Critical Pathways in Therapeutic Intervention

From The Critics

Reviewer: Christopher James Hughes, PT,PhD,OCS,CSCS(Slippery Rock University)
Description: According to the authors, this large textbook is written to provide a "Socratic approach" to learning to facilitate clinical problem solving in a realistic, case presentation format. The entire text presents mainly orthopedic cases classified by body region with a few cases emphasizing nerve and plexus lesions. The inclusion of relevant clinical questions along with each case is designed to foster critical thinking in arriving at a differential diagnosis and guiding treatment.
Purpose: The purpose is to provide a case-based approach to foster clinical decision-making and evidence-based practice. One of the goals of the authors is to integrate ideas and concepts from clinical sciences such as anatomy, kinesiology, pathology, and ergonomics to provide a fundamental base of knowledge for arriving at a clinical diagnosis. The objectives set by the authors are appropriate and I believe they have succeeded in accomplishing their intent for writing the book.
Audience: This book is written for clinicians who treat mainly orthopedic problems. I believe the audience who would best benefit would be physical therapists, occupational therapists, and possibly athletic trainers who treat primarily orthopedic injuries. The authors broadly state that the text addresses the needs of health professionals who treat injuries in a conservative manner prior to seeking surgical intervention. The authors are both licensed physical therapists. Both bring credibility to the topics in the text.
Features: This is a compilation of 63 case reports that are independent of one another but classified according to the body region they address. The 12 subdivisions make this a large text of over 1,000 pages. Each case is presented in a consistent format using a brief patient history with exam results and clinical observations to help readers formulate a differential diagnosis. A series of questions are then posed with an explanation of the author's research integrated into the answers. The primary focus of the questions relate to helping readers understand the etiology of the disorder and clinical components of the pathology or lesion. Treatment issues and surgical alternatives are also covered where appropriate. Each case includes references and recommended readings. Overall, the text is well-illustrated and offers a wide variety of cases. The only shortcoming would be its primary focus on orthopedic cases and the fact that not every clinical case can be covered in one text. However, readers should be able to extrapolate the thought process from the completed cases to their own patient populations. The question-and-answer format is well-done and does a nice job summarizing important facts for each case.
Assessment: I believe this book offers a refreshing format to help educators and practicing clinicians develop strong clinical decision-making skills. I think readers will at the very least find each case to be a good review and perhaps shed light on practice areas that demand a more scientific basis of treatment. The treatment sections should offer some guidance to clinicians in selecting and progressing treatments. I strongly recommend the text for those who are willing to test and evaluate their clinical knowledge in the areas of orthopedic evaluation and rehabilitation. I also believe the text would be suitable in a seminar course on injury evaluation and treatment in the academic setting.

3 Stars from Doody