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Spinal Cord Dysfunction — Volume III — Functional Stimulation
362
Multiple Sclerosis: An exercise gulde by Carole Shew BSR (PT) MCPA MCAP and Barbara Low BSR MCPA. University Hospital Rehabilitation Services, Physiotherapy Department, UBC Site, 2211 Westbrook Mall, Vancouve6 British Columbia, Canada v6T 2B5, 1992. Illus. 54 pages. $10.
This booklet begins with some very useful text explaining briefly about multiple sclerosis, fatigue and the value of exercise in the management of the disease. It is pleasing to see that it counsels a cautious approach to self-exercise with warnings about some of the dangers and detrimental dfedsin MS, and is generous in encouraging the MS person to seek guidance and advice from a physiotherapist. The exercises begin with posture in standing and sitting. In this section I found that the illustrations of ‘good posture’ were not careful enough. In the ‘good standing’ example (fig C page 13)it appears that the body weight and centre of gravity is too far back, with the earshoulder-hip plumb-line falling too near to the heels, while the ‘good sitting posture’ illustration shows the hips at a n angle of about 110”(fig B page 14). The other illustrations are good and instructive. The booklet opens in the landscape style. I found the layout puzzling in that the text begins half-way down each page. The sense of this is not apparent until page 13,where it is then obvious that the top half is for the illustrations. However, these only appear on 25 of the 56 pages, leaving the others halfempty. In addition, seven numbered pages are completely blank. It is a pity that the spare space has not been used to better effect, as the typeface of the text is neither noticeably enlarged nor double-spaced, except between paragraphs. The illustrations, where they do appear, are only 3 to 3% inches high or wide, and the excellent little warning notes are, unfortunately, set on a stippled background to appear black-on-grey. I wonder if the authors fully understand the serious limitations of the wide range of visual dysfunctions experienced by a great percentage of people with MS. Nonetheless, this booklet may be usefully recommended by their physiotherapists with due regard to the points raised. Lorraine de Souza MSc FCSP
Spinal Cord Dysfunction Volume 111 Functional Stimulation
-
-
edited by L S ///is. Oxford Univemity Press, 1992 (ISBN 0 19 261919 5). Illus. 360 pages. f50.
This is the third volume in a series of reference books that cover a wide range of pertinent topics and subjects of particular current interest and relevance to the spinal injured population. The content has been inspired by the demands and pressures from this group both to
Physlotherapy, May 1993, vol79, no 5
address the existing needs arising from the pathology of spinal cord injury and to pursue research and developments in this field. As such, this and the previous volumes provide essential reading to all professionals working with the spinally injured. This book is divided into two main sections on experimental and mathematical aspects; and clinical aspects peripheral, central and functional neurochemical stimulation. The authors are international experts. Each of the 15 chapters is well referenced and illustrated mainly with diagrams. Greater use of appropriate photographs would have been valuable. A wide and comprehensive range of aspects of functional stimulation are covered, including recovery in the central nervous system; central functional, experimental nerve-muscle, patterned and functional, electrical, and spinal cord stimulation; engineering and mathematical aspects; and pharmacology and physiology. There is intentional overlap between the content of chapters to stress the emphasis of this book, on ‘plasticity of the adult nervous system including muscle, the reaction of the intact central nervous system to injury or disease, and the possibilities of altering or provoking the undamaged nervous system in such a way as to negate partially the effects of the lesion and to improve function’. This book provides interesting reading, offering a comprehensive background to the many facets of this subject, while also facilitating further study by those specifically working in this field. I recommend it, and the other volumes in this series, to all physiotherapists working with those with spinal cord injury, 80 that they have the relevant knowledge and information resource for their clients. Dorothy Tussler BSc MCSP
-
Brain Injury Rehabilitatlon A neurofunctlonal approach
of applied behavioural analysis and treatment and the text is well referenced. The chapter on ‘Retraining physical skills in functional settings’ includes many similarities to the motor relearning programme, yet I failed to find any reference to this already well-recognised modality. Rood, Brunnstrom, PNF and conductive education are briefly described. The Bobath concept is also called NDT (neurodeveiopwntal), presumably for the American market, and unfortunately the subsequent text given is outdated, quoting, for example, ‘reflex-inhibiting patterns.’ Hence this chapter has little new to offer the physia therapist. However, for neuro-physiotherapists specialising in brain injury the book does have lots of other useful information. It covers a wide range of aspects in relation to brain injury including its nature and consequences, the theories of recovery,. psychological and psychiatric changes, the functional affects of altered perception and cognition and the importance of social skills. The reader is taken through the various rehabilitation processes from the acute stage in intensive care to community reintegration and employment. Many of the chapters are nicely illustrated with short case histories or clinical examples to clarify some theoretical points. There is also an excellent chapter on behaviour modification which may prove useful to therapists trying to limit or remediate behavioural disorders. It does, however, highlight the need, as the book does throughout, for a cohesive approach ideally by a n interdisciplinary team. I would not recommend this book to physiotherapists or hospital departments in general, with other books undoubtedly being more useful, but for a therapist who is part of a team treating this client group it does help to put the non-physical consequences of brain injury into perspective, thereby contributing to the holistic management of what can be a very complex, multi-faceted clinical picture. Cherry Kilbride GradDipPhys MCSP
by Gordon Muir Giles and Jo Clark-Wilson. Chapman and Hall, London, 1993 (ISBN 0 412 33520 4). 437 pages. f14.95.
