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Title: Prosthetics & Orthotics in Clinical Practice: A Case Study Approach

Authors: Bella J. May, EdD, PT, CEEAA, FAPTA;Margery A. Lockard, PT, PhD
Publisher: F.A. Davis Company; Number of pages: 418
Reviewed by: Jason T. Terry, PT, DPT, NCS

The authors of this text, both physical therapists, have written a wonderful text useful for physical therapy students and physical therapy assistants. The book's expressed desire is to "assist the physical therapy student become an effective clinical decision maker when working with individuals in need of prostheses and orthoses."

The book is organized into four sections, each containing multiple chapters. Each chapter begins with objectives, case studies, and case study activities written to assist the student to better visualize the covered concepts. Each section is well written, is able to stand on its own, and flows nicely from chapter to chapter.

The first section, Foundation for Prosthetic/Orthotic Practice, includes three chapters. The section begins with a brief history of prosthetics and orthotics, discusses associated biomechanical principles (including dialogue about types of forces, appliance design, lever arms, and a brief discussion on normal kinematics of gait), and covers psychosocial issues related to prosthetic and orthotic use.

Section Two, Amputation and Prosthetics takes the reader through the most common types of surgical amputations, including instruction on typical nomenclature, discusses postsurgical management, prosthetic components, and lower limb prosthetic management. One of the strengths of this book is found in this section in its discussions on prosthetic gait. The authors take the reader through normal prosthetic gait, followed by deviations related to both transtibial and transfemoral prostheses, offering possible explanations for deviations as well as plausible solutions. This discussion could be used as a resource both for novice and for more experienced clinicians. Chapters in this section also discuss less common levels of lower limb amputation, considerations in dealing with pediatric amputation, and one chapter on the management of upper limb amputations.

The third Section on Orthoses contains eight chapters and instructs the student on examination for orthotic prescription and checkout; design of orthosis, including developing a prescription and fabrication; discussion on shoes; and one chapter for deviations in several major regions of the body including the foot, ankle, knee, hip, trunk (including cercials and cranium), and upper limb.

Section Four, Living with a Prosthesis/Orthosis is the shortest section and touches on training for sports and leisure activities (with relevant photos and discussion of current adaptations and devices that allow for ease of return to lifestyles enjoyed prior to prosthesis/orthosis), and a chapter with detailed algorithms and tables that delve into clinical decision-making for physical therapists who work with patients and clients requiring prosthetics and orthotics.

In summary: This book is well written and easy to read. It is quite comprehensive, covering a breadth of material in just over 400 pages. Its target audience is physical therapy students, physical therapy assistant students, and other relatively inexperienced practitioners, providing basic information to the reader that more experienced clinicians may find rudimentary. Each chapter includes case studies to aid the reader, and is well supported with current and vivid photos, illustrations, informative tables, and valuable references. It will serve the reader as an excellent introduction to the world of prosthetics and orthotics.

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