapter 23); the knee (Chapter 24), the lower leg (Chapter 25); the ankle and foot (Chapter 26); the cervical and thoracic spines (Chapter 27); and the lumbar spine (Chapter 28). Of note is the addition of the comprehensive chapter on the cervical and thoracic region. Each of these regionally based chapters provides in-depth discussion of pathomechanics and injury mechanisms while focusing on rehabilitation strategies and concerns for specific injuries and providing example protocols. As the title indicates, this is a textbook dedicated to intervention. Thus, it should be noted that detailed examination strategies and special test procedures are not a part of these regional chapters; therefore, it is likely that this text will accompany a text on examination, differential diagnosis, evaluation, and prognosis.

The fifth part of the text, Part 5: Special Considerations for Specific Populations, provides application of all the previous intervention strategies and how these may need to be selected, adapted, and utilized in three unique groups of patients: the geriatric patient (Chapter 29), the pediatric patient (Chapter 30), and the physically active female (Chapter 31). The editors and authors believe that these groups of patients deserve special consideration and attention during the rehabilitation process.

Updated, Evidence-based Intervention Strategies

Musculoskeletal Interventions: Techniques for Therapeutic Exercise, 3rd ed, offers a state-of-the art comprehensive collection of rehabilitation techniques and strategies for the physical therapist who intervenes with patients of all ages, abilities, and functional levels. The contributing authors have made every attempt to provide the reader with updated, evidence-based strategies for patient management, while reflecting our unique experience and creativity. The editors have assembled a group of experienced and well-respected clinicians, researchers, and academics/educators in order to cover all aspects of musculoskeletal rehabilitation. All updates were submitted to critical editorial review to ensure accuracy and relevancy.

Learning Aids

The learning aids provided in this text include:

• Objectives—provided at the beginning of each chapter presented to identify critical concepts presented within each chapter.

• Tables—for presentation of concepts and organization of complex information.

• Figures—updated full-color illustrations and figures are a feature of the third edition!

• “Clinical Pearls,” new to this edition to assist the reader in application of concepts and offer insights or connections between information, as provided by the authors of chapters.

• Summary points provided at the end of each chapter outlining major points within, for the reader to determine their level of comprehension.

• End of Chapter Treatment Guidelines—present in the regionally organized chapters to illustrate a possible sequence of interventions or a postoperative protocol.

• References—a comprehensive, updated list of references is provided with each chapter.

Instructor Resources

• Power Points—Tables and photographs in the text will be available as PowerPoints to professors who adopt the text

• Videos—Videos of critical skills in the text will be available to professors who adopt the text and a larger selection of the video library will be available to AccessPhysiotherapy subscribers

• Enhanced Ebook—This third edition will also be offered as an enhanced ebook, which will incorporate videos and include interactive quizzes.