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Orthopaedics for the physical therapist assistant Mark Dutton,…
Orthopaedics for the physical therapist assistant Mark Dutton
Orthopaedics for the physical therapist assistant Mark Dutton
SECTION I Fundamentals
Chapter 1 The Physical Therapist Assistant’s Role in Orthopaedics
Overview
Direct Access
Evidence-Based Practice
The Role of the Physical Therapist Assistant
Appearance
The Rehabilitation Team
Models of Disablement
Personality
Values and Beliefs
Cultural Influences
Motivation and Compliance
Motivation
Compliance
Patient Education
Privacy and Patient Confidentiality
Reimbursement
Productivity
Summary
Chapter 2 Anatomy and Biomechanics of the Musculoskeletal System
Overview
Musculoskeletal Tissue
Connective Tissue
Fascia
Tendons
Ligaments
Bone
Articular Cartilage
Fibrocartilage
Bursae
Skeletal Muscle Tissue
Machinery of Movement
Muscle Fiber Types
Muscle Function
Vascular Tissue
Kinesiology
Anatomic Position
Directional Terms
Planes of the Body
Axes of the Body
Force
Load Deformation Curve
Levers
Mechanical Advantage
Equilibrium
Newton’s Laws of Motion
Active Length–Tension Relationship
Passive Length–Tension Relationship
Force–Velocity Relationship
Joint Kinematics
Close-Packed and Open-Packed Positions of the Joint
Range of Motion, Flexibility, and Joint Mobility
Summary
Chapter 3 The Nervous System
Overview
Central Nervous System
Peripheral Nervous System
The Cranial Nerves
The Spinal Nerves
The Brachial Plexus
Autonomic Nerves
Transmission of Pain
Implications for the PTA
Implications for the PTA
Implications for the PTA
Implications for the PTA
Recognizing a Medical Emergency
Medical Emergency Diagnoses
Laboratory Values
Musculoskeletal Pharmacology
Antibacterial Drugs
Opioid Analgesics
Nonopioid Analgesics
Corticosteroids
Muscle Relaxants
Chapter 4 Tissue Injury and Repair
Overview
Tissue Healing
Inflammatory (Acute) Stage
Proliferative (Subacute) Stage
Remodeling Stage
Tissue Specific Responses to Injury
Ligament Injury
Muscle, Tendon, and Ligament Healing—Implications for the PTA
Inflammatory (Acute) Stage
Proliferative (Subacute) Stage
Remodeling Stage
Fibrocartilage Healing
Bone
Fractures
Bone Healing
Implications for the PTA
Detrimental Effects of Immobilization
Surgical Interventions
Surgical Repair of Tendons
Surgical Repair of Ligaments
Surgical Repair of Cartilage, Bones, and Joints
Summary
Chapter 5 General Conditions
Overview
Soft Tissue Mobilization Techniques
Transverse Friction Massage
Augmented Soft Tissue Mobilization
Myofascial Release
Muscle Energy
Proprioceptive Neuromuscular Facilitation
Muscle Energy
Myofascial Trigger Point Therapy
Stretch and Spray or Stretch and Ice
Neurodynamic Mobilizations
Summary
Chapter 6 Assessment of the Musculoskeletal System
Overview
The Elements of Patient Management
Examination
Patient History
Systems Review
General Medical Assessment
Tests and Measures
Evaluation
Intervention
Outcomes
Plan of Care
Patient Coordination and Communication
Documentation
Abbreviations
Ongoing Assessment, Progression, and Compliance
Imaging Studies
Conventional (Plain Film) Radiography
Stress Radiograph
Arthrography
Myelography
Diskography
Angiography
Clinical Implications of the Neuromuscular System
Lesions of the Nervous System
Neurovascular Healing
Nerve Injury Classification
Medical Interventions for Nerve Injury
Neuromuscular Testing in Orthopaedics
Reflexes
Sensory Testing
Neuromeningeal Mobility Testing
Balance Testing
Coordination Testing
Upper and Lower Quarter Scanning Examination
Summary
Chapter 8 Decision-Making for the Physical Therapist Assistant
Overview
Clinical Decision-Making
Correct Therapeutic Exercise Progression
Exercise Precautions
Summary
Chapter 9 Manual Modalities
Overview
Correct Application of Manual Techniques
Indications for Manual Therapy
Contraindications to Manual Therapy
Massage
Specific Massage Techniques
Manual Lymphatic Drainage
Joint Mobilizations
Joint Mobilization Approaches
Australian Techniques
Clinical Application
Chapter 10 Physical Agents and Mechanical Modalities
Overview
Physical Agents
Cryotherapy
Thermotherapy
