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Title: Lower-Limb Prosthetics and Orthotics: Clinical Concepts
Authors: Joan E Edelstein, PT, MA, FISPO, and Alex Moroz, MD
The authors of this text, a physical therapist and physiatrist, have written a very concise, broad overview of lower-limb prosthetics and orthotics that will likely prove more valuable to students and clinicians in related fields, such as physical medicine, physical and occupational therapy, and case management, than to orthotists and prosthetists directly. The authors manage to cover a wide range of O&P topics in a relatively short text that will address the basic understandings needed by those who interact with these patients and their devices.
Following a seven-page review of normal gait, supported by numerous illustrations from the publisher's well-known text on the topic, Gait Analysis by Jacquelin Perry,MD, the text can be divided into two sections on prosthetics and orthotics respectively. The former begins with a brief chapter on "Early Management," treating such areas as pre- and post-operative evaluation, post-operative limb care, and inpatient care. This is followed by transtibial considerations including the individual components of transtibial prostheses, their biomechanics and alignment, static evaluation, and gait analysis, all of which are condensed into roughly 30 pages. Similar chapters covering the constituent components, biomechanics, static evaluation, and gait analysis of the transfemoral prosthesis comprise the next 28 pages. Individual chapters on partial foot considerations and knee and hip disarticulation prostheses consume an additional ten pages. These are followed by brief chapters on bilateral considerations, prosthetic gait and activities training, geriatric considerations, and functional outcomes. Thus, the entirety of lower-limb prosthetics is canvassed in just over 100 well-illustrated pages. While the text's depth of consideration will likely fall short of the immediate needs of clinical prosthetists, the text provides a good introductory overview of lower-limb prosthetics.
The treatment of orthotics is similarly concise. Individual brief chapters are found on shoes and foot orthoses, AFOs, KAFOs, HKAFOs, static evaluation of a lower-limb orthosis, pathological gait analysis, and functional outcomes in orthotics. Some areas are treated much more tersely than others, with some chapters comprising only two or three pages of written text. The book concludes with a chapter briefly reviewing the patient populations and pathologies commonly treated with orthoses and a fairly comprehensive chapter on pediatric considerations in the realm of orthotic and prosthetic care.
In summary: The strength of this text lies in its truly comprehensive coverage of lower-limb considerations in P&O, with a focus on breadth rather than depth. The authors' ability to condense this material into a text less than 200 pages long is admirable. Further, the text of the book is well supported by clear and current photographs and illustrations. While it lacks the depth found in thicker resources such as the atlases of prosthetics and orthotics, it certainly serves as an excellent introductory overview to the many considerations of lower-limb P&O.