Livro cinesiologia Special Tests in Musculoskeletal Examination
Disciplina<strong>mobiliário</strong>15 materiais • 3 seguidores
Special Tests in Musculoskeletal Examination www.specialtests.org Commissioning Editor: Rita Demetriou-Swanwick Development Editor: Veronika Watkins Project Manager: Vijayakumar Sekar Designer/Design Direction: Kirsteen Wright Illustration Manager: Bruce Hogarth Special Tests in Musculoskeletal Examination An evidence-based guide for clinicians Written by Paul Hattam MSc MCSP FSOM Director and Principal Physiotherapist, The Physios, Sheffield, UK Alison Smeatham MSc MCSP FSOM Extended Scope Practitioner, Royal Devon and Exeter Hospital, Exeter, UK Edinburgh\u2003 London\u2003 New\u2003York\u2003 Oxford\u2003 Philadelphia\u2003\u2003 St\u2003Louis\u2003 Sydney\u2003 Toronto\u2003 2010 First published 2010, © Elsevier Limited. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier\u2019s Rights Department: phone: ( \ufffd1) 215 239 3804 (US) or (\ufffd44) 1865 843830 (UK); fax: (\ufffd44) 1865 853333; e-mail: email@example.com. You may also complete your request online via the Elsevier website at http://www.elsevier.com/permissions . ISBN 978-0-7020-3025-3 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notice Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient. The Publisher Printed in China vi DeDication For Jean Barbara Smeatham 1937\u20132008 Faith, hope and love. vii About the Authors Paul Hattam and Alison Smeatham are physiotherapists with a special interest in musculoskeletal medicine, having accumulated many years of experience treating patients both in the National Health Service and in private practice. They were among the first extended scope physiotherapists (ESPs) to establish orthopaedic triage in primary care during the 1990s, a model that was subse- quently evaluated and reproduced throughout the UK. They com- pleted a musculoskeletal master\u2019s programme in 2002/3 and retain a keen interest in research in their area of specialty. Both tutor reg- ularly on postgraduate courses for doctors and physiotherapists in musculoskeletal medicine as well as being actively involved in educational programmes closer to their homes. Paul now leads the team at The Physios (www.thephysios.com) in Sheffield, UK, while Alison works as an ESP with the specialist hip team at the Princess Elizabeth Orthopaedic Centre in Exeter, UK. viii Acknowledgements The authors would like to thank everyone who helped us see this project through to completion. As is often the case, the size of an undertaking only becomes evident once you have started it and the encouragement we received from our families, friends and col- leagues was always welcome and helped to spur us on. We benefited enormously from the collective wisdom of a number of medical and physiotherapy colleagues from across the UK and are particularly grateful to the following: Jill Gillespie, Margaret Rees, Chris Blundell, and the hip and knee surgeons and ESPs at Princess Elizabeth Orthopaedic Centre and Devon PCT for their contributions. We appreciated the free exchange of informa- tion and ideas with our teaching colleagues Elaine Atkins, Jill Kerr and Emily Goodlad, even though they managed to pip us to the post and submit the manuscript for their book first. Nigel Hanchard contributed to the labral, tendon and impinge- ment tests at the shoulder. As lead author of the Cochrane proto- type diagnostic review on this topic (in development), and of the Chartered Society of Physiotherapy\u2019s clinical guidelines on shoulder impingement, his familiarity with the evidence base provided a rich resource of which we made good use. Nigel also made welcome suggestions for the introductory chapter, all of which were very valuable. We would like to thank Gordon Smith who, despite agreeing to completely unreasonable deadlines, painstakingly proof read each section and provided correction and challenge in equal measure. We were also very grateful for the fresh pair of eyes willingly provided by Joy Hattam at the final proof reading stage. Our model for the photographs, Alison Crewesmith, was good humoured throughout a very long day and Ant Clifford had the eye to make the photos clear and visually appealing. Space to spread out and edit the book was generously provided by Lindsay Jackson at EEF, Sheffield. Thanks to everyone at Elsevier, particularly Heidi Harrison for her initial enthusiasm that helped to launch the idea and to Veronika Watkins and Rita Demetriou-Swanwick for their endless patience and guidance during the writing and final editing stages. Acknowledgements ix Paul thanks Time away researching and writing the book inevitably meant an increased burden on my colleagues and I would like to thank every- one at The Physios for their encouragement and support. My family have exhibited patience beyond measure and I am hugely grateful to my wife, Alison, for taking everything perfectly in her stride and helping me keep things in perspective, as well as retaining a keen sense of humour throughout. The same can be said for Rachael, James and Naomi who happily got on with life while Dad tapped away on the computer. You\u2019re amazing! Alison thanks I would like to thank friends and colleagues who managed to remain interested and enthusiastic about this project over many cups of tea and glasses of wine. My family, and in particular Mum and Dad, continued to provide unwavering encouragement and support even when much more important events were taking place and my love and gratitude goes to them and to David, Karen, Tom, Rosie, Irene and Terry. \ufffd Foreword Paul Hattam and Alison Smeatham are long-time teaching col- leagues of mine. From their first musings that a new text was needed to acknowledge and examine the growing bank of addi- tional tests for peripheral lesions, I have been so excited to see their book in print knowing that they would create this clear, concise and highly readable resource drawn from a rigorous and objective trawl through the available evidence. They have wisely recruited the opinion of other experts too though, acknowledging that many tests are chiefly derived from empirical practice and should not be discarded without due consideration for clinical experience. As we might expect, many of the tests do not enjoy a strong, consistent evidence base to support their application and not surprisingly, it is the expert opinion that draws the eye to guide practice. I have read this book because I wanted to learn from it and I have already found it to be a valuable resource. The initial \u2018About the book\u2019 section sets the scene for the rest of the book, providing generic \u2018ground rules\u2019 for how to apply the tests and an explana- tion of how the literature was searched and the evidence appraised and interpreted. \u2018Likelihood ratios\u2019, combining sensitivity and spe- cificity, are justified as the best statistics to assess the clinical use- fulness of the diagnostic tests they have presented.