Livro  cinesiologia Special Tests in Musculoskeletal Examination
287 pág.

Livro cinesiologia Special Tests in Musculoskeletal Examination

Disciplina<strong>mobiliário</strong>15 materiais3 seguidores
Pré-visualização50 páginas
Special Tests in 
Musculoskeletal Examination
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 
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: You may also complete your request 
online via the Elsevier website at . 
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 
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 
For Jean Barbara Smeatham 1937\u20132008
Faith, hope and love.
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 ( in Sheffield, UK, while 
Alison works as an ESP with the specialist hip team at the Princess 
Elizabeth Orthopaedic Centre in Exeter, UK.
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 
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.
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.