Orthopedic Rehabilitation, Assessment, and Enablement PDF
Preview Orthopedic Rehabilitation, Assessment, and Enablement
David Ip Orthopedic Rehabilitation, Assessment, and Enablement David Ip Orthopedic Rehabilitation, Assessment, and Enablement With 133 Figures (cid:1) (cid:2) Dr. DavidIp MBBS (HKU), FRCS (Ed) Orth, FHKCOS, FHKAM,FIBA (UK), FABI (USA) Vice-President of the Recognition Board ofWorld Congress ofArts, Sciences, and Communications Deputy Governor, American Biographical InstituteResearch Association, MusculoskeletalRehabilitation Service, PamelaYoude Nethersole Eastern Hospital, Hong Kong ISBN 978-3-540-37693-4 Springer Berlin Heidelberg New York LibraryofCongressControlNumber:2006931062 Thisworkissubjecttocopyright.Allrightsarereserved,whetherthewholeorpartofthe materialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations, recitation,broadcasting,reproductiononmicrofilmorinanyotherway,andstorageindata banks. Duplication of this publication or parts thereof is permitted only under the provi- sions of the German Copyright Law ofSeptember 9, 1965, in its current version, and per- mission for use must always be obtained from Springer-Verlag. Violations are liable for prosecutionundertheGermanCopyrightLaw. SpringerisapartofSpringerScience+BusinessMedia springer.com ©Springer-VerlagBerlinHeidelberg2007 Theuseofgeneraldescriptivenames,registerednames,trademarks,etc.inthispublication does not imply, even in the absence of a specific statement, that such names are exempt fromtherelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. Editor:GabrieleM.Schröder,Heidelberg,Germany DeskEditor:IrmelaBohn,Heidelberg,Germany Production:LE-TEXJelonek,Schmidt&VöcklerGbR,Leipzig,Germany Cover:FridoSteinen-Broo,eStudioCalamar,Spain Typesetting:K+VFotosatzGmbH,Beerfelden,Germany Coverillustration:CourtesyofViconMotionSystemsLtd. Printedonacid-freepaper 24/3100Di 5 4 3 2 1 0 Foreword Medical practitioners involved in the treatment of diseases, disorders, and injuries of the musculoskeletal system will appreciate the very im- portant role of rehabilitation. Following the publication of two books Orthopedic Principles – A Resident’s Guide and Orthopedic Traumatology – A Resident’s Guide, Dr. Ip has expended further time and effort to pro- duce a third book, which contains a comprehensive account of orthopae- dic rehabilitation. The material is easy to graspwith succinct points. There are 19 chapters, arranged in a logical sequence. The first chap- ter gives a holistic view of what the rehabilitationprocess should include and emphasises that the unique feature of a rehabilitation service is thinking about a patient and his problems, not simply doing something to the patient, and the focus should be on trying to help each patient achieve his own goals. Chapters 2 to 8 are about the rehabilitation tools for assessing, inves- tigating and treating patients. Chapters 9 to 17 are about rehabilitation for specific types of musculoskeletal disorders, each of which has its own complex problems, requiring practitioners to gain further in-depth training and experience to give effective treatment. The format is similar to the previous two books, containing brief, yet comprehensive, core information on the subject, which can be enhanced by more detailed literature review if necessary. This unique feature ren- ders the book very readable. All three books should be available to residents and staff in any orthopaedic department. Therapists and nurses treating patients with musculoskeletaldiseases will also findthis book useful. Professor John C.Y. Leong, OBE, FRCS, FHKAM (Orth. Surgery), JP President, Open UniversityofHong Kong; Formerly Professor& Head, Departmentof Orthopaedic Surgery, Universityof Hong Kong; Past President, Société Internationalede Chirurgie Orthopédique etde Traumatologie (SICOT) Foreword Dr. David Ip, author of two extremely successful orthopaedic review texts, has producedyet a third andperhaps his very best, entitled Ortho- pedic Rehabilitation, Assessment, and Enablement. This is a remarkable work of scholarship covering topics that, to date, have rarely received sufficient exposure in the orthopaedic community. I can state with ex- treme certainty that it will become the standard review text for anyone involved inthe rehabilitation aspects of the musculoskeletalsystem. Nineteen comprehensive chapters cover not only every aspect of reha- bilitation of the musculoskeletal system, but extend further into such topics as alternative medicine, holistic therapies, acupuncture, neuro- physiologic testing, overuse injuries, workassessment and outcome mea- sures. Each chapter covers the basic science of the subject, clinical as- sessments, rehabilitation options and methods, and the outcomes of these. Take for example the chapteron gait analysis. Following the intro- duction, the subdivisions of information include the natureofgait analy- sis, key evaluations of the gaitcycle, the contributions ofground-reactive force data, kinematic data collection, temporal parameters, dynamic EMG data and gait anomalies. The latter covers gait issues with ampu- tees, prosthetic usage, cerebralpalsy, to namebut a few issues. The nineteenth