Additional Information
Book Details
Abstract
The legacy of Geoff Maitland and his seminal work, Peripheral Manipulation, continues in this fifth edition, with Elly Hengeveld and Kevin Banks leading an international team of experts who demonstrate how to manage peripheral neuromusculoskeletal disorders using the principles and practice of the Maitland Concept. Together, they ensure the heart of the Concept beats on by promoting collaborative decision-making with the patient at centre and emphasizing the art and science of observation, listening, palpation and movement skills.
A key feature of the new edition focuses on a more evidence-based and analytical view of the role of mobilization and manipulation in clinical practice. The authors have written in a way that reflects their application of the Maitland Concept and how they have integrated techniques in the light of advancement in professional knowledge. Each chapter stands alone as a ‘master class’.
The text is systematically arranged focusing on detailed assessment, clinical reasoning and re-assessment to determine the physical dysfunction and efficacy of manipulative physiotherapy techniques, while also advocating continuous communication and interaction. Techniques of passive mobilization are also described, specifically designed around the individual patient’s condition.
All the chapters are written from a clinical perspective and review the evidence which informs how to deal with and manage peripheral joint pain as they present to the practitioner. Furthermore, each peripheral region (craniomandibular, upper limbs and lower limbs) is considered from the point of view of best practice in analysing and hypothesising subjective data, examination, treatment and management of peripheral pain conditions.
Brand new to the fifth edition is the addition of a companion website – Maitland’s Manipulation eResources (www.maitlandsresources.com) – providing access to a range of valuable learning materials which include videos, MCQs, interactive case studies, research links, and bonus chapters.
- World-leading experts provide evidence relating the Maitland Concept to clinical practice
- Evidence supporting practice
- Covers both subjective and physical examination
- Best practice management using mobilization and manipulation
- Case studies – how and when to integrate the Maitland Concept into clinical practice
- Chapter-based learning outcomes, keywords and glossaries
- Companion website – Maitland’s Manipulation eResources (www.maitlandsresources.com)
- Expert perspectives and supporting evidence
- Case studies
- Companion website – www.maitlandsresources.com – containing:
- Video Bank of over 480 video clips showing examination and treatment techniques
- Image Bank of over 1,000 illustrations
- Interactive case studies
- Over 200 MCQs
- Bonus chapters on additional principles and techniques of examination / treatment
- Weblink references to abstracts
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Dedication | ii | ||
| Maitland's Peripheral Manipulation | iii | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| Contributors | vi | ||
| Biography | vii | ||
| Geoffrey Douglas Maitland MBE AUA FCSP FACP (Monograph), FACP (Specialist Manipulative Physiotherapist) MAppSc (Physiotherapy) | vii | ||
| Preface | xi | ||
| Acknowledgements | xiii | ||
| In Memoriam: Kevin Banks (1959–2012) | xiv | ||
| Glossary | xv | ||
| Chapter 1 The Maitland Concept as a clinical practice framework for neuromusculoskeletal disorders | xv | ||
| Chapter 2 The Maitland Concept: evidence-based practice and the movement sciences | xv | ||
| Chapter 3 Management of craniomandibular disorders | xvi | ||
| Chapter 4 Management of shoulder and shoulder girdle disorders | xvi | ||
| Chapter 5 Management of elbow disorders | xvii | ||
| Chapter 6 Management of wrist and hand disorders | xvii | ||
| Classification of neuro-musculo-skeletal disorders | xvii | ||
| Chapter 7 Management of hip disorders | xvii | ||
| Chapter 8 Management of knee disorders | xviii | ||
| Chapter 9 Management of foot and ankle disorders | xviii | ||
| References | xviii | ||
| 1 The Maitland Concept as a clinical practice framework for neuromusculoskeletal disorders | 1 | ||
| Chapter contents | 1 | ||
| Setting the scene – the Maitland Concept as a clinical practice framework | 1 | ||
| Adapt, adopt and improve | 1 | ||
| The five pillars of clinical practice | 2 | ||
