Physical Rehabilitation

Ch01: Introduction *Introduces the student to physical rehabilitation *Includes an introduction to disablement models (Nagi, ICIDH, ICF) and the Guide to Physical Therapist Practice, 2e * Introduces the student to the text, including the structure, its basis in the APTA Guide to Physical Therapist Practice, 2e, and the additional resources available with the text Ch02: Evidence-based Practice *Presents the history and principles of evidence-based practice *Includes a detailed discussion of techniques for evaluating the quality of research studies including criteria for what makes a study good or bad Ch03: Skeletal Demineralization *Pathology discussion includes: *Bone physiology (Unique) *Risk factors (Unique) *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Testing considerations for patients with skeletal demineralization *An overview of medical tests for bone mineral density *Intervention discussion includes: *Aerobic exercise *Resistance training *Weight-bearing exercise *Body mechanics training *Medications, diet, and rehabilitation interventions for osteoporotic spinal fractures Ch04: Posture *Introduction covers ideal alignment and forces affecting posture *Pathology discussion includes: *Impaired posture *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *General posture *Joint positions and motions, Positions and motions of specific joints (including the spine) *Joint alignment by region *Range of motion *Muscle performance test *Intervention discussion includes: *Stretching and mobilization *Stabilization *Exercise *Coverage of proper alignment and control by region (Unique) Ch05: Muscle Weakness *Chapter begins with discussion of muscle structure, including physiology of muscle contraction and factors that affect muscle performance (Unique) *Pathology discussion includes: *Muscle strain *Disuse atrophy *Muscle diseases *Neurological diseases affecting muscle performance *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Testing of muscle performance and joint integrity *Circulation, ventilation and respiration/gas exchange *Orthotic, protective and support devices *Intervention discussion includes: *Overload and SAID principles *Exercise prescription and progression (Unique) *Neuromuscular electrical stimulation *Resistance training *Muscle strength (isometric, isotonic, isokinetic, or plyometric) training (Unique) Ch06: Connective Tissue Dysfunction *Chapter focuses on systemic inflammatory diseases that cause joint inflammation *Pathology discussion includes: *Systemic lupus erythematosus *Rheumatoid arthritis *Spondyloarthropathies *Polymyalgia rheumatica *Polymyositis and dermatomyositis *Sjogren's syndrome *Crystal-induced arthropathies *Juvenile rheumatoid arthritis *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Focuses on musculoskeletal and neuromuscular examination *Functional examination includes discussion of self-care and home *management as well as community and leisure integration *Intervention discussion includes: *Concerns specific to all disease processes discussed Ch07: Localized inflammation *Discussion focuses on osteoarthritis, bursitis, tendonitis, and tenosynovitis *Pathology discussion includes: *Stages of tissue healing (Unique) *Components of the functional joint complex (Unique) *Specific inflammatory conditions: osteoarthritis, bursitis, capsulitis, ligament sprain, muscle strain, tendinitis, tenosynovitis, plantar faciitis, tensor fascia lata fasciitis, and pre- and post-natal soft tissue inflammation (Unique) *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Focus on musculoskeletal and functional examinations (gait, locomotion, and balance; assistive and adaptive devices/orthotic, protective, and supportive devices; ergonomics and body mechanics) *Intervention discussion includes: *Iontophoresis *Manual therapy *Therapeutic exercise *Orthotics *Joint protection and tool modification *Conservation of energy Ch08: Spinal Disorders *Discussion of low back pain, spinal degeneration, radiculopathy, intervertebral disc disease, spinal stenosis, spondylolysis, spondylolisthesis, whiplash-associated disorders, and back pain during (and after) pregnancy *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Specific examination techniques (including range of motion tests, muscle performance tests, mechanical provocation tests, peripheral nerve tests, neurodynamic tests) *Intervention discussion includes: *Techniques for specialized topics (spinal stenosis, spondylolisthesis, and whiplash) (Unique) *Special tests includes discussion of vertebral artery test, sacroiliac joint tests, examination of