Adaptability of Human Gait: Implications for the Control of Locomotion.

Adaptability of Human Gait: implications for the Control of Locomotion Patla AE, ed. New York, NY 10159, Elsevier Science Publishing Co Inc, 1991, hardback, 456 pp, illus, $137.25.

The purpose of this book is to address the generation and regulation of human locomotion from a multidisciplinary perspective. The book is an aggregate of works by authors with backgrounds in neural control, biomechanics, mathematical modeling, and clinical points of view, who have all used adaptability of human gait as their common theme. The book is divided into sections, with the introductory chapter serving as section 1. Patla puts the contents of the book into historical context in section 1 by defining locomotion and reviewing the vast literature on animal locomotion. He ends the introductory chapter by exploring the constraints of applying locomotor models derived from animals to the understanding of human locomotion. Sections 2 and 3 examine the role of various sensory modalities in modifying locomotor patterns. Reflex modulation during the gait cycle and the role of proprioceptive, vestibular, and visual input for feedback are addressed here, as well as feedforward information during the execution and planning of locomotion. Section 4 examines the adaptability of gait using different experimental paradigms, including motor adaptations that result from unilateral ischemic block of the leg and the development of independent human locomotion. Section 5 deals with the biomechanics of locomotion by relating the Newtonian laws of motion to the human body during locomotion. The sixth and seventh sections deal with modeling of human gait. The eighth section examines rehabilitation strategies for various gait pathologies, and the final section poses questions that must be addressed through research before we have a complete understanding of human locomotion. The book is refreshing because human locomotion is the central focus, as opposed to animal locomotion or posture. In general, the chapters are very readable, and the authors are well known and experienced with research in human locomotion. Hypotheses are offered and tested in each chapter. The sections on the role of sensory input and on rehabilitation strategies are particularly intriguing because they explore questions that are important to physical therapists but that are not usually found in the literature of physical therapy. Jansson, for example, addresses the control of locomotion when vision is reduced or missing, which is of importance in teaching the child who is blind or the older individual with impaired vision. The chapter by Gage and Ounpuu reviews the use of gait analysis in making surgical decisions for children with cerebral palsy. Several case studies are presented to illustrate the use of gait analysis to document gait abnormalities and to gain information about the causes of gait abnormalities. In the last chapter in the rehabilitation section, Richards et al propose the use of new rehabilitation strategies for the treatment of "spastic gait disorders." This chapter incorporates motor learning theory into principles of treatment. The authors present a theoretical basis for treatment and offer pilot data to test some of their theoretical propositions. The cost of this book may make it prohibitive for individual use. This would be an excellent resource, however, for an elective on motor control or as a reference for an entry-level student learning about gait analysis. Clinicians or researchers interested in gaining a more holistic perspective of human locomotion will find this book appealing as well. I recommend using this text as a reference in academic and certain clinical settings.

Rebecca L Craik, PhD, PT Beaver College Glenside, Pa