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Title: Introduction to Orthotics, A Clinical Reasoning and Problem-Solving Approach

Authors: Brenda M Coppard, PhD, OTR/L, FAOTA; Helene Lohman, MA, OTR/L, FAOTA
Publisher: Elsevier, 2015; 485 pages
Reviewed by: Megan Christ, MSPO, CPO

This spiral bound textbook covers a comprehensive range of low-temperature orthoses for the upper limbs. Written by occupational therapists and others in rehabilitation medicine, the target audience is occupational therapy students and entry-level practitioners.

The book is divided into three sections. Chapters 1-6 provide an overview of orthotics, covering rationale, fabrication tools, biomechanics, and clinical reasoning. Chapters 7-11 break down orthotic intervention by anatomical section (wrist, thumb, hand, elbow, and fingers). Each of these chapters is further broken down by diagnosis including rheumatoid arthritis, osteoarthritis, and burn. Chapters 12-16 address specific conditions (contractures, nerve injuries, and spasticity) and populations (pediatric and geriatric). Chapters 17-19 provide a concise, yet comprehensive overview of lower-limb orthoses and upper-limb prostheses.

Each chapter begins with a list of key terms and objectives, followed by a sample case narrative to engage the reader and set the tone for the subject matter. The book contains good illustrations and pictures of orthoses. It gives step-by-step instructions on how to fabricate low-temperature orthoses, including molding patterns, joint positioning, direct forming, and strapping. Case studies, quizzes, lab exercises, and review questions enhance the text and reinforce important concepts. Some chapters conclude with a fun exercise that begins with a picture of a poorly made orthosis. Based on the picture, the reader has to identify the errors in the orthosis and state the impact on the patient.

The text goes beyond just teaching how to make an orthosis. It also focuses on the provider's responsibility to the patient, the importance of patient education, and follow-up protocols. The book provides examples of how to communicate with the physician to get prescription clarification and documentation as to the appropriateness of the device as well as charts showing the available literature on evidence-based practice to support orthotic intervention.

Summary: Introduction to Orthotics is geared toward occupational therapists who provide low-temperature upper-limb orthoses. It provides a comprehensive guide to rationale, design, and fabrication of upper-limb orthoses, as well as patient management. Orthotists who work in a multidisciplinary clinic, rehabilitation hospital, or orthopedic clinic will find it useful. This text is a valuable reference for communicating with occupational therapists and physicians about upper-limb orthoses.

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