Hydrotherapy
Electrotherapeutic Modalities
Physiological Effects
Electrodes and Their Placement
Electrical Equipment Care and Maintenance
Transdermal Iontophores
Transcutaneous Electrical Nerve Stimulation
Russian Current or Medium-Frequency Alternating Current
Interferential Current
Biofeedback
Mechanical Modalities
Mechanical Spinal Traction
Summary
SECTION II Therapeutic Activities
Chapter 11 Therapeutic Exercise
Overview
Kinematic Chains
Closed Kinematic Chain
Open Kinematic Chain
Exercise Physiology
Measures of Energy Expenditure
Basal Metabolic Rate (BMR)
Video Fluoroscopy
Computed Tomography
CT Myelogram
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Diagnostic Ultrasound (Ultrasonography)
Radionuclide Scanning
Chapter 12 Improving Mobility
Overview
Improving Range of Motion
Passive Range of Motion
Active-Assisted Range of Motion
Active Range of Motion
Improving Flexibility
Stretching
Self-Stretching
Improving Joint Mobility
Summary
Chapter 13 Improving Muscle Performance
Overview
Improving Strength
Methods of Strengthening Muscles
Neuromuscular Electrical Stimulation
Isometric Exercises
Concentric/Isotonic Exercises
Eccentric Exercises
Isokinetic Exercise
Proprioceptive Neuromuscular Facilitation
Stabilization Exercises
Periodization
Types of Resistance
Considerations for Strength Training
Strengthening Exercise Programs
Maintaining Strength
Improving Muscular Endurance
Improving Muscle Power
Plyometrics
Summary
Structural Dysfunctions
Sternal Deformities
Intervention
Intercostal Muscles
Intervention
Intervention
Intervention
Techniques to Increase Soft Tissue Extensibility
Manual Stretch into Extension
Bucket Handle Stretch
Summary
Chapter 14 Improving Balance
Overview
Somatosensory System
Visual and Vestibular Input
Sensory Motor Integration
Motor Output Generation
Improving Balance
Agility
Summary
Chapter 15 Improving Cardiovascular Conditioning
Overview
Physical Fitness
Physical Activity
Cardiorespiratory Endurance
Recovery
Precautions with Aerobic Conditioning
Techniques for Improving, Maintaining, and Monitoring Cardiorespiratory Endurance
Aerobic Conditioning Programs
Summary
SECTION III The Joints
Chapter 16 The Vertebral Column
Overview
Design
Structure
Motion Segments
Intervertebral Foramina
Neutral Zone
Spinal Motion
Coupled Motions
Fryette’s Laws of Physiological Spinal Motion
Fryette’s First Law
Fryette’s Second Law
Fryette’s Third Law
General Guidelines for Interventions for Spinal Dysfunction
Acute Phase
Subacute and Chronic (Functional) Phases
Summary
Body Mass Index
Bioelectrical Impedance Analysis
Motor Learning
Open Versus Closed Skills
Gentile’s Taxonomy of Motor Tasks
Stages of Motor Learning
Practice and Feedback
Patient Safety
Summary
Chapter 17 Cervical Spine and Temporomandibular Joint
Overview
Anatomy and Kinesiology
Cervical Spine
Temporomandibular Joint
Examination
Range of Motion
Evidence-Based Testing
Intervention Strategies for the Cervical Spine
Acute Phase
Subacute Through Chronic Phases
Functional Retraining
Intervention Strategies for the Temporomandibular Joint
Common Conditions
Whiplash-Associated Disorders
Intervention
Therapeutic Techniques
Techniques to Increase Soft Tissue Extensibility
General Soft Tissue Techniques
Self-Stretches
Summary
Chapter 18 Thoracic Spine and Rib Cage
Overview
Anatomy and Kinesiology
Muscles
Thoracic Motions
Respiration
Examination
Range of Motion
Intervention Strategies
Acute/Subacute Phase
Functional/Chronic Phase
Examination of the Elbow Complex
Goniometry
Intervention Strategies
Acute Phase
Chronic/Functional Phase
Common Conditions
Pathologic Bone Formation
Therapeutic Techniques
Techniques to Increase Soft Tissue Extensibility
Transverse Frictional Massage
Selective Joint Mobilizations
Summary
Chapter 19 Lumbar Spine and Sacroiliac Joint
Overview
Anatomy of the Lumbar Spine
Ligaments
Vertebrae
Intervertebral Disk
Kinesiology of the Lumbar Spine
Flexion
Extension
Side Bending
Axial Rotation
Axial Loading (Compression)
Anatomy of the Sacroiliac Joint
Posterior Muscle System
Anterior Muscle System
Kinesiology of the Sacroiliac Joint
Sacral Motion
Innominate Motion