| Patient-centred practice | 2 | ||
| Clinical reasoning | 2 | ||
| Examination | 2 | ||
| Interventions | 2 | ||
| Assessment | 2 | ||
| Professional and clinical competencies supporting physiotherapists as autonomous practitioners | 2 | ||
| The bio-psychosocial paradigm | 2 | ||
| Evidence-informed practice, research and the Maitland Concept | 3 | ||
| The Maitland Concept as a clinical practice framework | 3 | ||
| The five pillars of clinical practice | 3 | ||
| Patient-centred practice | 4 | ||
| The patient and healthy living | 4 | ||
| Analyzing the patient experience | 4 | ||
| Patient inclusion and participation in decision making | 5 | ||
| Patient-centred communication | 6 | ||
| Understanding the body’s capacity to inform and adapt | 7 | ||
| The role of collaborative reasoning | 9 | ||
| Clinical reasoning | 9 | ||
| Clinical reasoning and the brick wall concept | 9 | ||
| Patient-centred clinical reasoning | 10 | ||
| Clinical reasoning and treatment selection and progression | 11 | ||
| Clinical reasoning and the expert clinician | 11 | ||
| Clinical reasoning, specific care pathways and best practice | 13 | ||
| Clinical reasoning and the clinical practice framework of the Maitland Concept | 13 | ||
| Examination | 13 | ||
| Communication during the subjective examination | 20 | ||
| The subjective examination-interview strategies | 20 | ||
| Manual testing | 20 | ||
| Reassessment during examination | 20 | ||
| The order and structure of examination | 21 | ||
| Reasoning strategies during examination | 27 | ||
| Planning and performing the physical examination | 27 | ||
| Interventions | 28 | ||
| An overview of mobilization and manipulation and their effects | 28 | ||
| An understanding of how techniques are selected, progressed and related to self-management strategies | 30 | ||
| Assessment | 30 | ||
| Assessment and outcome measures | 30 | ||
| Analytical assessment | 33 | ||
| Forms of assessment | 34 | ||
| First assessment | 34 | ||
| The first session | 35 | ||
| Reassessment before and after treatment | 38 | ||
| Indicators of change | 39 | ||
| The ‘art’ of reassessment | 39 | ||
| Assessment while performing a treatment procedure | 40 | ||
| Retrospective assessment | 41 | ||
| When improvement has stopped | 41 | ||
| Final analytical assessment | 41 | ||
| Prognosis | 41 | ||
| Competencies framework and autonomous practice | 46 | ||
| OMT and IFOMPT | 46 | ||
| Autonomous practice | 47 | ||
| The bio-psychosocial model of health care | 50 | ||
| The International Classification of Functioning, Disability and Health (WHO 2001) | 50 | ||
| The movement continuum theory of physiotherapy | 50 | ||
| The movement continuum theory and the International Classification of Functioning, Disability and Health (ICF) | 51 | ||
| From a medical to a bio-psychosocial paradigm | 52 | ||
| The role of the biomedical model in manipulative physiotherapy | 52 | ||
| International classifications of disease (ICD) and functioning, disability and health (ICF) and the brick wall concept | 53 | ||
| The bio-psychosocial paradigm and healthy living | 54 | ||
| Research and the Maitland Concept | 54 | ||
| Passive movement | 55 | ||
| Irritability | 55 | ||
| Grades of mobilization and manipulation | 56 | ||
| Dosage parameters of mobilization and manipulation | 58 | ||
| Movement diagrams | 58 | ||
| Reassessment | 59 | ||
| The oxymoron that is the Maitland Concept | 62 | ||
| References | 62 | ||
| 2 The Maitland Concept: | 66 | ||
| Chapter contents | 66 | ||
| Introduction | 66 | ||
| Physiotherapy diagnosis and ICF | 66 | ||
| International Classification of Functioning, Disability and Health (ICF) | 67 | ||
| Evidence-based practice | 68 | ||
| Dilemmas and challenges of evidence-based practice | 68 | ||
| Evidence-based practice and clinical reasoning | 71 | ||
| Movement sciences and paradigms to movement | 72 | ||
| Paradigms to movement | 72 | ||
| Physiotherapy diagnosis | 73 | ||
| From biomedical models to bio-psychosocial models | 73 | ||
| The role of the biomedical model | 74 | ||
| The role of the bio-psychosocial model | 75 | ||
| Phenomenological perspective | 75 | ||
| Neurophysiological models | 78 | ||
| Neurophysiological pain mechanisms | 79 | ||
| End-organ dysfunction and altered nervous system processing – complex clinical reasoning processes | 80 | ||
| Dynamics of a pain experience | 81 | ||
| Integrative, dynamic models of pain | 81 | ||
