Customer Reviews: Rehabilitation of the Spine: A Practitioner's Manual
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on May 26, 2006
This is one of the most comprehensive texts for rehabilitation of the spine I have seen in over 10 years of practice. As a physical therapist, I've learned that spine rehabilitation requires a broad knowledge of techniques, since every spine patient is different. The modern practitioner needs to have an ecelctic approach to rehabilitation since no 2 patients are alike, even with the same diagnosis. Dr. Liebenson has done a great job in providing the scientific and clinical application of a variety of spine rehabilitation principles with a multidisciplinary approach including a virtual "who's who" of physicians, chiropractors, physical therapists, and researchers from around the world. Of particular interest to me is the Czech approach to spinal rehabilitation based on contributions from legendary physicians Vladimir Janda and Karel Lewit. Top researchers including Bogduk, McGill, and Hodges also present the latest evidence-based interventions. I was quite pleased to see the amount of photographs and diagrams illustrating specific techniques and exercises, which is even further enhanced with videos on the enclosed DVD. Long gone (I hope) are the days of "hot packs, ultrasound and massage" as the treatment of choice for low back pain. We know that exercise is the most important component in back rehabilitation, but we must first be able to accurately assess the patient and prepare the tissues for exercise programs specific to the patient needs and goals. Dr. Liebenson and his contributors have given us the tools do do just that... they have captured a virtual paradigm shift in the way we approach the assessment and rehabilitation of the spine. I highly recommend this textbook for any healthcare professional treating spine patients.
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on November 11, 2006
Liebenson, Craig. Rehabilitation of the Spine: A Practitioner's Manual, 2nd edition. 2007.

By Ron LeFebvre, DC, Dean of Clinical Education, Western States Chiropractic College.

Because busy practitioners often rapidly skim articles, especially book reviews, let me start with the bottom line. Dr. Liebenson's second edition of Rehabilitation of the Spine is a "must" book. Any practitioner or student interested in physical rehabilitation of the spine must own and must read this book. The contributing authors represent an impressive array of some of the most notable experts across multiple disciplines, including Nikolai Bogduk, Paul Hodges, Vladimir Janda, Gwendolen Jull, Karel Lewit, Steven Linton, Stuart McGill, Robin McKenzie, Don Murphy, Vert Mooney, John Triano, and Howard Vernon. The cast is much larger yet, is international in reach, and represents some of the most important schools of thought in rehabilitation today. The second edition significantly improves upon the first, which was itself, a watershed document. Every chapter has been re-written and updated. The basic science chapters offer an exceptional overview for the clinical practitioner of what we have learned about the mechanics of the spine over the last 10 years. It re-establishes the foundation upon which so much of our practical rehabilitation lies. It also gives us a lens through which to judge both old and new approaches and techniques. But above all, this is a practitioner's manual, replete with a level of detail that is essential for actual application. In many of the chapters, one can almost hear the voice of an experienced workshop instructor correcting common errors in technique and imparting expert advice. The inclusion of the DVD-ROM is a huge leap forward, taking a lot of the guesswork out of trying to interpret what is written on the printed page. It also has the potential to standardize at least some procedures across multiple disciplines. This could have positive implications for co-treatment within or across professions and could provide a common therapeutic and assessment language for research.

The lay out of the book re-enforces the clinical strategy espoused, having sections devoted first to assessment, then the first 4 weeks of acute care, followed by later recovery care. Then the whole strategy is again re-packaged by region.

Having a keen interest in the field myself, I specifically perused the book for a few specific "bell weather" indicators. I was pleased to see a chapter devoted to manipulation of the spine, an omission which I thought was a weakness in the first edition. For those steeped in some of the current controversies in lumbar stabilization, I found it very interesting to compare the arguments posited by McGill and Hodges regarding the relative value of teaching patients to perform abdominal bracing versus abdominal hollowing. I was pleased to see that the simple and elegant three question Patient Specific Functional Scale was contained in the chapter on Outcome Assessment. And that DeFranca's section on pre-manipulation procedures for the cervical spine abandoned the recommendation to perform DeKleyn's maneuver and or any other extreme positioning of the neck--procedures which have a good sold base of evidence holding them to be worthless. I also noted that Janda's interpretation of the muscle firing pattern associated with hip extension has been abandoned (because of subsequent research findings).

The book also has welcome additions in the arena a neuromobilization, a much improved chapter on breathing, and many interesting additions from the Czech school of rehabilitation. Although not all of these schools of thought work together in complete harmony and although there are often significant differences in practical application, Dr. Liebenson has a real knack for organizing them into a coherent organization that suggests more agreement than disagreement in their overall strategies. The three great strategic pillars support the grand "unifying theory" behind the manual: a variety of approaches to hands-on manual therapy, specific low tech exercise prescription, and focused activity modification for the patient.
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on March 17, 2006
--- Note: This review is for the 2nd edition only. ---

Craig Liebenson has accomplished a monumental task with this 972 page tome that covers back rehab from A to Z. In the first 90 pages he exhaustively covers the back pain rehab literature with a special focus on Low Back Pain (LBN.) With 100's of references per chapter, (279 for Chapter One alone!) he convincingly shows the failure of conventional approaches and the new hope for LBN sufferers offered by the latest soft tissue techniques combined with patient reeducation and exercise prescription.