Pelvic Stabilization
Examination of the Lumbopelvic Complex
Goniometry
General Intervention Strategies
Acute Phase
Functional/Chronic Phase
Common Conditions
Chapter 20 Shoulder Complex
Overview
Anatomy and Kinesiology
Sternoclavicular Joint
Scapulothoracic Articulation
Acromioclavicular Joint
Glenohumeral Joint
Coracoacromial Arch
Suprahumeral/Subacromial Space
The Scapulohumeral Rhythm
Muscle Function During Shoulder Motions
Examination
Range of Motion
General Intervention Strategies
Acute Phase
Chronic/Functional Phase
Common Conditions
Therapeutic Techniques
Scapular Assist
Rhythmic Stabilization
Transverse Frictional Massage (TFM)
Joint Mobilizations
Summary
Chapter 21 Elbow and Forearm Complex
Overview
Anatomy and Kinesiology
Ligaments
Muscles
Nerve Supply
The Cubital Fossa
Fractures of the Acetabulum
Hip Preservation Surgery
Intervention
Therapeutic Techniques
Self-Stretching
Selective Joint Mobilizations
Summary
Chapter 22 Wrist and Hand
Overview
Anatomy
Distal Radioulnar Joint
Radiocarpal (Wrist) Joint
Midcarpal Joint
Antebrachial Fascia
Extensor Retinaculum
Flexor Retinaculum
Metacarpophalangeal Joints of the Second to Fifth Digits
Carpometacarpal Joints of the Second to Fifth Digits
First Carpometacarpal Joint
Metacarpophalangeal Joint of the Thumb
Interphalangeal Joints
Palmar Aponeurosis
Anatomic Snuff Box
Muscles of the Wrist and Forearm
Kinesiology
Pronation and Supination
Movement of the Hand on the Forearm
Functional Use of the Hand
Flexion and Extension Movements of the Wrist
Frontal Lateral Movements of the Wrist
Thumb Movements
Spondylolysis
Rectus Abdominis Strain
Summary
Chapter 23 Hip Joint Complex
Overview
Anatomy
Bones
Muscles
Ligaments
Kinesiology
Lumbopelvic Rhythm
Collum/Inclination Angle
Anteversion/Retroversion
Examination
Range of Motion
General Intervention Strategies
Acute Phase
Functional Phase
Common Conditions
Hip Flexion Contracture
Chapter 24 Knee Joint Complex
Overview
Anatomy
Knee Menisci
Osteokinematics of the Tibiofemoral Joint
Arthrokinematics of the Tibiofemoral Joint
The Patellofemoral Joint
Muscles of the Knee Joint Complex
Patellar Tracking
Examination
Range of Motion
General Intervention Strategies
Acute Phase
Functional Phase
Common Conditions
Therapeutic Techniques
Self-Stretching
Techniques to Increase Soft Tissue Extensibility
Selective Joint Mobilizations
Summary
Examination
Range of Motion
General Intervention Strategies
Acute Phase
Functional/Chronic Phase
Common Conditions
Wrist Sprains
Therapeutic Techniques
To Improve Hand Dexterity
To Improve Hand Strength
Joint Mobilizations
Summary
Chapter 25 Ankle and Foot
Overview
Anatomy and Kinesiology
Terminology
Joints of the Ankle and Foot
Examination
Goniometry
General Intervention Strategies
Acute Phase
Functional/Chronic Phase
Common Conditions
Deformities of the Arch
sprain
Lesser Toe Deformities
Therapeutic Techniques
Techniques to Increase Soft Tissue Extensibility
Techniques to Increase Strength
Selective Joint Mobilizations
Summary
SECTION IV Special Considerations
Chapter 26 The Pediatric Orthopaedic Population
Overview
Guidelines for Exercise Training in the Young
Pediatric Orthopaedic Conditions
Acquired Conditions
Congenital
Summary
Chapter 27 The Geriatric Orthopaedic Population
Overview
The Aging Process
Theories of Aging
Pathologic Conditions Associated with the Elderly
Musculoskeletal Disorders and Diseases
Geriatric Fractures
Neurological Disorders and Diseases
Multisystem Dysfunction
General Guidelines for Strength Training in the Elderly
Ethical and Legal Issues
The Living Will (Advanced Care and Medical Directive)
Refusal of Treatment
Do Not Resuscitate (DNR) Orders
Healthcare Proxy
Informed Consent
Summary
Appendix
Appendix A American Physical Therapy Association Guide for Conduct of the Physical Therapist Assistant
Appendix B American Physical Therapy Association’s Documentation Guidelines
Appendix C Commonly Used Abbreviations in Orthopaedics
Appendix D Common Laboratory Values
Appendix E Proprioceptive Neuromuscular Facilitation (PNF) Terms and Techniques
Appendix F Close-Packed and Open-Packed Positions of the Joints