Orthotics and Prosthetics in Rehabilitation

This comprehensive text offers an up-to-date, evidence-based approach to rehabilitation for people with prosthetic and orthotic issues, with a focus on interdisciplinary model of care; it is a great resource for assessment, treatment planning, and outcome evaluations for prosthetic/orthotic students. For clinicians, the book reinforces the importance of ongoing evaluation of assessment tools and provides practical treatment strategies for orthotic and prosthetic rehabilitation. Orthotics and Prosthetics in Rehabilitation is a collaborative effort with knowledgeable contributors from orthotics, prosthetics, physical and occupational therapy, medicine, and surgery. Learning objectives for each chapter are clearly identified. The tables and illustrations are of good quality and add value to the text. A thorough and up-to-date reference list at the end of each chapter indicates that information is current. Each chapter ends with case studies that challenge the reader to critically problem-solve clinical scenarios and develop intervention strategies. The book is divided into three parts. Part 1 covers baseline knowledge of factors that can influence orthotic and prosthetic rehabilitation outcomes, such as multidisciplinary approach, ageing and activity tolerance, motor learning, gait assessment, and footwear. A chapter titled “Motor Control and Motor Learning” reviews the current understanding of human motor control and the process of motor learning. Concepts such as type of feedback, when and how feedback should be used, mental imagery and practice, the role of sleep in motor learning, and the importance of patient-centred goals will help practitioners to plan interventions that will enhance retention of motor learning for people with movement impairments. Part 2 outlines the principles of designing and fitting orthoses for individuals with musculoskeletal dysfunction and neurological impairments. Information on orthotic management of various conditions, from bracing options for people with knee dysfunction to splinting techniques for contracture management for people with burns, is useful. The text emphasizes the benefits of soliciting input from all rehabilitation team members in selecting the most appropriate orthotic device to maximizing a person's function. The chapter on lower-extremity orthosis reviews factors to consider when prescribing an orthotic device and clearly outlines the criteria for prescribing stance-control orthotic knee joints in the knee-ankle-foot orthosis (KAFO) and who will benefit from this orthosis. Part 3 is devoted to current rehabilitation prosthetics options. The chapter on wound healing and the high-risk foot discusses up-to-date options for managing wound-healing issues, from dressings to orthotics to the use of therapeutic modalities. The chapters that follow, which cover amputation surgery levels and pre-prosthetic/prosthetic management, are augmented with clear illustrations and provide a sound knowledge base on the rehabilitation process following amputation. The chapter dealing with early rehabilitation of lower-extremity dysvascular amputation includes a comprehensive, user-friendly table on common prosthetic gait deviations for the transfemoral and transtibial prosthetic user. The table separates possible causes of gait deviations into intrinsic (client-related) factors and extrinsic (prosthetic or environmental) factors, and will help guide therapists in their clinical decision-making for determining the possible reasons for gait deviations (i.e., client vs. prosthetic). The chapter focusing on advanced rehabilitation for people with microprocessor knees covers common mobility problems and provides prosthetic and practical training solutions to asymmetric step length, stairs and ramps, sitting and squatting, and fall protection. The accompanying photographs are helpful in demonstrating treatment techniques. This text is well written, covering the important aspects of orthotic and prosthetic care. It is a valuable clinical resource for practitioners involved in prosthetic and orthotic rehabilitation, and would be a well-used resource for both clinicians and students.