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Steps to Follow
Book reviews
unsurprisingly has only a short reference list. I consider this particularly unfortunate as this is a chapter that most physiotherapists might be drawn towards. The treatment and rehabilitation sections in part 8 would be of particular interest to physiotherapists. In the main the treatment strategies and exercise regimes are useful basic guides; however on occasion the advice is a little outmoded. An example of this is a quote dating back to 1979 recommending a lumbar support to alleviate back pain in swimmers (chapter 31, page 464). These are the only negative points, the rest of the book is extensively referenced, well compiled and makes interesting reading. This is largely a book for women written by women, understandably this may deflect potential readers who have a general rather than a female-specific interest in sports medicine. However, many of the chapters cite studies conducted upon male athletes as a basis of comparison, thus making the encyclopaedia a useful general sports medicine text. In summary this unique encyclopaedia represents a landmark text for any clinicians, coaches and athletes who have an interest in the specific requirements of sporting females. At £75 its price may be prohibitive to those with only a peripheral interest in this field, but this volume has been compiled by an eminent array of contributors of vast experience and international repute and therefore justifies
443
Projection velocity
Projection angle
Projection height
Factors to consider in projectile motion: projection velocity, angle and height – from ‘Women in Sport’ its cost. With this in mind I would readily endorse this encyclopaedia to physiotherapists and all other sports clinicians with an interest in sports science. Trevor Lewis MSc MCSP
Steps to Follow The comprehensive treatment of patients with hemiplegia Springer, Berlin 2000, 2nd edn (ISBN 3 540 60720 X). Illus. 514 pages by Patricia M Davies £29.50 The theme of this book is reflected in its subtitle – the comprehensive treatment of patients with hemiplegia. It is written primarily for clinical physiotherapists (or students) by a very experienced practising neuro-physiotherapist, using a ‘practical-humanistic’ approach. For this, Patricia Davies can most certainly be applauded. Her style is easy to absorb, highly illustrative and pragmatic but is also firmly focused on the more discrete needs of the patients. Her attention to detail with regard to retraining functional activities in stroke patients is explicit, and her willingness to explore and problem-solve through many ‘less obvious’ patient tasks is commendable. Patricia Davies has the ability and authority as an author to challenge preconceived ideas about the role of physiotherapists in neurological rehabilitation, and in doing so expands our remit and forces us to consider patients much more holistically. She maintains the individuality of each patient and the comprehensive role of physiotherapists throughout her text.
Although much of the content of this second edition is similar to that of the first, there have been some useful updates to include topics such as nervous system mobilisation and sporting and leisure activities. The author has also sourced her information more widely and her reference list is more comprehensive than in the first edition. This serves to ground some of her statements more appropriately in research evidence; a necessary requirement for evidence-based practitioners. There are many commendable attributes of this book, but there are also a few questionable points. There is a distinct lack of reference to the treatment (as opposed to prevention) of soft tissue shortening or contractures (aside from the hand) which are very real problems for hemiplegic patients. Similarly, little attention is given to muscle strengthening in stroke, which is currently deemed an important precursor to functional activity. Instead, there is an emphasis upon tonal changes and strategies to deal with these. Perhaps this can be attributed to the implicit application of the reflex-hierarchal model throughout the text. Another more serious matter that should be addressed regarding the practical nature of this book concerns the clinical application of chapter 5 ‘The acute phase – Physiotherapy August 2001/vol 87/no 8
444
Positioning and moving in the bed and in the chair’. Many of the manoeuvres that are advocated and endorsed as ‘safe’ have been shown to be dangerous by other authors and researchers. Although they were accepted as common practice in the early 1980s (the time of the first edition of Steps to Follow), to use them clinically today can be considered extremely hazardous. This largely un-referenced chapter has therefore not been ‘completely revised and updated’ as the title suggests, following the EC Manual Handling Operations Regulations (1992), and the vast amount of manual handling research that has been undertaken since 1985. The issues which cause greatest concern are the use of
Pain Management An interdisciplinary approach Churchill Livingstone, Edinburgh 2000 (ISBN 0 443 05683 8). 428 pages by Chris Main and Chris Spanswick £36.95 This book should shock physiotherapists and physiotherapy educators into realising how little we know and understand about pain and the development and consequences of chronic pain. Reading it was a humbling experience. A great deal of research into the long-term personal and social impact as well as costs of ongoing pain to patients and society has been going on since the pioneering work of figures like John Bonica and the behavioural psychologist Wilbert Fordyce. It is a tragedy that physiotherapists working with stubborn chronic pain disorders using poorly researched and largely ineffective modality-based treatment paradigms within an inflexible medical model-based reasoning approach have done so in ignorance of a massive contribution from the psychology discipline. A biopsychosocial, multidisciplinary framework using cognitive-behavioural based approaches to pain management and improving physical fitness and physical function is now backed up by an ever-expanding, sound and well documented literature which is here to stay. Co-author, co-editor and clinical psychologist, Chris Main, passionately advocates that physiotherapists have a major role to play in the implementation of chronic pain management using cognitive behavioural based skills. It is my view that this book is essential to all those working with patients who report pain and have pain-related physical incapacity. This includes the great many physiotherapists working in acute pain clinics and departments. Understanding the multiple factors responsible for the development and impact of chronic pain and incapacity goes a long way to helping avoid using approaches and styles that have been shown to bear responsibility for Physiotherapy August 2001/vol 87/no 8
