Electrotherapy explained: principles and practice, ed 4.

Robertson V, Ward A, Low J, Reed A. Philadelphia, PA 19106, Elsevier, 2006, paperback (with CD-ROM), 448 pp, illus, ISBN: 0-7506-8843-7, $64.95.

This is the fourth edition of this text, which was first published in 1990. Although the types of physical agents that are used in the clinic today are essentially unchanged, the technology used to deliver physical agents, the way this technology is used, and the knowledge necessary for their use has changed significantly over the years. The authors state that the purpose of the new edition remains the same as that of the first edition: "to keep on explaining electrotherapy and electrophysical agents (EPAs)." Although the purpose remains the same, the fourth edition is directed at a significantly broader audience than the previous editions. This fourth edition is designed for current and beginning practitioners, as well as physical therapists, dentists, veterinary surgeons, podiatrists, and a wide array of other health care professionals. The book not only explains how EPAs work and their clinical application, but also provides information that can be used in making the best possible evidence-based decisions in practice. To this end, EPAs are evaluated relative to the biophysical principles used and the available clinical evidence for their effectiveness.

The therapeutic modalities covered in the book's 17 chapters include electrical stimulation, biofeedback, and therapeutic heating and cooling (eg, ultrasound, electromagnetic fields, and infrared and ultraviolet radiation, among several others). Each chapter dealing with these various modalities follows a similar format. First, the biophysical principles involved in the modality are presented, followed by the current evidence for their therapeutic and clinical effectiveness. The rest of the chapter is then devoted to how the modality is used clinically and to the contraindications or dangers inherent in its use.

Perhaps one of the most confusing aspects of electrotherapy is the jargon surrounding the various types of electrical current and the unsupported statements often made regarding the physiological effect or clinical utility. The authors tackle this issue in their book head-on; they do a very thorough and straightforward job of explaining how electrical currents affect nerve tissue. The reader can then apply the information in a logical and systematic approach to patient care. Although the student who is unfamiliar with the subject will likely still have some trouble keeping all of the various types of electrical currents straight, the authors' presentation is clear, direct, and supported by research. Clinicians who are already somewhat familiar with the topic may be confused as they read the chapters on this subject. However, if they are willing to "unlearn" some of their prior knowledge of the subject that was incorrect or misleading, they will gain a better understanding of how electrical stimulation modalities work and why. As a result, they will gain a very practical and functional understanding of electrical currents that will guide them in selecting the most appropriate treatment parameters.

Although previous editions of this book have been in print since 1990, it is not a mainstream text for physical therapist professional education programs in the United States. This is unfortunate. The authors have a very nice style to their collective writing and have successfully worked evidence into all aspects of the subject matter. As such, I feel that this would be an excellent text for professional clinical education programs, especially if principles and application of evidence-based practice is a focus of the curriculum. This text would be an excellent resource not just for the beginning clinician but for anyone looking to either expand or update their knowledge on the subject. Finally, the book is accompanied with a CD-ROM that includes the full text of 2 additional books: Physical Principles Explained by Low and Reed and Biopbysical Basis of Electrotherapy by Ward. The inclusion of the CD makes this text an even richer source for the best information concerning therapeutic modalities.

Mark W Cornwall

MW Cornwall, PT, PhD, is Professor and Chair of the Program in Physical Therapy, at Northern Arizona University in Flagstatt, Ariz.

[DOI: 10.2522/ptj.2007.87.8.1088]