Table Of ContentSIXTH EDITION
Physical
Rehabilitation
SIXTH EDITION
Physical
Rehabilitation
Susan B. O’Sullivan, PT, EdD Thomas J. Schmitz, PT, PhD George D. Fulk, PT, PhD
Professor Emerita Professor Emeritus Chair and Associate Professor
Department of Physical Therapy Department of Physical Therapy Department of Physical Therapy
School of Health and Environment School of Health Professions Clarkson University
University of Massachusetts Lowell Long Island University Potsdam, New York
Lowell, Massachusetts Brooklyn Campus
Brooklyn, New York
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Library of Congress Cataloging-in-Publication Data
Physical rehabilitation / [edited by] Susan B. O’Sullivan, homas J. Schmitz, George D. Fulk. — 6th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8036-2579-2
I. O’Sullivan, Susan B. II. Schmitz, homas J. III. Fulk, George D.
[DNLM: 1. Physical herapy Modalities. 2. Disability Evaluation. 3. Orthopedic Equipment. 4. Physical Examination.
WB 460]
RM700
615.8´2—dc23
2013015288
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P R E F A C E
With the sixth edition of Physical Rehabilitation, we con- to continue to critically examine clinical practice using
tinue a tradition of striving for excellence that began validated clinical methodologies. We also hope it will
more than 25 years ago. We are gratified by the contin- inspire enthusiasm about the importance of continuous,
uing wide acceptance of PhysicalRehabilitationby both lifelong, self-directed learning.
faculty and students. he visuals have been substantially enhanced with the
he text is designed to provide a comprehensive ap- addition of many new illustrations and photographs.
proach to the rehabilitation management of adult patients. Changes in design and the introduction of a full-color
As such, it is intended to serve as a primary textbook for format provide a reader-friendly environment, as well as
professional-level physical therapy students, and as an im- augment understanding of content. New to the sixth
portant resource for practicing therapists as well as for other edition are 13 online case studies with accompanying
rehabilitation professionals. he sixth edition recognizes video segments illustrating aspects of the initial exami-
the continuing growth of the profession and integrates nation, interventions, and outcomes for patients under-
basic and applied clinical research to guide and inform ev- going active rehabilitation. he cases were authored by
idence-based clinical practice. It also integrates terminol- practicing therapists from various parts of the country
ogy, practice patterns, specific tests and measures, and who were directly involved in the care of the case study
interventions presented in the American Physical herapy patient participant. he case studies include patients
Association’s Guide to Physical herapist Practice and the with chronic obstructive pulmonary disease and respira-
World Health Organization’s International Classification tory distress syndrome, burns, amputation, spinal cord
of Functioning, Disability, and Health(ICF). injury, Parkinson’s disease, traumatic brain injury,
Physical Rehabilitation is organized into three sec- stroke, and vestibular dysfunction. Questions are posed
tions. Section One (Chapters 1–9) includes chapters on that address key elements in developing the plan of care
clinical decision making and examination of basic sys- for each patient. All case study materials (patient history,
tems, as well as examination of functional status and the examination data, video segments, answers to guiding
environment. Section Two (Chapters 10–29) addresses questions for student feedback) are available online at
many of the diseases, disorders, and conditions com- DavisPlus.
monly seen in the rehabilitation setting. Appropriate Also new to this edition are sample examination ques-
examination and intervention strategies are discussed tions consistent with the format of the National Physical
for related body structure/function impairments, activ- herapy Examination. In separate files, answers to the
ity limitations, and restrictions in social participation. questions are provided for student feedback that are also
Health promotion and wellness strategies are also con- available at DavisPlus.
sidered. Emphasis is placed on parameters of learning As we have noted in previous editions, our greatest
critical to ensuring the patient/client can achieve antic- asset and inspiration in preparing the sixth edition of
ipated goals and expected outcomes. he final section, Physical Rehabilitation has been an outstanding group
Section hree (Chapters 30–32), includes orthotics, of contributing authors. We are most fortunate to have
prosthetics, and the prescriptive wheelchair. this group of talented individuals whose breadth and
A central element of the text is a strong pedagogical scope of professional knowledge and experience seems
format designed to facilitate and reinforce the learning unparalleled. hese individuals are recognized experts
of key concepts. Each chapter of Physical Rehabilitation from a variety of specialty areas who have graciously
includes an initial content outline, learning objectives, shared their knowledge and clinical practice expertise
an introduction and summary, review questions for self- by providing relevant, up-to-date, and practical infor-
assessment, and extensive references. Additional supple- mation within their respective content areas. To our
mental readings and recommended resources are also group of contributors, we enthusiastically welcome the
provided. Key terms are bolded throughout each chap- many talented, dedicated clinicians whose knowledge
ter indicating their inclusion in a master glossary toward and clinical skills are well represented in the online case
the end of the text. Application of important concepts study materials that accompany the text. To the sixth
is promoted through end-of-chapter case study exam- edition, a welcome is also extended to George D. Fulk
ples and guiding questions designed to enhance clinical as a new contributing editor.