| Definitions of pain with regard to inclusion criteria in research | 81 | ||
| Cognitive–behavioural models | 82 | ||
| Phases of change | 83 | ||
| The physiotherapist as an educator | 83 | ||
| Compliance enhancement | 83 | ||
| Research | 83 | ||
| Biomechanical models | 83 | ||
| Conclusion | 84 | ||
| References | 84 | ||
| 3 Management of craniomandibular disorders | 88 | ||
| Chapter contents | 88 | ||
| Introduction | 88 | ||
| Theory – functional anatomy | 89 | ||
| Causes and contributing factors for craniomandibular dysfunction | 91 | ||
| Subjective examination | 94 | ||
| Kind of disorder | 94 | ||
| Areas of symptoms (body chart) | 95 | ||
| Behaviour of symptoms (over a 24-hour period) | 96 | ||
| History of symptoms (present and past) | 99 | ||
| Trauma | 99 | ||
| Events | 100 | ||
| Spontaneous onset | 100 | ||
| Gradual onset | 101 | ||
| Contributing factors | 101 | ||
| Medical screening questions | 101 | ||
| Physical examination | 102 | ||
| Present pain? | 102 | ||
| Observation | 102 | ||
| In standing | 102 | ||
| In sitting | 102 | ||
| En face | 102 | ||
| In profile (Fig. 3.10) | 103 | ||
| Functional demonstration | 105 | ||
| Brief appraisal | 105 | ||
| In sitting | 105 | ||
| Active movements | 106 | ||
| Mouth opening (depression) (Figs. 3.14 and 3.15) | 106 | ||
| Mouth closing (elevation) (Fig. 3.21) | 109 | ||
| Protraction | 109 | ||
| Retraction | 109 | ||
| Isometric tests | 112 | ||
| In supine lying | 112 | ||
| Active tests of the cervical spine | 113 | ||
| Precautions | 113 | ||
| Neurological examination | 113 | ||
| Neurodynamic tests | 113 | ||
| Cervical slump and occipital nerve major test (Maitland et al. 2005) | 113 | ||
| Mandibular nerve, right side | 113 | ||
| Facial nerve, right side | 114 | ||
| Extraoral palpation | 114 | ||
| Palpation of the TMJ | 114 | ||
| Extra- and intraoral palpation of stomatognathic muscles | 114 | ||
| Intraoral observation and palpation | 115 | ||
| Accessory movements | 116 | ||
| Extraorally applied accessory movements | 116 | ||
| Transverse movement medially (Fig. 3.35) | 116 | ||
| Localization of forces (position of therapist’s hands) | 117 | ||
| Application of forces by therapist (method) | 117 | ||
| Interpretation of findings | 117 | ||
| Uses | 117 | ||
| Intraorally applied accessory movements (Figs 3.36 and 3.37) | 117 | ||
| Longitudinal movement caudad | 117 | ||
| Localization of forces (position of therapist’s hands) | 118 | ||
| Application of forces by therapist (method) | 118 | ||
| Interpretation of findings | 118 | ||
| Uses | 118 | ||
| Posteroanterior and anteroposterior movement | 119 | ||
| 4 Management of shoulder and shoulder girdle disorders | 142 | ||
| Chapter contents | 142 | ||
| Introduction | 142 | ||
| A brief introduction to the role of the extended scope physiotherapist | 143 | ||
| Diagnostic considerations – a perspective from the medical profession, an ESP role and the traditional physiotherapy role | 144 | ||
| Physiotherapy diagnosis | 144 | ||
| Diagnosis and the ESP in the neuromusculoskeletal specialty | 145 | ||
| The diagnosis and diagnostic titles of shoulder conditions | 146 | ||
| Diagnosis and the Maitland Concept | 146 | ||
| The biomedical perspective | 146 | ||
| Diagnostic labels and shoulder conditions | 146 | ||
| Physical examination related to the differential medical diagnosis of shoulder conditions | 149 | ||
| Diagnostic accuracy – a brief review | 149 | ||
| Diagnostic accuracy of physical tests | 151 | ||
| Rotator cuff integrity and diagnosis based on physical examination tests | 151 | ||
| Impingement and diagnosis based on physical examination tests | 153 | ||
| Glenoid labrum pathology and diagnosis based on physical examination tests | 153 | ||
| Shoulder instability and diagnosis based on physical examination tests | 155 | ||
| Acromioclavicular joint conditions and diagnosis based on physical examination tests | 155 | ||
| Frozen shoulder diagnosis based on physical examination tests | 155 | ||
| Diagnosis of shoulder conditions based on physical examination tests – an appraisal | 156 | ||
| Medical diagnosis of shoulder conditions based on physical examination tests – a summary | 158 | ||
| Imaging and the diagnosis of shoulder conditions | 159 | ||
| The use of imaging in the diagnosis of shoulder conditions | 159 | ||
| Rotator cuff integrity and imaging | 159 | ||
| Subacromial impingement and imaging | 160 | ||
| Glenoid labrum and imaging | 161 | ||
