Alignment in Postural and Movement Transitions in the Normal Adult

no Part 1 has Ms Bohman speaking and reflects the ethos of the video in its simplicity. It specifically to camera and explaining the addresses those at risk, using a principles of NDT, including its check-list format, with additional development as a concept and the bullet points for carers.The presen- part played by Berta Bobath. The tation is attractive and user friendly term NDT is not clarified. Patient demonstrations constiand succinctly reinforces the video’s message. Both booklet and video tute tapes 2 to 5. Ms Bohman is raise awareness of the most impor- seen treating a variety of patients tant factors; they are not intended with problems of balance, muscle to offer comprehensive coverage of tone, postural alignment, and selecthe subject. Both explain how to tive movement. She treats all the access professional help, ifrequired. patients alone, using an array of Michele Williamson equipment where perhaps another MSc BSc MCSP pair of hands would be preferable. This may, of course, reflect clinical practice in the USA. None of the Ailgnment in Postural and patients is ‘uncomplicated‘. Time Movement Transitions in since onset varies from five months the Normal Adult to six years. The 12-year-old-girlin by Isabelle M Bohman MS PT (1993). part 3 is presented five years after Available from Winslow, Telford Road, brain injury. &ester, Oxon OX6 OTS. f125 per set. The series follows a logical The Adult Hemiplegia Treatment progression. At the start of each of series comprises several tapes: part the patient demonstration tapes 1 ‘Introduction to Treatment there is a short resume of the Concepts and Ap&cation of NDT patient’s history and functional Principles’, part 2 ‘Preparation for Moving into Gait’, part 3 ‘Gaining Runk Mobilily and Head Control in a Head Iqiured Adolescent’, part 4 A Self-Help Guide to Working for Better Alignment in Back Pain Sitting and Standing‘, and part 5 by Anita Eanfonl MCSP HT.presented by ’Preparing for Weight Bearing on an Dave Kilner and Maggie Jarrold. DistribArm‘. They were produced in Albu- uted by Ericson Physiotherapy Video, querque, New Mexico. The tapes Ericson House, 42 Kenwood Road, focus on normal movement, princi- Sheffield 57 INQ. f12.95 plus pep. plea of NDT and the application of Duration 30minutes. these principles in the treatment of This video focuseson a self-management regime for the care of low back neurologically damaged patients. There is no accompanying litera- pain. It systematically deals with ture but the ‘blurb’ on the pack- various issues involved i n back aging indicates that the videos pain, starting with an overview of are intended for use by qualified spinal anatomy and pathology and physiotherapists ‘to observe the progressing to posture (with the clinical thinking and approach of demonstration of good and bad experienced therapists’. The exper- posture) and postural exercises, ienced therapist in question is ergonomic issues, liftingtechniques, Isabelle Bohman, whom, we are told the identification of risk areas in in the voice-over which starts every the home and how to avoid them. It tape, is an ‘internationally recog- also provides a routine.of easy exernised‘ physical therapist working cises to do at home and a s u m m a r y of dos and don’ts. in the USA. To date the majority of selfIn the introductory tape, ‘Alignment in Postural and Movement management tools have been in the Transitions in the Normal Adult’, form of books. However, the author the viewer is assumed to have no of this self-management guide has knowledge of normal movement, chosen to use a video. Its advanand is encouraged to join in with tages are that exercises can be two normal subjects performing 18 demonstrated and examples given activities. Variations in the normal of how, for example, to correct poor are not discussed.At one point the posture. In books, exercises are models demonetrate a ’typical hemi- usually only shown at their starting plegic gait’ which is of doubtful and finishing positions and it is often easier to demonstrate things value.

abilities. The aims of treatment are then discussed and the success or otherwise in achieving them examined after the treatment session. Each tape opens with a rather poorly designed and amateurish logo. Ms Bohman seems ill at ease when speaking to camera but when describing her practice in a voiceover is much more fluent and appears more enthusiastic. It would be helpful, however, to hear the actual interaction between therapist and patient sometimes. The filming is evidently done in a working department and the background is a little distracting. Despite the weaknesses in presentation and the unfavourable first impression, this is a wellthought-out video series whose content would be useful to students, junior physiotherapists and those new to, or returning to, working with neurologically impaired patients. Hilary Mann MCSP

than attempt to describe them in words. A video therefore leads to easier comprehension by low back pain sufferers. The video deals with many preventive issues and how to avoid back pain in the future.Although a series of exercises is given, these exercises deal only with flexibility issues and a programme of muscle strengthening for both the erector spinae and abdominal muscles is not provided. Strengthening exercises that are bad for the back are demonstrated during the ‘dos and don’ts’ section but there is no demonstration of how these exercises could be performed without damaging the spine. Pain is usually the main concern of patients with back problems, but no advice is given on simple ways of pain management. However, this video is a useful tool to reinforce back school teaching and physiotherapy management, which can be recommended or loaned out to patients. It also has potential as a tool for avoiding back pain, and could thus easily be incorporated into preventive regimes.

A H McGregor MSc MCSP