neighboring joints (Unique) *Detailed mobility examination tests *Tests for spinal instability (Unique) *Craniovertebral joint examination tests (Unique) Ch09: Fractures (Unique) *Chapter begins with an introduction to normal bone *Pathology discussion includes: *Fracture etiology, classification, risk factors, and healing *Healing discussion that covers primary and secondary healing, stages and prognosis of healing, and types of fixation *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Examination for peripheral nerve integrity *Examination of function (including gait, locomotion, and balance, and an examination of pre-existing assistive, adaptive, or support devices) *Intervention discussion includes: *Communication, Documentation *Exercise, Conditioning *Functional training *Manual therapy *Physical, mechanical, and electrotherapeutic modalities Ch10: Joint Arthroplasty (Unique) *Chapter covers arthroplasty of the hip, knee, shoulder, elbow, wrist, and fingers *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Range of motion and joint mobility *Muscle performance *Gait, locomotion, and balance *Intervention discussion includes: *Options specific to the type of arthroplasty discussed *Specific intervention topics within individual joints focus on examination, pathology, prognosis, and interventions (including pre- and post-operative care) *Individual interventions such as the use of modalities and reintegration of previous activities Ch11: Soft Tissue Surgery (Unique) *Pathology discussion includes: *Non-mineralized connective tissues of the musculoskeletal system: ligaments and tendons, articular cartilage, joint capsules, superficial fascia, and synovium *Biomechanics *Effects of immobilization and remobilization *Overview of rehabilitation following soft-tissue surgery *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Functional examination covering gait, locomotion, and balance; orthotic, protective, and support devices; ergonomics and body mechanics; environmental barriers; and work, community, and leisure integration *Intervention discussion includes: *General recommendations for the immediate and intermediate postoperative phases as well as in advanced strengthening and return to activity phases *Specific recommendations after surgery of bursa and/or synovium, cartilage, fascia, ligament or capsules, or tendons (all tissue-specific topics cover examination, prognosis, and intervention) Ch12: Amputations and Prostheses *Pathology discussion includes: *Basic surgical procedures *Reasons for amputations (including acquired versus congenital conditions) *Types of amputations (both upper- and lower-extremity) *Illustrations to clearly demonstrate levels of amputation *Examination discussion includes: *All body systems, but is specific to the needs of a patient with an amputation *Focus on the musculoskeletal examination and nerve sensation *Evaluation, Diagnosis, and Prognosis discussion includes: *Medicare/Medicaid functional levels *Functional impact of amputation on the patient *Prognoses in patients with specific medical conditions *Intervention discussion includes: *Pre- and post-operative care (mental, emotional, and physical) *Early postoperative management *Lower extremity prosthetic optionsh26 *Upper extremity prosthetic options (Unique) *Prosthetics for lower extremity (partial foot, Syme's, transtibial, knee, transfemoral, hip, transpelvic, translumbar, and bilateral) and upper extremity (partial hand, transradial, transhumeral) *Sections dedicated to functional training are also included (dressing, transfers, balance, gait, wearing schedule, use training, vocations, care of the residual limb) Ch13: Balance and Fall Risk *Epidemiology and definitions of balance and falls *Pathology discussion includes: *Causes of balance dysfunction (peripheral sensory, central sensory, peripheral motor, central motor, and cognitive impairments) *Impact of poor balance and limited postural control on gait *Neurological disorders that affect balance (including Parkinson's disease, ataxia, and multiple sclerosis) *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Focus on the musculoskeletal, neuromuscular and functional examinations *Six standardized tests of locomotion, balance, and fall risk *Intervention discussion includes: *Flexibility exercises, strength training *Vestibular training, sensory and perceptual training *Postural awareness training *Canalith repositioning treatments or maneuvers *Patient education and injury prevention Ch14: Impaired Neuromuscular Development *Introduction to pediatric disorders (Unique) *Introduction covers development