Then he turns the book over to a host of guest experts including Stuart McGill and the Czech pioneers Vladimir Janda and Karel Lewit. They fully cover assessment and treatment for acute and chronic recovery management of back pain with multiple soft tissue modalities fully explained.

This is $100 bucks extremely well spent. If you're a back pain professional who wants to see patients get out of pain, you can't afford not to buy this book.

Chronic back pain CAN be resolved. But only if you're willing to learn something new. This is a GREAT place to start!
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on July 19, 2008
As a neurosurgical resident, the care of the spine patient can be summed up as: "can I cut it out." For many patients, this is helpful. For many others, sadly, my knife cannot help - most of these patients are left without a diagnosis, and more importantly without an explanation for why they are having the troubles they are having.

This book clearly and comprehensively covers the topic of spine pain, providing a context and perspective that I have found extremely useful in the clinical setting. This book can help the spine surgeon give direction to otherwise direction-less patients with life-ruining conditions.

This should be required reading for anyone operating on the spine.
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on June 6, 2006
One of the remarkable aspects of this text, and there are many, is that Dr. Liebenson has added so grandly to his original book. New and re-written chapters reflect the continued evolution of the current biopsychosocial model of lower back pain. New authors have been added and contribute further depth to this updated gem.

The chapters are written by many of the giants of the field, and they don't disappoint. Contemporary perspectives, evaluation and treatment techniques are frequently presented by the researchers whose studies have continued to bring light to the current approach.

This text is appropriate to the practioner who is getting his first exposure to this information as well as the seasoned student. Introductory chapters explore, in great detail, rationalle for current approaches in spinal care. Essentially taking the most current research of the past decade and giving it perspective. Sections on basic science, assessment and treatment all are made contemporary and vibrant as they are taught from the perspective of a multifaceted approach.

This text is NOT a re-tread of basic anatomy, common orthopedic tests(of questionable validity), and treatment options that have not been properly scrutinized. Treatment, including practitioners techniques as well as patient driven active exercise prescriptions, tissue sparing techniqies and behavioral modification are based on specific patient assessment consistent with the biopsychosocial model.

In studying this book you will be challenged to re-evaluate your perspectives and treatment options, and will be exposed to new information and approaches. Scientific evaluations that elucidate the most common generators of lumbar pain are presented in aggressive and compelling fashion. We all must rise to the challenge of incorporating these facts into our understanding of the problems of the spine.

In contrast to a text with only pictures, the enclosed DVD is a tremendous training tool that allows you to see the new techniques and study them repeatedly.

Reading this text is invigorating and will be a wonderful present to your patients.
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on January 9, 2007
This text is the "sine qua non" for spine physicians and therapists who focus on rehabilitation. It establishes a firm foundation for spinal stability and how this process becomes dysfunctional, discussing the neurophysiological, pathophysiological, and biopsychosocial dimensions of the patients we treat. Additionally, more information is provided for the cervical spine and upper and lower extremities. Moreover, the treatment procedures and accompanying DVD are excellent resources for the practitioner. Dr. Liebenson is to be praised and thanked for this needed update to the first edition. The international experts, including Dr. Liebenson, have provided an outstanding text. Many thanks!
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on August 4, 2015
For any clinician that works with the spine, this is a must have. Dr. Liebenson is a pioneer in manual therapy and chiropractic and this book shows it. It is loaded with tons of information from many of the leaders in their fields. Whether you want to learn about the functional paradigm in manual medicine or want to learn how to diagnose low back disorders, this book has what you need. This is one of the few books that is based on the biopsychosocial model. My chiropractic education was mostly founded on the structural paradigm, so this book expanded my knowledge base quite a bit.
I have read this book cover to cover, and I frequently reference this text as it has so much information. I would have loved to see a little more pain physiology included, but that's just me wanting more information. Like I said in the beginning, this is a must have for anyone in the chiropractic or physical therapy professions working with spinal patients.
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on June 16, 2006
As a Licensed acupuncturist focusing on muskuloskeletal pain, I am always looking for pragmatic, integrative data to increase the wellbeing of my patients and their resiliency to injury. Dr. Liebenson did an excellent job in combining top of the line clinical pearls that are ready to melt into one's practice essentially the next day. The DVD is great in adding visual cues to enhance the learning experience acquired throughout the textbook. Excellent work.

Tarek Adra, L.Ac

Los Angeles, CA
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on May 5, 2008
Best comprehensive approach to rehabilitation methods to date. I have taken the diplomate program to get board certified in rehabilitation, the basis of which is from the Rehabilitation of the Spine. Craig Liebenson's book is one of the finest rehab manuals out there today.
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on November 9, 2008
Must have for chiropractic students. I'll be going into clinic soon and this book is a savior. GREAT summarization of the most popular soft tissue techniques and core stabilization.
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