and final chapter is an extremely stimulating one en- titled “New Evidence-Based Programme for Preventing and Rehabilitat- ing Hip Fractures”. For such a common injury, rarely has such an ex- haustive study of all of the issues related to hip fracture rehabilitation been made, and is contained in this thesis written by Dr. Ip to the Hong Kong College of Orthopedic Surgeons. The thesis presents a scientific in- vestigation of the problems regarding not only epidemiology, but also is- sues as to aetiologic factors in the causation of hip fractures, the science of data analysis, kinematics and joint function, and of equal importance, rehabilitation. There are a number of factors that have been recognised to be important not only in the rehabilitation of the hip, but also in the rehabilitation of the individual back to an independent lifestyle. VIII Foreword The work in this thesis must become part of the general curriculum of all individuals involved in the management of the elderly patient far beyond those that deal primarily with the musculoskeletal system. This should be part of general medical training and knowledge, and in the long run the information presented in this thesis should go far to help our fellow citizens avoid the disastrous effects of a fractured hip and en- hance the qualityof lifefor citizens around the world. While the information throughout the text is presented in bullet points, the subjects are covered in extraordinary detail. I feel for certain that this text will serve a wide community of healthcare professionals and will be part of required reading for any and all disciplines involved in musculoskeletal rehabilitation, neuromuscular disorders, burn rehabil- itation, and evaluation of pain andpain management. Jesse B. Jupiter, M.D. Director, Orthopaedic Hand Service Massachusetts GeneralHospital Hansjörg Wyss/AO Professor, Harvard Medical School Preface It was to the author’s delight that the medical and scientific communities have so warmly received his previous two books, also published by Springer, on the subjects of orthopaedic trauma and orthopaedic princi- ples. The current text summarises the many conceptual and technological advances in the field of orthopaedic rehabilitation that the trainee sur- geons will be eager to know. It breaks away from the traditional “cook- book”-like approach detailing “standardprotocols” from one or two cen- tres, but rather places stress on a basic understanding of the subject matter, not only in an evidence-based manner, but also by looking at eachparticular subject fromvariousviewpoints. The book ends with the description of a thesis originally submitted by the author to the Rehabilitation Sub-Specialty Board of the Hong Kong College of Orthopedic Surgeons detailing a brand new look and new strategies for the rehabilitation of fragility hip fractures. The design of such an evidence-based programme is far from easy, for it requires knowledge of neurophysiology, biomechanics, theoretical physics, phys- iotherapy, besides orthopaedics and gait analysis. Overall, the current book represents a distillation of the experiences of the author throughout more than 20 years in medicalpractice; includ- ing his overseas training in rehabilitation in the Scandinavian countries, USA, UK and Canada. The author is now the Hon Director General Asia of the International Biographical Association in Cambridge UK. Besides being a fellow of several orthopaedic societies including the Royal Col- lege of Surgeons (orthopaedic sub-specialty) and the Hong Kong College of Orthopedic Surgeons; he is also a member of the AAOS, the Associa- tion of Academic Physiatrists in the USA, and an active member of the IASP (International Association for the Study of Pain), the WIP (World Institute of Pain), the ESMAC (European Society of Movement Analysis), and the GCMAS (Gait and Clinical Movement Analysis Society). The author’s biography can be found in Marquis Who’s Who in Science and X Preface Engineering and Marquis Who’s Who in Medicine and Healthcare, among others. Finally, the author wishes to extend his heartfelt gratitude to Professor John Leong and Professor Jesse Jupiter for kindly writing the forewords to this book. Thanks are also due to the many different companies that have kindly provided pictures for illustration purposes, such as Vicon Motion Systems Ltd, Stryker, Bioness, Sigmedics, Ossur, among manyothers. David Ip Hong Kong, November 2006 Contents 1 The Rehabilitation Process, ICIDH vs ICF 1 2 Physical Forces Used in MusculoskeletalRehabilitation 19 3 Basic Science on Injury and Repair of SkeletalMuscle, Ligaments and Tendons 53 4 Common Physical TherapyTechniques and “AlternativeMedicine” 73 5 Principles of Assessment: A Holistic and Case-Based Approach 111 6 Assistive Technology 137 7 Neurophysiological Testing and Intraoperative Monitoring 171 8 Gait Analysis 189 9 Principles of Sports Rehabilitation 219 10 AmputeeRehabilitation 237 11 Cerebral Palsy Rehabilitation 287 12 Rehabilitation of Spinal Cord Injuries 321 13 Burn Rehabilitation 387 14 Rehabilitation After Total Joint Replacement 407 15 Orthopaedic Pain Management 433
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