| Other shoulder structures and imaging | 161 | ||
| The limitations of imaging – an appraisal and some considerations | 161 | ||
| Surgical findings – some considerations with regard to specific diagnosis | 162 | ||
| The impact of changing knowledge on the diagnosis of shoulder conditions – a clinical example relating to rotator cuff tendinopathy | 164 | ||
| Shoulder conditions – a perspective from an ESP role | 168 | ||
| ESP role practice and the diagnostic task | 168 | ||
| The importance of screening for red flags | 169 | ||
| Screening for conditions which require early medical attention | 170 | ||
| Screening for extrinsic sources – analytical assessment and differentiation | 171 | ||
| Cervical spine disorders – an example of an extrinsic source | 172 | ||
| Establishing the medical diagnosis of the shoulder disorder | 180 | ||
| A diagnostic dilemma | 180 | ||
| Considerations relating to medical shoulder diagnosis in primary care | 180 | ||
| Considerations relating to patients with persistent symptoms | 181 | ||
| Psychosocial considerations | 182 | ||
| Conservative management considerations | 182 | ||
| Surgical considerations | 186 | ||
| Summaries of the most common shoulder disorders – a biomedical perspective with implications for ESP and traditional physiotherapy practice | 188 | ||
| Shoulder conditions – a physiotherapy perspective | 213 | ||
| An overview | 213 | ||
| Physiotherapy diagnosis and shoulder conditions | 213 | ||
| Physiotherapy diagnosis and the ICF | 214 | ||
| Physiotherapy diagnosis and shoulder conditions – the American Physical Therapy Association perspective | 215 | ||
| Other developments and considerations in the physiotherapeutic management of shoulder conditions | 216 | ||
| Physiotherapy diagnosis and the concept of non-specific shoulder pain and subgrouping classification | 216 | ||
| Physiotherapy diagnosis and the concept of clinical prediction rules | 218 | ||
| Integration of the Maitland Concept into contemporary physiotherapy practice relating to shoulder conditions | 219 | ||
| The symbolic permeable brick wall | 220 | ||
| Integrating evidence from Tables 4.8–4.15 into clinical physiotherapy practice using the brick wall model | 220 | ||
| Orthopaedic special tests – a reinterpretation and redefinition with respect to the Maitland Concept and the brick wall model | 222 | ||
| Physiotherapy examination, assessment and treatments of shoulder disorders | 222 | ||
| Demonstration through case studies | 232 | ||
| References | 250 | ||
| 5 Management of elbow disorders | 261 | ||
| Chapter contents | 261 | ||
| Introduction | 261 | ||
| Anatomical and biomechanical considerations | 262 | ||
| Subjective examination | 263 | ||
| Body chart | 263 | ||
| Behaviour of symptoms | 264 | ||
| History (present episode and its progression since onset and past episodes and their natural histories) | 266 | ||
| Special questions | 266 | ||
| Evidence-based practice with reference to manual therapy | 266 | ||
| Physical examination: elbow region | 268 | ||
| In standing | 270 | ||
| In sitting | 270 | ||
| In supine | 271 | ||
| In side lying | 272 | ||
| In prone lying | 272 | ||
| Precautions and planning | 272 | ||
| Physical examination: the elbow complex | 272 | ||
| Observation | 272 | ||
| Functional demonstration/injuring movements/active functional movements and differentiation of these movements (to P1 or limit) | 272 | ||
| If necessary tests | 275 | ||
| Upper limb dynamic control | 277 | ||
| Muscle isometric and length testing | 278 | ||
| Palpation | 278 | ||
| Upper limb neurodynamic tests, nerve palpation and neurological examination | 278 | ||
| Passive movements (joints) | 282 | ||
| Mobilization with movement (MWM) | 284 | ||
| Differentiation tests | 285 | ||
| Examination and treatment techniques: elbow complex | 285 | ||
| Neurological examination | 285 | ||
| Nerve palpation | 286 | ||
| Median nerve (Fig. 5.28) | 286 | ||
| Radial nerve (Fig. 5.29) | 286 | ||
| Ulnar nerve (Fig. 5.30) | 286 | ||
| Passive movements | 286 | ||
| Extension/adduction (Fig. 5.31) | 286 | ||
| Localization of forces (position of therapist’s hands) | 287 | ||
| Application of forces by therapist (method) | 288 | ||
| Uses | 288 | ||
| Extension/abduction (Fig. 5.32) | 288 | ||
| Localization of forces (position of therapist’s hands) | 289 | ||
| Application of forces by therapist (method) | 289 | ||
| Uses | 289 | ||
| Flexion/adduction (Fig. 5.33) | 290 | ||