lifts to move ‘a very disabled or heavy patient’, and the suggestion that ‘passive lifts’ could, and indeed should, be part of the rehabilitation process. Although this text is extremely useful for its practical content, it is suggested that clinicians who refer to it for helpful and innovative ideas in the clinical setting should approach chapter 5 with extreme caution. It is a great shame that such a valuable update to a previously much-referred-to text now needs to be furnished with a safety warning! Victoria Sparkes MSc MCSP with Pat Alexander MSc MCSP
causing it, as well as in applying interventions that can powerfully prevent it (section 5, chapter 18). The pain management/cognitive behavioural process, since it has such a strong evidence base, should not be deemed a specialist area, but be a significant and well taught part of our basic training. I would plead with physiotherapy educators and schools of physiotherapy urgently to consider revising the current undergraduate curriculum to incorporate not only better pain education, but also the principles and practice of pain management using cognitive behavioural skills. This book provides all the material required for this inclusion. Buy two and give one to your tutor! The 428 pages in this book at £36.95 represent superb value for money. There are five sections covering an ‘Introduction to pain management’, ‘Assessment’, ‘The pain management programme’, ‘Issues in delivery and evaluation’ and ‘New directions in pain management’. Key information and helpful summaries are clearly presented in boxes and tables and there are many illustrative case histories throughout. Assessment tools, questionnaires and many patient handouts and charts are included in the appendices to each chapter. For those to whom this area is quite new I would recommend they begin by reviewing section 3, ‘The pain management programme’, which really helps put the material in the book into the context of the patient and sufferer and simply demonstrates what pain management has to offer and how it goes about it. For those who are setting up a pain management programme or who already have done so, this book is essential. I would like to commend the editors and authors and cannot recommend it more highly to all physiotherapists and physiotherapy educators. We should be proud that among the ten contributors there are two highly regarded chartered physiotherapists, Paul Watson and George Peat. Louis Gifford MCSP
unsurprisingly has only a short reference list. I consider this particularly unfortunate as this is a chapter that most physiotherapists might be drawn towards. The treatment and rehabilitation sections in part 8 would be of particular interest to physiotherapists. In the main the treatment strategies and exercise regimes are useful basic guides; however on occasion the advice is a little outmoded. An example of this is a quote dating back to 1979 recommending a lumbar support to alleviate back pain in swimmers (chapter 31, page 464). These are the only negative points, the rest of the book is extensively referenced, well compiled and makes interesting reading. This is largely a book for women written by women, understandably this may deflect potential readers who have a general rather than a female-specific interest in sports medicine. However, many of the chapters cite studies conducted upon male athletes as a basis of comparison, thus making the encyclopaedia a useful general sports medicine text. In summary this unique encyclopaedia represents a landmark text for any clinicians, coaches and athletes who have an interest in the specific requirements of sporting females. At £75 its price may be prohibitive to those with only a peripheral interest in this field, but this volume has been compiled by an eminent array of contributors of vast experience and international repute and therefore justifies
443
Projection velocity
Projection angle
Projection height
Factors to consider in projectile motion: projection velocity, angle and height – from ‘Women in Sport’ its cost. With this in mind I would readily endorse this encyclopaedia to physiotherapists and all other sports clinicians with an interest in sports science. Trevor Lewis MSc MCSP
Steps to Follow The comprehensive treatment of patients with hemiplegia Springer, Berlin 2000, 2nd edn (ISBN 3 540 60720 X). Illus. 514 pages by Patricia M Davies £29.50 The theme of this book is reflected in its subtitle – the comprehensive treatment of patients with hemiplegia. It is written primarily for clinical physiotherapists (or students) by a very experienced practising neuro-physiotherapist, using a ‘practical-humanistic’ approach. For this, Patricia Davies can most certainly be applauded. Her style is easy to absorb, highly illustrative and pragmatic but is also firmly focused on the more discrete needs of the patients. Her attention to detail with regard to retraining functional activities in stroke patients is explicit, and her willingness to explore and problem-solve through many ‘less obvious’ patient tasks is commendable. Patricia Davies has the ability and authority as an author to challenge preconceived ideas about the role of physiotherapists in neurological rehabilitation, and in doing so expands our remit and forces us to consider patients much more holistically. She maintains the individuality of each patient and the comprehensive role of physiotherapists throughout her text.
