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12394376 Therapeutic Exercise Chapter

12394376 Therapeutic Exercise Chapter

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Therapeutic Exercise
Foundations and Techniques
FIFTH EDITION
CAROLYN KISNER,
 PT, MS
Assistant Professor Emeritus 
The Ohio State UniversitySchool of Allied Medical ProfessionsPhysical Therapy DivisionColumbus, Ohio
 LYNN ALLEN COLBY,
 PT, MS
Assistant Professor Emeritus 
The Ohio State UniversitySchool of Allied Medical ProfessionsPhysical Therapy DivisionColumbus, Ohio
 Note: The second color in this sample, cyan, is not the final print  color.
 
F. A. Davis Company1915 Arch StreetPhiladelphia, PA 19103www.fadavis.com
Copyright © 2007 by F. A. Davis CompanyCopyright © 2002, 1996, 1990, 1985 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmit-ted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,without written permission from the publisher.Printed in the United States of AmericaLast digit indicates print number: 10 9 8 7 6 5 4 3 2 1
 Publisher:
Margaret Biblis
 Manager, Content Development:
Deborah J. Thorp
 Developmental Editor:
Jennifer A. Pine
 Art and Design Manager:
Carolyn O’BrienAs new scientific information becomes available through basic and clinical research,recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty,expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always tocheck product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs.
Library of Congress Cataloging-in-Publication Data
Kisner, Carolyn.Therapeutic exercise : foundations and techniques / Carolyn Kisner, Lynn Allen Colby. — 5th ed. p. ; cm.Includes bibliographical references and index.ISBN-13: 978-0-8036-1584-7ISBN-10: 0-8036-1584-11.Exercise therapy—Handbooks, manuals, etc.I.Colby, Lynn Allen.II.Title. [DNLM: 1.Exercise Therapy—methods. WB541K61t2007]RM725.K53 2007615.8
2dc222007007512Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the CopyrightClearance Center (CCC) Transactional Reporting Service, provided that the fee of $.10 per copyis paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations thathave been granted a photocopy license by CCC, a separate system of payment has been arranged.The fee code for users of the Transactional Reporting Service is: 8036-1042-03 0
$.10.
 
vii
 Preface
Y
ou will notice a new “face” with the fifth edition of 
Therapeutic Exercise—Foundations and Techniques
. Thesoft cover, a feature of the first four editions, has beenreplaced with a hard cover. Each edition of this text hasgrown in scope and depth to reflect the expanding body of knowledge related to therapeutic exercise. The fifth editionis no exception.There are many exciting trends in physical therapywhich have influenced therapeutic exercise, and thus thecontent of this edition. These trends include entry-level physical therapist education rapidly progressing toward theDoctor of Physical Therapy degree, basic and clinicalresearch lending evidence for critical analysis and supportfor therapeutic exercise interventions, and the practice of  physical therapy moving toward direct access and autono-my enabling physical therapists with the assistance of  physical therapist assistants to provide services to individu-als with movement disorders that impair function.Although there are a number of new features in thisedition directed toward the changes in education, clinical practice, and the healthcare environment, this text contin-ues to provide a foundation of concepts, principles, and techniques on which an individualized program of thera- peutic exercise can be built. This foundation remains animportant component of the text. In addition to principlesof exercise and background information on various pathologies and musculoskeletal surgeries, descriptions of exercise interventions and management guidelines areincluded to assist the reader in the development and pro-gression of individualized and comprehensive therapeuticexercise programs.Major changes we have made in this fifth editioninclude:A new feature called “Focus on Evidence” appearsthroughout the text to underscore the importance of evi-dence-based practice. The reader will find brief descrip-tions of research that highlight evidence related tovarious concepts and therapeutic exercise interventions.This feature is in addition to summaries of “outcomes”on selected topics that were added as a feature of thefourth edition and were extensively updated for this edi-tion.The content of the text has been expanded to includeseveral new areas and has also been completely reorgan-ized. There are now five major sections. Highlights of each of the sections are as follows.
Part I,
General Concepts.
We have added a newchapter, “Prevention, Health, and Wellness,” by KarenHoltgrefe, DHS, PT, OCS. She has done considerablegraduate work and teaches in this area. The content of the chapter describes the importance of these topicsin physical therapy practice.
Part II,
Applied Science of Exercise and Tech-niques
, covers the basic concepts and principles of therapeutic exercise and foundational techniques. Wehave added a new chapter, “Exercise for Impaired Balance.” This chapter reflects the combined expert-ise of Anne D. Kloos, PT, PhD, NCS whose doctoralstudies, teaching, and research have focused on neu-ral plasticity and neurological physical therapy, and Deborah Givens Heiss, PT, PhD, DPT, OCS whosedoctoral studies, teaching, and research have inte-grated the areas of orthopedic physical therapy and motor control. Their chapter has a rich blend of neu-rological and orthopedic perspectives to the manage-ment of impaired balance.
Part III,
Principles of Intervention
, was one chapter in previous editions, but to accommodate expandingscience and evidence, we divided the content and developed three new chapters. In addition to “SoftTissue Injury, Repair, and Management” and “Surgi-cal Interventions and Postoperative Management,” weadded chapters on “Joint, Connective Tissue, and Bone Disorders and Management” (with new infor-mation of myofascial pain syndrome and fibromyal-gia and expanded information on fracture healing and management) and “Peripheral Nerve Disorders and Management.” These chapters provide background information for the practitioner to make sound clini-cal judgments when developing, implementing,and progressing programs that utilize therapeuticexercise.
The chapters in Part IV,
Exercise Interventions byBody Region
, have been extensively revised, updat-ed, and expanded. In each of these chapters we fea-ture a table that links physical therapist preferred  practice patterns to each of the pathologies and sur-geries presented. In addition, the chapters on postureand spinal impairments have been placed before

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