| Localization of forces (position of therapist’s hands) | 290 | ||
| Application of forces by therapist (method) | 290 | ||
| Uses | 290 | ||
| Flexion/abduction (Fig. 5.34) | 290 | ||
| 6 Management of wrist and hand disorders | 324 | ||
| Chapter contents | 324 | ||
| Introduction | 324 | ||
| Origin of the symptoms | 325 | ||
| Finding consistency in functional demonstrations | 325 | ||
| Defining the dominant pain mechanism | 326 | ||
| Input | 326 | ||
| Output | 326 | ||
| Processing | 326 | ||
| Deciding the normal range or ideal range for wrist and hand movement (Fig. 6.1) | 327 | ||
| Subjective examination (C/O) | 328 | ||
| Kind of disorder: establishing the patient’s main problem(s) | 328 | ||
| Areas of symptoms | 329 | ||
| Behaviour of symptoms | 330 | ||
| History (present and past) | 330 | ||
| Medical screening questions | 330 | ||
| Planning the physical examination (P/E) | 330 | ||
| Physical examination (P/E) (Boxes 6.1-6.9) | 331 | ||
| Observation | 331 | ||
| Functional demonstration | 333 | ||
| Active movements of whole hand | 333 | ||
| If necessary tests | 337 | ||
| Isometric tests (grip strength test) | 337 | ||
| Neurological examination | 338 | ||
| Neurodynamic tests | 338 | ||
| In supine lying | 338 | ||
| Inspection and palpation | 338 | ||
| Differentiation of movements reproducing pain | 338 | ||
| Passive movements wrist and hand – examination and treatment techniques | 339 | ||
| Whole hand movements, differentiating rows: | 339 | ||
| Differentiation of radial and ulnar deviation | 339 | ||
| Differentiation of horizontal flexion and extension | 339 | ||
| Supination (Figs 6.16 and 6.17) | 339 | ||
| 7 Management of hip disorders | 375 | ||
| Chapter contents | 375 | ||
| Introduction | 375 | ||
| Components of hip disorders | 375 | ||
| Structural sources | 375 | ||
| Functional causes (contributing factors) | 375 | ||
| Pathobiological disorders | 376 | ||
| Applied theory | 379 | ||
| Integration of structural and functional disorders | 379 | ||
| Muscle classification and associated muscle imbalance | 381 | ||
| Muscle classification | 381 | ||
| Muscle imbalance and associated dysfunction | 381 | ||
| Motor control | 383 | ||
| Treatment principles | 383 | ||
| Evidence supporting practice | 385 | ||
| Subjective examination | 385 | ||
| Main problem (‘Question 1’) | 387 | ||
| Areas of symptoms (body chart) | 388 | ||
| Behaviour of symptoms | 389 | ||
| History | 389 | ||
| Special questions and medical screening questions | 391 | ||
| Physical examination | 391 | ||
| Observation | 392 | ||
| Functional demonstration tests | 394 | ||
| Active movements | 394 | ||
| Gait analysis | 394 | ||
| Active testing in standing | 395 | ||
| Weight bearing (Fig. 7.7) | 395 | ||
| Technique | 395 | ||
| Swing movement | 395 | ||
| Trunk movements: assessment of relative flexibility of the movement chain | 396 | ||
| Step-down test (Fig. 7.8) | 396 | ||
| Getting up and down steps | 396 | ||
| Descending steps | 396 | ||
| Squatting | 396 | ||
| Progression of the examination | 396 | ||
| Active testing in sitting | 397 | ||
| Active testing in supine and prone positions, including overpressure | 397 | ||
| In supine | 397 | ||
| In prone | 397 | ||
| In four-point kneeling | 397 | ||
| In sitting | 397 | ||
| Active hip flexion in supine (Fig. 7.9) | 397 | ||
| Deviations | 398 | ||
| Additional manoeuvre | 398 | ||
| Flexion in four-point kneeling | 398 | ||
| Comparison of hip flexion test in supine and four-point kneeling | 399 | ||
| Medial and lateral rotation in 90° flexion (Fig. 7.10) | 399 | ||
| Lateral rotation | 399 | ||
| Medial and lateral rotation in sitting | 399 | ||
| Lateral rotation in supine (relative flexibility test) (Fig. 7.11) | 400 | ||
| Abduction in supine (Fig. 7.12) | 400 | ||
| Adduction in supine (Fig. 7.13) | 400 | ||
| Extension in prone (Fig. 7.14) | 401 | ||
| Medial and lateral rotation in prone (Fig. 7.15) | 401 | ||
| Muscle tests | 402 | ||
| Isometric tests | 402 | ||
| Muscle length tests | 403 | ||
| Global stabilizers | 403 | ||
| Iliacus (Fig. 7.16) | 403 | ||
| Deep gluteus maximus (Wagner et al. 2010) (Fig. 7.17) | 404 | ||
| Posterior gluteus medius (Fig. 7.18) | 404 | ||
| Anterior gluteus medius and minimus (Fig. 7.19) | 405 | ||
| Hip adductors: pectineus, adductor brevis, longus and magnus and quadratus femoris (Fig. 7.20) | 405 | ||
| Global mobilizers | 406 | ||
| Hamstrings (Fig. 7.21) | 406 | ||
