Clinical Implications of Normal Biomechanical Stresses on Spinal Function.

Clinical implications of Normal Biomechanical Stresses on Spinal Function

By Junghanns H; edited by Hager HJ. Gaithersburg, MD 20878, Aspen Publishers Inc, 1990, hardback, 394 pp, illus, $89

The title of the book perfectly describes its contents. The author has successfully compiled and organized a sizable amount of descriptive and research information relevant to the spine primarily thoracolumbar regions). He emphasizes the importance of recognizing how normal, day-to-day stress related to occupation, leisure, and sport can affect the spine. He encourages prophylactic care of the spine. He does not, however, provide a definitive problem-solving scheme for addressing spinal dysfunction, which makes this text less useful for the general practitioner.

The table of contents is organized using a detailed outline format, giving the reader an immediate sense of the text's subject matter. In chapter 1, general problems of the stressed spinal column are discussed.

In chapters 2 and 3, the author reviews spinal column development and tissue anatomy and biochemistry. He seems to emphasize the anatomy and function of the intervertebral unit. in chapters 4 and 5, external and internal factors that can interfere with function or strain structures are presented. Spinal examination principles are discussed in chapter 6. The last two chapters deal with the effects of daily life and sporting activities on the spinal column.

This book was not particularly easy to read, in part, I think, because of the translation from the German language. Also, the author frequently referred the reader to previous or forthcoming sections or figures that were in other chapters, which disrupted the flow and continuity of the narrative text. Although this work is well-referenced, most of the references are in German, and, because the original text was published in 1986, the references are not very current. The author has drawn extensively on the intervertebral disk and vibration literature to support his apparent bias that most spinal dysfunction is disk-related. I liked the fact that the author discussed ergonomic issues and sport/leisure activities. The sections on prophylaxis were good. The sections on treatment were lacking. I was displeased with the definition and scope of physical therapy as defined in chapter 7 and am concerned that some readers of this text may develop misconceptions about our profession. The examination chapter is brief, covering only very basic concepts, and thus is not useful in assisting the clinician in making a differential diagnosis. The figures, tables, charts, and photographs are numerous and clear and enhance the text.

I was excited when I first became aware of this book. The excitement has been dampened somewhat, but I believe that this text does have a place in the reference library of the advanced physical therapy practitioner.

Gordon Alderink, PT Grand Valley State University Allendale, Mich