This second edition of David Byfield's valuable text Chiropractic Manipulative Skills reinforces, extends and elaborates on the material previously available. The extremely successful first edition has proven itself internationally to be an essential source of information and support for both undergraduate and postgraduate students of manipulative skills. Dr Byfield recognises that the demands of modern healthcare delivery place enormous responsibilities on clinicians and seeks to provide a firm base for the acquisition and utilization of psychomotor skills. A careful and thoughtful approach to the evaluation of the patient and the decision-making process leading to the application of an adjustive thrust is presented in meticulous detail, giving great confidence to the student of these skills. Expanded topics presented in new chapters include important areas of clinical practice such as paediatrics and geriatrics. The specialized assessment of and manipulative techniques for these groups of patients is especially welcome and is an acknowledgement of the expansion of interest in these areas and the demand for appropriately focused clinical care. The text benefits from clarity of presentation and is supported by the excellent quality of illustrative material. The original text has been revised to reflect new knowledge and this is evident from an expanded literature source. As well as utilizing experts in the field of manipulative skills from the first edition, a wider author base also includes experienced educators. Their understanding of teaching and learning methodologies is reflected in the specificity of every element necessary to achieve the appropriate skill. Attention is paid to both practitioner and patient in recognition that a successful outcome of care involves each participant in the process. The authors are mindful that both participants must be protected from adverse consequences and are exceptionally detailed in both the rationale for and the delivery of the appropriate manipulative thrust. The authors also place much emphasis upon patient safety and comfort during skill acquisition. It is clear that the teaching of psychomotor skills is complex and difficult, requiring patience, practice and dedication. It is also clear that there is an expanding interest in manipulative skills from a clinical, an educational and a research perspective. This newest contribution to the literature is a wonderful source of inspiration to all students and practitioners for whom manipulative skills are essential for patient care. I thank Atlas Clinical Ltd UK for supplying the table and other equipment used in the production of this book. The table that appears throughout this text is a highly developed clinical tool, which, in my opinion, constitutes a foundation for the skilled performance of many chiropractic manipulative skills. The equipment provides comfort for both patient and practitioner and yields clinical adaptability. I once again acknowledge Dr Michael Kondracki as the original model and thank Kristian Ekstrom as the new model for the second edition and for his valuable suggestions during the photo session. I thank also the photographer, Mr Michael Davies from the University of Glamorgan Media Services, Stills Department, University of Glamorgan, for his expertise, patience and professional advice during and after the actual photo sessions. Mr John Dodds, Bournemouth, UK, is still remembered as the original photographer whose work also appears in the second edition. I would like to thank my colleague Dr Michael Barber for his help and expertise during the photographic sessions and chapter revisions. I once again acknowledge my friend and colleague Dr Peter McCarthy for his chapter and for his support throughout this project and our work together at the Welsh Institute of Chiropractic. If it was not for Dr Kim Humphreys and Dr Michael Kondracki things would not be the same. In addition, I would like to welcome Dr Jesper Wiberg, Vince Cascioli, Mark Webster and Dr Annabel Kier and thank them for their contributions. I would also like to thank Professor Susan King for her ability to see the importance of such projects in advancing the quality and standards of chiropractic education. Last but not least I extend my thanks to Claire Wilson and Mary Law at Elsevier for their patience and trust that this project would come in on time. I would also just mention Caroline Makepeace for her belief and conviction from the beginning that the project would succeed against all odds.

Table of Contents:
Chiropractic Manipulative Skills - An Introduction 1. Educational aspects of the teaching and learning of manual psychomotor skills 2. Some biomechanical considerations in manipulative skills training - An evidence-based investigation 3. The physiology of skill performance 4. Postural considerations for the practitioner 5. Hand-arm-shoulder positional skills 6. Manipulative thrust skills, other movements and related exercises 7. Patient positioning skills 8. Identification of important spinal landmarks 9. Pelvic/sacroiliac manipulative skills 10. Lumbar spine manipulative skills 11. Thoracic spine 12. Cervical spine manipulative skills 13. Pediatric manipulative skills 14. Manipulative skills for the pregnant patient 15. Manipulative skills for the elderly/geriatric patient Appendix I - A summary of cardinal rules Appendix II - Recommended sequence of manipulative skills and other considerations