decision making skills. Disability-focused chapters con- he sixth edition has also benefited from the input of
tain Evidence Summary Boxesthat summarize and criti- numerous individuals engaged in both academic and
cally appraise research focused on a particular topic or clinical practice settings who have used and reviewed the
intervention relevant to the chapter content. Our hope content. We are grateful for their constructive feedback
is that the boxes may provide a model for readers and have instituted many of their suggestions and
v
vi Preface
changes. As always, we welcome suggestions for im- We acknowledge the very important contributions
provements from our colleagues and students. that physical therapists make in the lives of their patients.
As physical therapists continue to take on more and his book is dedicated to those therapists—past, present,
greater professional responsibilities and challenges, the and future—who guide and challenge their patients to
very nature of this text makes it a perpetual “work in lead a successful and independent life.
progress.” We are grateful for the opportunity to con-
—SUSAN B. O’SULLIVAN
tribute to the academic literature in physical therapy, as
THOMAS J. SCHMITZ
well as to the professional development of those prepar-
GEORGE D. FULK
ing to enter a career devoted to improving the quality of
life of those we serve.
C O N T R I B U T I N G E D I T O R S
Case Study and Multimedia Editor Test Bank Editor
Edward W. Bezkor, PT, DPT, OCS, MTC Evangelos Pappas, PT, PhD, OCS
University of California, San Diego Health System Associate Professor
Perlman Clinic, Rehabilitation Services Department of Physical herapy
La Jolla, California School of Health Professions
Long Island University
New York University Langone Medical Center
Brooklyn Campus
Rusk Institute of Rehabilitation Medicine
Brooklyn, New York
New York, New York
vii
C O N T R I B U T I N G A U T H O R S
Andrea L. Behrman, PT, PhD, FAPTA Joan E. Edelstein,PT,MA, FISPO, CPed
Professor Special Lecturer
Department of Neurological Surgery Program in Physical herapy
University of Louisville Columbia University
Louisville, Kentucky New York, New York
Edward W. Bezkor, PT, DPT, OCS, MTC George D. Fulk, PT, PhD
University of California, San Diego Health System Chair and Associate Professor
Perlman Clinic, Rehabilitation Services Department of Physical herapy
La Jolla, California Clarkson University
Potsdam, New York
New York University Langone Medical Center
Rusk Institute of Rehabilitation Medicine Jessica Galgano, PhD, CCC-SLP
New York, New York Associate Research Scientist
Department of Rehabilitation Medicine
Janet R. Bezner, PT, PhD
School of Medicine
Vice President
New York University
Education and Governance and Administration
New York, New York
American Physical herapy Association
Alexandria, Virginia Maura Daly Iversen, PT, DPT, SD, MPH
Professor and Chairperson
Beth Black, PT, DSc
Department of Physical herapy
Assistant Professor
School of Health Professions
Physical herapy Program
Bouve College of Health Sciences
School of Health Sciences
Northeastern University
Oakland University
Boston, Massachusetts
Rochester, Michigan
Clinical Epidemiologist
Judith M. Burnfield, PT, PhD
Division of Rheumatology, Immunology and Allergy
Director, Institute for Rehabilitation Science and
Brigham and Women’s Hospital
Engineering
Harvard Medical School
Institute for Rehabilitation Science and Engineering
Boston, Massachusetts
Madonna Rehabilitation Hospital
Lincoln, Nebraska Deborah Graffis Kelly, PT, DPT, MSEd
Associate Professor
Kevin K. Chui, PT, DPT, PhD, GCS, OCS
Division of Physical herapy
Associate Professor
Department of Rehabilitation Sciences
Department of Physical herapy
College of Health Sciences
Program in Geriatric Health and Wellness
University of Kentucky
College of Health Professions
Lexington, Kentucky
Sacred Heart University
Fairfield, Connecticut Bella J. May, PT, EdD, FAPTA, CEEAA
Professor Emerita
Vanina Dal Bello-Haas, PT, PhD
Georgia Health Science University
Associate Professor
August, Georgia
Assistant Dean, Physiotherapy Program
School of Rehabilitation Science Adjunct Professor of Physical herapy
McMaster University California State University Sacramento
Hamilton, Ontario Sacramento, California
Canada
Coby D. Nirider, PT, DPT
Konrad J. Dias, PT, DPT, CCS Area Director of herapy Services
Associate Professor Touchstone Neurorecovery Center
Program in Physical herapy Conroe, Texas
Maryville University of St. Louis
St. Louis, Missouri
ix