This book is number 33 in the ‘Therapy in Practice’ series and it is primarily aimed at occupational therapists. The book was co-written by two such professionals, but from opposite sides of the Atlantic - America and England. This dichotomy is subsequently evident in the text, with clinical examples being given from both health care systems, providing some interesting contrasts. The neudunctional approach is said to provide a new frame of reference within occupational therapy, aiming to maximise a client’s functional independence and psychosocial adaptation with a strong emphasis throughout on assessment and treatment in a contextual environment pertaining to the speciiied individual. The client’s pre-morbid life is also taken into consideration. The authors state that the particular techniques which are advocated for use are based on the scientific principles
Aggression: A nurses’ guide to therapeutic management by Gerald A FMIBII and W i n Gray Scutari Press Harrow, 1992 (ISBN 1 871364 60 4). Illus. 158 pages. f14.99.
Many health care professionals are included in the target readership of this book, and need not be deterred by the specific reference to nurses in the title. It suggests reasons for aggressive behaviour and shows how to foresee and defuse aggression before a situation gets out of hand. Practical hints are set out in a workbook style of boxes and diagrams; they do not promise a recipe for every encounter but offer a system for dealing with similar types of problem. The book should be useful for anyone likely to deal with aggressive patienta, and does not overlook the fact that staff may also be angry and hostile without direct justification.
Multiple Sclerosis: An exercise gulde by Carole Shew BSR (PT) MCPA MCAP and Barbara Low BSR MCPA. University Hospital Rehabilitation Services, Physiotherapy Department, UBC Site, 2211 Westbrook Mall, Vancouve6 British Columbia, Canada v6T 2B5, 1992. Illus. 54 pages. $10.
This booklet begins with some very useful text explaining briefly about multiple sclerosis, fatigue and the value of exercise in the management of the disease. It is pleasing to see that it counsels a cautious approach to self-exercise with warnings about some of the dangers and detrimental dfedsin MS, and is generous in encouraging the MS person to seek guidance and advice from a physiotherapist. The exercises begin with posture in standing and sitting. In this section I found that the illustrations of ‘good posture’ were not careful enough. In the ‘good standing’ example (fig C page 13)it appears that the body weight and centre of gravity is too far back, with the earshoulder-hip plumb-line falling too near to the heels, while the ‘good sitting posture’ illustration shows the hips at a n angle of about 110”(fig B page 14). The other illustrations are good and instructive. The booklet opens in the landscape style. I found the layout puzzling in that the text begins half-way down each page. The sense of this is not apparent until page 13,where it is then obvious that the top half is for the illustrations. However, these only appear on 25 of the 56 pages, leaving the others halfempty. In addition, seven numbered pages are completely blank. It is a pity that the spare space has not been used to better effect, as the typeface of the text is neither noticeably enlarged nor double-spaced, except between paragraphs. The illustrations, where they do appear, are only 3 to 3% inches high or wide, and the excellent little warning notes are, unfortunately, set on a stippled background to appear black-on-grey. I wonder if the authors fully understand the serious limitations of the wide range of visual dysfunctions experienced by a great percentage of people with MS. Nonetheless, this booklet may be usefully recommended by their physiotherapists with due regard to the points raised. Lorraine de Souza MSc FCSP
Spinal Cord Dysfunction Volume 111 Functional Stimulation
-
-
edited by L S ///is. Oxford Univemity Press, 1992 (ISBN 0 19 261919 5). Illus. 360 pages. f50.