terminology; delay, dissociation, and deviance; core developmental concepts (including forces that can impact development), principles of motor development and acquisition of motor milestones *Examination discussion includes: *All body systems with a focus on how those systems develop *Standardized tests of participation and activity *Eight common measures for developmental testing Ch15: Pediatric Nonprogressive Central Nervous System Disorders *Discussion of pediatric disorders (Unique) *Main chapter focus is cerebral palsy and spinal dysraphism in the pediatric population *Intervention discussion includes: *Activity- and impairment-focused interventions *Prevention of secondary complications *Modification of the home environment *Surgical interventions *Structure of each section reflects structure of individual chapters from the text (follows the progression of pathology, examination, evaluation, diagnosis, prognosis, and intervention) Ch16: Adult Nonprogressive Central Nervous System Disorders *This chapter focuses on stroke and traumatic brain injury *Introduction covers stroke etiology and sequelae *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Focus on the neuromuscular examination including: arousal, attention, and cognition; spasticity and muscle tone; and coordination, and movement patterns *Functional examination: balance, and gait, self-care and home management and a variety of standardized functional measures specific to this population *Intervention discussion includes: *Neurodevelopmental treatment (NDT) *Proprioceptive neuromuscular facilitation (PNF) *Task-oriented approaches *Functional training in self-care and home management Ch17: Progressive Central Nervous System Disorders *This chapter focuses on Alzheimer's disease, amyotrophic lateral sclerosis, Huntington's disease, Parkinson's disease, and multiple sclerosis *Pathology discussion includes: *Stages of progressive central nervous system disorders *A table outlining common impairments and disabilities at different disease stages *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Considerations specific to each condition *Intervention discussion includes: *Strength training and aerobic exercise *Gait and balance training *Sensory cueing *Relaxation *Functional and task-specific training *Assistive devices and equipment *Ventilatory support and airway clearance techniques *Considerations specific to each condition are included within individual intervention topics Ch18: Peripheral Nerve Injuries *Chapter includes an overview of the peripheral nervous system including anatomy, physiology, and pathology of peripheral nerves (Unique) *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Neuromuscular examination focuses on: pain, cranial and peripheral nerve integrity, reflex integrity, and sensory integrity *Three approaches to cranial and peripheral nerve integrity testing: electrophysiological, provocative, and autonomic *Wide range of provocative tests used to detect nerve injury: Tinel's test, Roos test, neural tension tests, elbow flexion test, Phalen's test, carpal compression test, and piriformis tests *A discussion of assessment of muscle function in children with obstetrical brachial plexus palsy (Unique) *Intervention discussion includes: *Patient education *Therapeutic exercise (including nerve gliding exercises) *Joint range of motion and muscle stretching *Sensory retraining *Manual therapy techniques *Splints and orthoses *Electrotherapeutic, physical, and manual modalities *Surgical intervention Ch19: Polyneuropathies *Pathology discussion includes incidence, etiology, pathogenesis, and clinical presentation for: *Guillain-Barre Syndrome *Chronic Inflammatory Demyelinating Polyradiculopathy *Diabetic neuropathy *Charcot-Marie-Tooth disease *Toxic neuropathies *Examination discussion includes: *All body systems, and focuses on nerve integrity, electrodiagnostic evaluation, quantitative sensory testing, and the Semmes-Weinstein monofilament testing *Intervention discussion includes: *Education (patient and family) *Exercise *Electrical stimulation *Orthoses Ch20: Nonprogressive Spinal Cord Disorders *Pathology discussion includes: *Spinal shock *Evolution of spinal cord injury *Autonomic dysreflexia *Pressure ulcers *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Neuromuscular examination includes examination of cognition, pain, reflex integrity, sensory integrity, and motor control *American Spinal Injury Association (ASIA) scale *Concerns of circulation, ventilation, aerobic capacity, and levels of function (Unique) *Intervention discussion includes: *Options specific to the acute and