Dynamics of Human Biologic Tissues.

Currier DP, Nelson RM, eds. Philadelphia PA, 19103-1493, FA Davis Co, 1992, hardback, 276 pp, illus, $35.

The stated purpose of this text is to present an overview of the salient normal and mutable features of muscle, nerve, and connective tissue (CT) elements as they relate to the theory and practice of physical therapy. Furthermore, the editors state that this text represents the most sophisticated and comprehensive presentation on muscle, tendon, and CT ever written by physical therapists for students or clinicians in health-related fields. There are 14 contributors to the text, and each of the 11 chapters is authored, either in whole or in part, by a physical therapist.

The first chapter covers the histology and physiology of CT. Of particular interest to therapists is the coverage of the effect of temperature changes on CT and scar tissue healing. In a similar manner, the second chapter reviews the effects of immobilization and remobilization on CT strength and remodeling. Of particular interest in this chapter is the section on CT's response to short-term and prolonged stretching. Chapters 3 and 4 review muscle physiology. Most of this information can be found in physiology books, but the authors do a splendid job of reviewing topics that are relevant to physical therapists. The focus of the book then changes and covers electrical stimulation's (ES) effect on CT, muscle, and nerve.

Chapter 5 addresses the effect of ES on ultrastructural changes in both normal and denervated muscle. it is concluded that although ES can induce positive ultrastructural changes in normal muscle, the effect on denervated muscle is still open to question. Chapter 6 deals with peripheral vascular effects of ES, and the author does a good job of reviewing the literature and providing clinical guidelines for the use of ES. The mechanisms of skeletal muscle fatigue are reviewed in chapter 7. Chapter 8 does an excellent job of addressing the use of functional ES in paralytic muscles. Chapter 9 reviews nerve injury and provides some clinical treatment programs that are useful in dealing with these types of patients. Chapters 10 and 11 cover the effect of ES on tendons and cartilage, respectively. Both chapters provide an excellent overview of tissue healing and remodeling and the effect of ES on these processes.

The book is well illustrated, using photographs, micrographs, charts, and line drawings. The most outstanding aspect of the book, in my opinion, is the extensive and up-to-date reference sections that follow each chapter. They provide one of the most comprehensive bibliographies available dealing with CT, muscle, and nerve. The reference sections alone would probably be reason enough to purchase the book. The book's content appears to be up-to-date, and even though the authors do not break any new ground, they do an excellent job of reviewing the available literature.

This book would be of particular interest, as a reference book, to faculty members who teach on any one of the areas addressed. The book may serve as a textbook for a course, but because the topics are rather diverse, the course would have to be designed around the book's contents. Clinicians who are involved in writing protocols would find the book's coverage of CT healing and mobilization very useful. Researchers dealing with ES would definitely be interested in those sections. The book would appear to have more relevance to graduate-level students, as the authors apparently assume that the reader has some general knowledge of the material. Overall, this a welcome addition to the growing list of books written for physical therapists.

Thomas M Mohr, PhD, PT Univ of North Dakota Grand Forks, ND