Although much of the content of this second edition is similar to that of the first, there have been some useful updates to include topics such as nervous system mobilisation and sporting and leisure activities. The author has also sourced her information more widely and her reference list is more comprehensive than in the first edition. This serves to ground some of her statements more appropriately in research evidence; a necessary requirement for evidence-based practitioners. There are many commendable attributes of this book, but there are also a few questionable points. There is a distinct lack of reference to the treatment (as opposed to prevention) of soft tissue shortening or contractures (aside from the hand) which are very real problems for hemiplegic patients. Similarly, little attention is given to muscle strengthening in stroke, which is currently deemed an important precursor to functional activity. Instead, there is an emphasis upon tonal changes and strategies to deal with these. Perhaps this can be attributed to the implicit application of the reflex-hierarchal model throughout the text. Another more serious matter that should be addressed regarding the practical nature of this book concerns the clinical application of chapter 5 ‘The acute phase – Physiotherapy August 2001/vol 87/no 8
444
Positioning and moving in the bed and in the chair’. Many of the manoeuvres that are advocated and endorsed as ‘safe’ have been shown to be dangerous by other authors and researchers. Although they were accepted as common practice in the early 1980s (the time of the first edition of Steps to Follow), to use them clinically today can be considered extremely hazardous. This largely un-referenced chapter has therefore not been ‘completely revised and updated’ as the title suggests, following the EC Manual Handling Operations Regulations (1992), and the vast amount of manual handling research that has been undertaken since 1985. The issues which cause greatest concern are the use of
Pain Management An interdisciplinary approach Churchill Livingstone, Edinburgh 2000 (ISBN 0 443 05683 8). 428 pages by Chris Main and Chris Spanswick £36.95 This book should shock physiotherapists and physiotherapy educators into realising how little we know and understand about pain and the development and consequences of chronic pain. Reading it was a humbling experience. A great deal of research into the long-term personal and social impact as well as costs of ongoing pain to patients and society has been going on since the pioneering work of figures like John Bonica and the behavioural psychologist Wilbert Fordyce. It is a tragedy that physiotherapists working with stubborn chronic pain disorders using poorly researched and largely ineffective modality-based treatment paradigms within an inflexible medical model-based reasoning approach have done so in ignorance of a massive contribution from the psychology discipline. A biopsychosocial, multidisciplinary framework using cognitive-behavioural based approaches to pain management and improving physical fitness and physical function is now backed up by an ever-expanding, sound and well documented literature which is here to stay. Co-author, co-editor and clinical psychologist, Chris Main, passionately advocates that physiotherapists have a major role to play in the implementation of chronic pain management using cognitive behavioural based skills. It is my view that this book is essential to all those working with patients who report pain and have pain-related physical incapacity. This includes the great many physiotherapists working in acute pain clinics and departments. Understanding the multiple factors responsible for the development and impact of chronic pain and incapacity goes a long way to helping avoid using approaches and styles that have been shown to bear responsibility for Physiotherapy August 2001/vol 87/no 8
lifts to move ‘a very disabled or heavy patient’, and the suggestion that ‘passive lifts’ could, and indeed should, be part of the rehabilitation process. Although this text is extremely useful for its practical content, it is suggested that clinicians who refer to it for helpful and innovative ideas in the clinical setting should approach chapter 5 with extreme caution. It is a great shame that such a valuable update to a previously much-referred-to text now needs to be furnished with a safety warning! Victoria Sparkes MSc MCSP with Pat Alexander MSc MCSP
causing it, as well as in applying interventions that can powerfully prevent it (section 5, chapter 18). The pain management/cognitive behavioural process, since it has such a strong evidence base, should not be deemed a specialist area, but be a significant and well taught part of our basic training. I would plead with physiotherapy educators and schools of physiotherapy urgently to consider revising the current undergraduate curriculum to incorporate not only better pain education, but also the principles and practice of pain management using cognitive behavioural skills. This book provides all the material required for this inclusion. Buy two and give one to your tutor! The 428 pages in this book at £36.95 represent superb value for money. There are five sections covering an ‘Introduction to pain management’, ‘Assessment’, ‘The pain management programme’, ‘Issues in delivery and evaluation’ and ‘New directions in pain management’. Key information and helpful summaries are clearly presented in boxes and tables and there are many illustrative case histories throughout. Assessment tools, questionnaires and many patient handouts and charts are included in the appendices to each chapter. For those to whom this area is quite new I would recommend they begin by reviewing section 3, ‘The pain management programme’, which really helps put the material in the book into the context of the patient and sufferer and simply demonstrates what pain management has to offer and how it goes about it. For those who are setting up a pain management programme or who already have done so, this book is essential. I would like to commend the editors and authors and cannot recommend it more highly to all physiotherapists and physiotherapy educators. We should be proud that among the ten contributors there are two highly regarded chartered physiotherapists, Paul Watson and George Peat. Louis Gifford MCSP