| Superior gluteus maximus/iliotibial tracts (see Wagner et al. 2010) (Fig. 7.22) | 406 | ||
| Tensor fascia lata in standing (Fig. 7.23) | 406 | ||
| Modified Thomas’ test (Sahrmann 2002) (Fig. 7.24) | 407 | ||
| Modified ober test: tensor fascia lata (see Ferber et al. 2010, Milner et al. 2010) (Fig. 7.25) | 408 | ||
| Rectus femoris (Sahrmann 2002) (Fig. 7.26) | 409 | ||
| M. piriformis (Tonley et al. 2010) (Fig. 7.27) | 409 | ||
| Adductors (Fig. 7.28) | 409 | ||
| Screening of other structures in ‘plan’ | 410 | ||
| Palpation | 410 | ||
| Passive test procedures | 411 | ||
| Flexion/adduction | 411 | ||
| Localization of forces (position of therapist’s hands) | 412 | ||
| Application of forces by therapist (method) | 412 | ||
| Variations of F/Ad as an examination technique | 412 | ||
| Progression of examination | 412 | ||
| Differentiation tests | 413 | ||
| Uses of flexion/adduction and its variations | 414 | ||
| Accessory movements | 414 | ||
| Specific tests for restricted gliding movements | 414 | ||
| Restricted posterior gliding (Fig. 7.38) | 414 | ||
| Test in flexion/adduction: right hip (Addison 2004) | 416 | ||
| Restricted anterior gliding | 416 | ||
| Stability tests | 416 | ||
| Excessive anterior gliding dysfunction (Sahrmann 2002) (Fig. 7.39) | 416 | ||
| Excessive posterior gliding dysfunction (Fig. 7.41) | 416 | ||
| Excessive lateral gliding dysfunction | 417 | ||
| Treatment | 417 | ||
| Passive mobilizing techniques: accessory movements | 417 | ||
| Lateral movement (Figs 7.42, 7.43) | 417 | ||
| Localization of forces (position of therapist’s hands) | 418 | ||
| 8 Management of knee disorders | 450 | ||
| Chapter contents | 450 | ||
| Introduction | 450 | ||
| Applied theory and evidence supporting practice | 451 | ||
| Anatomy | 451 | ||
| Stability and mobility | 452 | ||
| Movement patterns, motor control patterns | 452 | ||
| Range of motion | 452 | ||
| Nerve supply | 453 | ||
| Pathobiological processes | 453 | ||
| Osteoarthritis of the knee | 453 | ||
| OA-related research | 455 | ||
| ‘Anterior knee pain’ | 457 | ||
| Total knee replacement | 457 | ||
| Clinical reasoning | 461 | ||
| Subjective examination | 461 | ||
| Main problem (‘Question 1’) | 462 | ||
| Locking | 462 | ||
| Catching | 462 | ||
| Instability – ‘giving way’ | 462 | ||
| Swelling | 462 | ||
| Areas of symptoms (body chart) | 462 | ||
| Behaviour of symptoms – activity limitations | 462 | ||
| History | 463 | ||
| Medical and health screening questions | 463 | ||
| Physical examination | 463 | ||
| Present Pain | 464 | ||
| Observation | 464 | ||
| Alignment | 464 | ||
| Functional demonstration tests | 466 | ||
| Brief appraisal | 466 | ||
| Active movements | 466 | ||
| Weight bearing | 466 | ||
| Active tests of the knee (in non-weight bearing) | 467 | ||
| Extension (supine) | 467 | ||
| Flexion (Fig. 8.2) | 467 | ||
| In 90° of flexion: medial rotation, lateral rotation | 468 | ||
| If necessary tests | 468 | ||
| Muscle tests | 468 | ||
| Isometric tests – as symptom reproduction | 468 | ||
| Recruitment patterns, patellar alignment and symptom reproduction | 468 | ||
| Muscle function and strength tests | 470 | ||
| Muscle length tests | 470 | ||
| Screening of other structures ‘in plan’ | 470 | ||
| Palpation | 474 | ||
| Temperature | 474 | ||
| Effusion | 474 | ||
| Swelling | 474 | ||
| Tenderness | 474 | ||
| Passive tests | 475 | ||
| Movement diagram | 475 | ||
| Stability, integrity and meniscus testing | 475 | ||
| Passive test movements of the various knee components | 477 | ||
| Tibiofemoral joint | 477 | ||
| Patellofemoral joint | 478 | ||
| Superior tibiofibular joint | 480 | ||
| Treatment | 481 | ||
| Selection | 481 | ||
| Group 1 – pain | 482 | ||
| Accessory movements in a part of the range that is totally free of any pain or discomfort | 482 | ||
| Physiological movements | 482 | ||
| Group 2 – stiffness | 483 | ||
| Group 3 – pain with stiffness | 483 | ||
| Group 4 – momentary pain | 484 | ||
| Tibiofemoral joint | 485 | ||
| Patellofemoral joint | 485 | ||
| Superior tibiofibular joint | 488 | ||
| Description of techniques | 488 | ||
| Physiological movements of the tibiofemoral joint: examination and treatment techniques | 488 | ||
| Extension (Fig. 8.31) | 488 | ||
| Localization of forces (position of therapist’s hands) | 488 | ||
| Application of forces by therapist (method) | 488 | ||
| Variations in the application of forces | 488 | ||