rehabilitation phases *Ten types of mobility skills including five types of transitions *Functional training and leisure activity reintegration *Airway clearance techniques Ch21: Disorders of Consciousness: Coma, Vegetative State, and Minimally Conscious State *Pathology discussion includes: *Etiologies for changes in consciousness including structural lesions, toxic or metabolic abnormalities, or diffuse brain damage (Unique) *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) in a manner that addresses the medical needs of patients with changes in level of consciousness *Intervention discussion includes: *Options presented to address general care concerns for patients with varying levels of awareness as well as optional interventions for special-needs patients (e.g. sensory stimulation or casting) Ch22: Vital Signs *Definitions and measurements of: temperature, pulse, blood pressure, respiratory rate, arterial oxygen saturation, and pain *Discussions also include outside factors that can affect vital sign measurements (e.g. white coat hypertension or low perfusion rates) (Unique) *The discussion of blood pressure includes both hypo- and hypertension (Unique) *Specific information on autonomic dysreflexia Ch23: Deconditioning *Pathology discussion includes: *Introduction to the processes that result in deconditioning *Etiologies *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Body composition and BMI *Aerobic capacity and endurance *Sub-maximal aerobic testing to estimation of VO2max *Aerobic capacity *Self-care and home management *Intervention discussion includes: *Communication, education, and motivation *Aerobic exercise guided by heart rate, metabolic demand, and perceived exertion *Weight and circuit weight training Ch24: Airway Clearance Dysfunction *Examination discussion includes: *Chest examination; inspection; auscultation, palpation, and percussion *Intervention discussion includes: *Breathing strategies for airway clearance *Manual and mechanical techniques *Mechanical devices for airway clearance Ch25: Congestive Heart Failure *Pathology discussion includes: *Classification of types of heart failure *Characteristics of heart failure contributing to exercise intolerance *Examination discussion includes: *All body systems with a focus on the cardiovascular and pulmonary components *Circulation, and aerobic capacity and endurance *Staging of heart failure *Functional examination: quality-of-life measures *Interventiondiscussion includes: *Aerobic, resistive, or interval training *Safety concerns for patients with heart failure *Special considerations for patients with heart transplants or mechanical assist devices Ch26: Respiratory Failure *Pathology discussion includes: *Anatomy of the respiratory system *Physiology of ventilation and gas exchange *Pathophysiology of the respiratory system *Examination discussion includes: *Oxygen requirements and ventilation *Arterial blood gases *Chest and abdominal muscle function *Intervention discussion includes: *Oxygen prescription, mechanical ventilation, breathing techniques, inspiratory muscle training, and behavioral interventions Ch27: Lymphatic System Disorders *Thorough introduction to the anatomy and physiology of the lymphatic system *Pathology discussion includes: *Definitions of primary- and secondary- lymphedema *Stages of lymphedema *Examination discussion includes: *Measurement of edema *Evaluation of circulation *Intervention discussion includes: *Manual therapy (complete decongestive physical therapy and manual lymphatic drainage) *Compression therapy (pneumatic, bandaging, garments) *Exercise Ch28: Tissue Healing and Pressure Ulcers *Chapter includes epidemiology of pressure ulcers *The chapter describes the process of wound healing and serves as an introduction to chapters 29, 30, and 31 *Pathology discussion includes: *Wound healing *Chronic wounds *Etiology of pressure ulcers (including an extended discussion of risk factors) *Examinationdiscussion includes: *Wound and periwound tissue description *Wound measurements *Techniques for taking wound cultures *Pressure ulcer staging *Intervention discussion includes: *Wound prevention: support surfaces, positioning, moisture management, and nutrition *Wound dressing *Adjunctive therapies: pulsed lavage with suction, vacuum-assisted closure, and electrical stimulation Ch29: Vascular Ulcers *Pathology discussion includes: *Vascular anatomy *Etiology of arterial ulcers, venous ulcers, and mixed arterial and venous ulcers *Examination discussion includes: *Circulation (pulses, ankle-brachial index, transcutaneous partial pressure of oxygen measurement, capillary