Disorders of Voluntary Muscle, ed 7.

Karpati G, Hilton-Jones D, Griggs RC, eds. New York, NY 10011-4211, Cambridge University Press, 2001, hardcover, 775 pp, illus, ISBN: 0-521-65062-3, $220.

Since the publication of the first edition in 1964, this text has proven to be a widely used, cross-disciplinary reference source for disorders of skeletal muscle. According to the editors, this seventh edition is a "total re-write of the sixth edition" that was necessitated by recent advancements in the study of myopathies, and it presents the most current information on the etiology and pathogenesis of skeletal muscle diseases. It also improves upon previous editions by addressing advancements in the areas of diagnosis and treatment of these diseases since the publication of the sixth edition in 1994. Furthermore, this edition presents the most recent progress in molecular and developmental biology, cell membrane and signal transduction science, and imaging technology.

With a contributor list that includes an international ensemble of 56 clinical and laboratory scientists, this text is targeted for physicians in neurology, orthopedics, pediatrics, rheumatology, physiatry, and other specialties that manage skeletal muscle disorders. According to the preface, this text is also a comprehensive source for medical students, graduate students in the sciences, residents, and research scientists.

The purpose of this text is to "enable the practicing physician to maintain a state-of-the-art ability to diagnose and treat diseases of skeletal muscles with a sufficient understanding of their scientific basis." To meet this purpose, the text offers 36 clear, well-written chapters that are divided into 4 parts: (1) "The Scientific Basis of Muscle Disease" (11 chapters), (2)"Methods of Investigation of Muscle Disease" (5 chapters), (3) "Description of Muscle Disease" (18 chapters), and (4) "The Principles of Management of Muscle Disease" (2 chapters). Each chapter is well organized, with black-and-white photographs, selected charts and graphs, and a plethora of recent references following any chapter that has been updated since the last edition.

Part 1 addresses the anatomy and physiology of normal muscle development and the molecular and biochemical basis for skeletal muscle diseases. The presentation of this material begins with "the basics" and quickly progresses to more complex subjects, affording readers at almost any level of expertise with an opportunity to expand their understanding. Part 2 addresses imaging and diagnostic techniques, including electron microscopy, magnetic resonance imaging, and histochemistry, all of which may be somewhat overwhelming to readers who are unfamiliar with these techniques. To the credit of the authors, however, the material is presented in such a manner that even those readers without previous exposure to such technology can gain from the information presented.

Part 3, the most substantial portion of the book, accounts for half the text, both in number of chapters and in page count. The description of muscle diseases varies in style between chapters because of the various contributors, but each illustrated chapter offers a complete description of the diseases, including history, pathology, clinical presentation, genetics, laboratory findings, and occasionally, but not consistently, interventions. Unfortunately for the physical therapist reader, these interventions are provided by physicians, not physical therapists.

Part 4 addresses the management of these previously described skeletal muscle diseases, but it is not nearly as thorough as the description of diseases provided in part 3 or any of the preceding parts, as evidenced by the inclusion of only 2 chapters. For example, an entire chapter is devoted to genetic analysis and counseling and is included because "the majority of genes involved in inherited muscle disease have been identified" since the last edition was published. Although some general information is presented regarding inheritance of diseases, those readers without previous exposure to genetics may find this chapter arduous. The last chapter, which finally addresses treatment, prevention, and rehabilitation, comprises only 13 of the text's 775 pages and presents further information on more systemic effects of muscle diseases, including complications of the cardiovascular, pulmonary, and gastrointestinal systems as well as other body systems. Quite frankly, physical therapists will be left unsatisfied with part 4 if they expect a presentation and discussion of treatment and management concepts.

The editors of the seventh edition state that their text offers the most recent information on the etiology, pathogenesis, and diagnosis of skeletal muscle diseases and the latest on treatment and management techniques. The text succeeds in the former but is lacking in the latter. Largely focused on interventions provided by physicians, this book offers little information that specifically addresses treatment and management provided by the physical therapist or rehabilitation professional. As a resource primarily designed for the clinical management of skeletal muscle diseases, this text is not recommended for the practicing physical therapist. As a resource for the basic science of skeletal muscle and skeletal muscle diseases, this text would be an excellent addition to any reference library and would certainly assist in advanced studies of skeletal muscle disease. In this context, the editors have appropriately targeted this text toward their intended audience and are to be commended on their efforts.

James W Bellew, PT, EdD Louisiana State University Health Sciences Center Shreveport, La

Dr Bellew is an Assistant Professor in the Department of Physical Therapy. His teaching areas include exercise physiology, electrophysiology, and cardiopulmonary science. He has published several articles and textbook chapters in the areas of age-related changes in skeletal muscle performance and the role of strength training in advanced age.