| Uses | 488 | ||
| Extension/abduction, extension/adduction (extension) (see Fig. 8.18) | 489 | ||
| An example of this concept’s approach | 489 | ||
| Localization of forces (position of therapist’s hands) | 489 | ||
| 9 Management of foot and ankle disorders | 512 | ||
| Chapter contents | 512 | ||
| Introduction | 512 | ||
| Anatomy and regions of the foot and ankle | 512 | ||
| Movements of the foot and ankle | 514 | ||
| Axes and planes of movements | 514 | ||
| Movements of the single joints | 514 | ||
| Distal tibiofibular joint (syndesmosis) | 514 | ||
| Talocrural joint | 514 | ||
| Subtalar joint | 515 | ||
| Midtarsal joint | 515 | ||
| Rays | 515 | ||
| The first metatarsophalangeal joint | 515 | ||
| Musculoskeletal foot and ankle disorders | 516 | ||
| Typical medical diagnoses of the foot and ankle | 516 | ||
| Plantar fasciitis | 516 | ||
| Diagnosing plantar heel pain | 516 | ||
| Chronic ankle instability | 516 | ||
| Chronic ankle instability and mobility of the ankle | 517 | ||
| Chronic ankle instability and pain | 517 | ||
| Cognitive processes and injury | 517 | ||
| Chronic musculoskeletal foot and ankle disorders | 517 | ||
| Psychosocial factors of pain and disability | 518 | ||
| Psychosocial factors and neurophysiological pain mechanisms | 519 | ||
| Psychosocial factors and musculoskeletal foot and ankle disorders | 519 | ||
| Lifestyle factors and musculoskeletal foot and ankle disorders | 519 | ||
| Work-related factors and musculoskeletal foot and ankle disorders | 519 | ||
| Subjective examination | 520 | ||
| Kind of disorder | 520 | ||
| Symptom area(s) | 521 | ||
| Behaviour of the symptom(s) | 522 | ||
| Behaviour of the patient according to the disorder | 522 | ||
| History of the symptoms | 522 | ||
| History of the patient’s behaviour according to the disorder | 523 | ||
| Medical screening questions | 523 | ||
| Planning the physical examination | 523 | ||
| Reflection on the subjective examination | 523 | ||
| Expressing hypotheses categories | 523 | ||
| Nature of the disorder | 524 | ||
| Source of the symptoms | 524 | ||
| Neurophysiological pain mechanisms | 524 | ||
| Direction of the impairment | 524 | ||
| Contributing factors | 524 | ||
| Intervention | 525 | ||
| Precautions and contraindications | 525 | ||
| Prognosis | 525 | ||
| Planning physical examination procedures | 525 | ||
| Physical examination | 525 | ||
| Observation in non-weight bearing | 525 | ||
| Observation in weight bearing | 527 | ||
| Functional tests | 527 | ||
| Observation of gait | 528 | ||
| Active movements | 528 | ||
| Passive movements | 528 | ||
| Provocation tests | 528 | ||
| Treatment techniques | 528 | ||
| Passive physiological movements of the foot and ankle | 530 | ||
| Plantar flexion (Fig. 9.5) | 530 | ||
| 1 The Maitland Concept as a clinical practice framework for neuromusculoskeletal disorders | e1 | ||
| 2 The Maitland Concept: | e3 | ||
| 3 Management of craniomandibular disorders | e5 | ||
| 4 Management of shoulder and shoulder girdle disorders | e9 | ||
| 5 Management of elbow disorders | e12 | ||
| 6 Management of wrist and hand disorders | e14 | ||
| 7 Management of hip disorders | e17 | ||
| 8 Management of knee disorders | e20 | ||
| 9 Management of foot and ankle disorders | e23 | ||
| Vertebral manipulation | e25 | ||
| Chapters from 4th edition/Bonus text for eResources | e26 | ||
| Principles of assessment | e26 | ||
| Chapter contents | e26 | ||
| Glossary of terms | e26 | ||
| Introduction | e27 | ||
| Communication | e28 | ||
| Balance between procedures and interactions: client centredness | e28 | ||
| Interview style | e29 | ||
| Purposes of assessment | e29 | ||
| Forms of assessment | e29 | ||
| Assessment at initial examination | e30 | ||
| Algorithm for first session(s) | e30 | ||
| Objectives of the first session(s) | e30 | ||
| Causes and contributing factors | e31 | ||
| Treatment planning | e31 | ||
| Treatment objectives regarding movement dysfunctions | e31 | ||
| Cognitive and affective goals | e31 | ||
| Selection of interventions | e32 | ||
| Therapeutic relationship and active integration of the patient | e32 | ||
| Precautions and contraindications | e32 | ||
| Direct-contact practitioners | e33 | ||
| Contraindication or precaution? | e33 | ||
| Precautions | e34 | ||
| Physical examination | e34 | ||
| Precautions in treatment planning | e34 | ||
| Summary: purpose of initial assessment | e35 | ||
| Reassessment | e35 | ||