refill time *Typical characteristics of venous and arterial ulcers *Intervention discussion includes: *For arterial ulcers: dressings, pain management, exercise and activity, electrotherapy, growth factors, intermittent pneumatic (dynamic) compression, hyperbaric oxygen therapy, nutrition, surgery, education *For venous ulcers: focus on compression therapy Ch30: Neuropathic Ulcers *This chapter focuses on treatment of ulcers associated with diabetes *Pathology discussion includes: *Sensory, motor, and autonomic neuropathies *Pathology of diabetes mellitus *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Sensation testing *Evaluation of circulation (capillary refill test, venous filling time, rubor of dependency test, great toe pressure, transcutaneous oxygen tension, systemic blood pressure) *Integumentary integrity *Intervention discussion includes: *Patient education *Blood glucose control *Exercise *Orthoses and footwear *Foot care *Treatment of the neuropathic wound focuses on off-loading with total-contact casting or cast alternatives *Management of the post-amputation wound and post-healing foot Ch31: Burns *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Integumentary examination focuses on burn depth, burn size, and scar *Intervention discussion includes: *Wound care *Edema control *Pain control *Strengthening, range of motion, and aerobic exercises *Scar management *Rehabilitation for associated injuries Ch32: Gait Assessment and Training *This chapter provides clear and extensive discussion of functional walking and the gait cycle (Unique) *Pathology discussion focuses on: *Each phase of the cycle; their subdivisions and functional events; temporal and distance parameters; and limb and trunk kinematics *Examination discussion includes: *All body systems in relation to gait *Gait-specific tests and measures in a framework of observational gait analysis (OGA) and stride analysis *Observational gait analysis: procedure, reliability and validity, videotaping, standardized tests and measures that rely on OGA, and standardized tests and measures that do not rely on OGA *Stride analysis: gait velocity, and footfall measurement technologies discussion includes hand-held stopwatch, six-minute walk test, inked footprint methods, instrumented walkways, stride analyzers and in-shoe microprocessor systems *Intervention discussion includes: *Task-specific training for gait *Body weight support treadmill training *Non-task-specific training for gait (strength training, neurodevelopmental treatment approaches, motor relearning program approach, balance training, and aerobic conditioning) Ch33: Assistive Devices for Mobility: Canes, Crutches, Walkers, and Wheelchairs *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *Musculoskeletal and neuromuscular examination, including discussions of range of motion, muscle performance, pain, nerve integrity, and sensory integrity *Intervention discussion includes: *Selection of assistive devices for ambulation (canes, crutches, and walkers) *Fitting of assistive devices for ambulation includes canes, crutches, walkers, and complications of assistive device use *Wheelchair selection *Wheelchair features: mode of propulsion (dependent, independent, combination), frame, seat, backrest, armrests, front rigging, wheels, and support accessories *Wheelchair fitting: seat, backrest, armrests, and complications of wheelchair use Ch34: Orthotics *Design factors (function, comfort, pressure systems) and materials *Lower-extremity orthoses: *Shoe and foot *Ankle-foot *Knee-ankle-foot *Hip-knee-ankle-foot *Trunk-hip-knee-ankle-foot *Spinal orthoses: *Trunk (corsets, and rigid lumbosacral and thoracolumbosacral) *Cervical *Orthoses for patients with scoliosis *Upper-extremity orthoses: *Wrist-hand *Thumb and finger *Forearm and elbow *Shoulder Ch35: Environmental Assessment: Home, Community, and Work *Examination discussion includes: *All body systems (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary) *A focus on environmental barriers outside the home, inside the home, in specific rooms, and special work considerations *A section on Americans with Disabilities legislation *Intervention discussion focuses on: *Optimization and modification of environmental barriers *Environmental barriers: *Exterior (access routes, stairs, ramps, handrails, elevators, escalators) *Interior barriers (access routes, doorways, turning, lighting, seating, countertops, reach zones, sinks) *Specific rooms (kitchen, bathroom, toilet, bath/shower, bedroom, laundry room) *Communication (telephone, writing, computer use) *Unique workplace considerations