This is the third volume in a series of reference books that cover a wide range of pertinent topics and subjects of particular current interest and relevance to the spinal injured population. The content has been inspired by the demands and pressures from this group both to
Physlotherapy, May 1993, vol79, no 5
address the existing needs arising from the pathology of spinal cord injury and to pursue research and developments in this field. As such, this and the previous volumes provide essential reading to all professionals working with the spinally injured. This book is divided into two main sections on experimental and mathematical aspects; and clinical aspects peripheral, central and functional neurochemical stimulation. The authors are international experts. Each of the 15 chapters is well referenced and illustrated mainly with diagrams. Greater use of appropriate photographs would have been valuable. A wide and comprehensive range of aspects of functional stimulation are covered, including recovery in the central nervous system; central functional, experimental nerve-muscle, patterned and functional, electrical, and spinal cord stimulation; engineering and mathematical aspects; and pharmacology and physiology. There is intentional overlap between the content of chapters to stress the emphasis of this book, on ‘plasticity of the adult nervous system including muscle, the reaction of the intact central nervous system to injury or disease, and the possibilities of altering or provoking the undamaged nervous system in such a way as to negate partially the effects of the lesion and to improve function’. This book provides interesting reading, offering a comprehensive background to the many facets of this subject, while also facilitating further study by those specifically working in this field. I recommend it, and the other volumes in this series, to all physiotherapists working with those with spinal cord injury, 80 that they have the relevant knowledge and information resource for their clients. Dorothy Tussler BSc MCSP
-
Brain Injury Rehabilitatlon A neurofunctlonal approach
of applied behavioural analysis and treatment and the text is well referenced. The chapter on ‘Retraining physical skills in functional settings’ includes many similarities to the motor relearning programme, yet I failed to find any reference to this already well-recognised modality. Rood, Brunnstrom, PNF and conductive education are briefly described. The Bobath concept is also called NDT (neurodeveiopwntal), presumably for the American market, and unfortunately the subsequent text given is outdated, quoting, for example, ‘reflex-inhibiting patterns.’ Hence this chapter has little new to offer the physia therapist. However, for neuro-physiotherapists specialising in brain injury the book does have lots of other useful information. It covers a wide range of aspects in relation to brain injury including its nature and consequences, the theories of recovery,. psychological and psychiatric changes, the functional affects of altered perception and cognition and the importance of social skills. The reader is taken through the various rehabilitation processes from the acute stage in intensive care to community reintegration and employment. Many of the chapters are nicely illustrated with short case histories or clinical examples to clarify some theoretical points. There is also an excellent chapter on behaviour modification which may prove useful to therapists trying to limit or remediate behavioural disorders. It does, however, highlight the need, as the book does throughout, for a cohesive approach ideally by a n interdisciplinary team. I would not recommend this book to physiotherapists or hospital departments in general, with other books undoubtedly being more useful, but for a therapist who is part of a team treating this client group it does help to put the non-physical consequences of brain injury into perspective, thereby contributing to the holistic management of what can be a very complex, multi-faceted clinical picture. Cherry Kilbride GradDipPhys MCSP
by Gordon Muir Giles and Jo Clark-Wilson. Chapman and Hall, London, 1993 (ISBN 0 412 33520 4). 437 pages. f14.95.
This book is number 33 in the ‘Therapy in Practice’ series and it is primarily aimed at occupational therapists. The book was co-written by two such professionals, but from opposite sides of the Atlantic - America and England. This dichotomy is subsequently evident in the text, with clinical examples being given from both health care systems, providing some interesting contrasts. The neudunctional approach is said to provide a new frame of reference within occupational therapy, aiming to maximise a client’s functional independence and psychosocial adaptation with a strong emphasis throughout on assessment and treatment in a contextual environment pertaining to the speciiied individual. The client’s pre-morbid life is also taken into consideration. The authors state that the particular techniques which are advocated for use are based on the scientific principles
Aggression: A nurses’ guide to therapeutic management by Gerald A FMIBII and W i n Gray Scutari Press Harrow, 1992 (ISBN 1 871364 60 4). Illus. 158 pages. f14.99.
Many health care professionals are included in the target readership of this book, and need not be deterred by the specific reference to nurses in the title. It suggests reasons for aggressive behaviour and shows how to foresee and defuse aggression before a situation gets out of hand. Practical hints are set out in a workbook style of boxes and diagrams; they do not promise a recipe for every encounter but offer a system for dealing with similar types of problem. The book should be useful for anyone likely to deal with aggressive patienta, and does not overlook the fact that staff may also be angry and hostile without direct justification.