| Indicators of change | e36 | ||
| Quality of communication during reassessment procedures | e36 | ||
| Subjective reassessment | e36 | ||
| Convert statements of fact into comparisons | e36 | ||
| Some relevant communication techniques in reassessment procedures | e37 | ||
| Collaborative goal setting and parameter definition | e37 | ||
| Balance in reassessment in subjective and physical parameters | e38 | ||
| Measurable changes | e38 | ||
| Behavioural parameters | e38 | ||
| Change within the first 24 hours after treatment | e39 | ||
| The ‘art’ of reassessment | e39 | ||
| Which interventions influence which parameters? | e39 | ||
| Follow multiple parameters in reassessment procedures | e40 | ||
| Profound reassessment | e40 | ||
| A balanced approach to reassessment and therapeutic interventions | e40 | ||
| Reassessment of cognitive objectives | e40 | ||
| Cognitive–behavioural perspective to reassessment procedures | e41 | ||
| Therapy as a learning process | e41 | ||
| Guide patients in their experience | e41 | ||
| Reassessment of physical examination tests | e41 | ||
| A balanced approach to reassessment of pain and function and activity – use of metaphors | e43 | ||
| Metaphors | e43 | ||
| Functional demonstrations in physical examination | e43 | ||
| Conclusion: reassessment | e43 | ||
| Assessment during treatment | e43 | ||
| ‘Nothing at the price of’ | e44 | ||
| Pain responses during the application of passive movement techniques | e44 | ||
| Progressive analytical assessment: retrospective and prospective assessment | e45 | ||
| Retrospective assessment in review phases | e45 | ||
| Prospective assessment | e46 | ||
| If therapy seems to be stagnating | e46 | ||
| Planned break from treatment | e47 | ||
| Conclusion: retrospective and prospective assessment | e47 | ||
| Final analytical assessment | e47 | ||
| Assessment and clinical reasoning | e49 | ||
| Interactive clinical reasoning | e49 | ||
| Narrative clinical reasoning | e49 | ||
| Procedural clinical reasoning | e50 | ||
| Hypothesis deduction and induction | e50 | ||
| Cyclical process | e50 | ||
| Categorization of hypotheses | e50 | ||
| Reflection | e52 | ||
| Clinical patterns: illness scripts | e52 | ||
| Pattern development by ‘trial and error’ | e53 | ||
| Differences between experts and novices | e54 | ||
| Conclusion: procedural clinical reasoning | e54 | ||
| Psychosocial assessment as an integral part of the physiotherapy assessment | e54 | ||
| Objectives of psychosocial assessment in physiotherapy | e54 | ||
| Appendix 1 Self-management strategies: Compliance and behavioural change | 558 | ||
| Chapter contents | 558 | ||
| Compliance | 559 | ||
| Barriers to compliance | 559 | ||
| Cognitive–behavioural approach | 559 | ||
| Habits don’t change overnight – phases of change | 560 | ||
| Motivational phase | 560 | ||
| Short-term compliance | 561 | ||
| Long-term compliance | 561 | ||
| Compliance enhancement strategies | 561 | ||
| Selection of coping strategies to control pain and wellbeing | 562 | ||
| Example | 562 | ||
| Integration of the exercises into daily life situations | 562 | ||
| Conclusion | 563 | ||
| References | 564 | ||
| Appendix 2 Recording | 565 | ||
| Chapter contents | 565 | ||
| Introduction | 565 | ||
| SOAP notes | 566 | ||
| Asterisks | 567 | ||
| Conditions | 567 | ||
| Some remarks with regards to recording | 567 | ||
| Recording of subjective examination findings | 568 | ||
| Body chart | 568 | ||
| Clinical tip | 568 | ||
| Behaviour of symptoms and activities | 568 | ||
| History | 569 | ||
| Recording of physical examination findings | 570 | ||
| Active movements | 570 | ||
| Passive movements | 572 | ||
| Recording of treatment interventions | 573 | ||
| Examples: | 573 | ||
| Other forms of treatment: | 574 | ||
| Information, instructions, exercises, warning at the end of a session | 574 | ||
| Example | 574 | ||
| Recording of follow-up sessions | 574 | ||
| Retrospective assessment | 574 | ||
| Written records by the patient | 575 | ||
| Conclusion | 575 | ||
| References | 576 | ||
| Index | 577 | ||
| A | 577 | ||
| B | 578 | ||
| C | 578 | ||
| D | 580 | ||
| E | 580 | ||
| F | 581 | ||
| G | 582 | ||
| H | 582 | ||
| I | 583 | ||
| J | 584 | ||
| K | 584 | ||
| L | 584 | ||
| M | 585 | ||
| N | 586 | ||
| O | 586 | ||
| P | 586 | ||
| Q | 587 | ||
| R | 588 | ||
| S | 588 | ||
| T | 590 | ||
| U | 591 | ||
| V | 591 | ||
| W | 591 | ||
| Y | 591 |