Essential Physical Medicine and Rehabilitation.

Cooper G, ed. Totowa, NJ 07512, Humana Press Inc, 2006, paperback, 347 pp, illus, ISBN: 1-58829-618-0, $71.55.

This book is intended to provide a summary of the physical medicine and rehabilitation specialty for medical students and junior residents. There are a total of 19 contributing authors covering 12 subspecialties of physical medicine, including traumatic brain injury; stroke; spinal cord injury; prosthetics and orthotics; spine and musculoskeletal medicine; electrodiagnostic medicine; and cardiac, pulmonary, pediatric, neuromuscular, cancer, and orthopedic rehabilitation. Each of these subspecialties is covered in a chapter that is written in a concise, easy-to-read format and is designed to be completed in 1 to 2 days of review.

Each chapter begins with background information regarding the topic, including epidemiological information, a general description of the condition, and classifications of the condition. Most chapters then discuss the acute medical management of the condition and common complications. Each chapter ends with references and additional suggested readings. Some chapters, such as the one on stroke, are presented almost exclusively in a bulleted format; others have the feel of a classroom lecture. Despite these differences, the book does flow easily.

The book is obviously intended for physicians. For example, more than half of the chapter on traumatic brain injury reviews the initial physical examination of the patient. Other subjects include medications and medical complications. A total of 1 page is dedicated to physical therapy interventions (constraint therapy and management of spastic hypertonia). These sections essentially describe what the intervention is and suggest when a patient should be referred for physical therapy. In the chapter dealing with stroke, there are references to rehabilitation as far as rehabilitation goals and the appropriate rehabilitation process for a patient.

The chapter on prosthetics and orthotics is disappointing. It contains an excellent review of the levels of amputation and the types of prosthetic limbs available; however, the section on lower-extremity amputations makes no mention of the types of gait deviations and how to correct them within the prosthesis. The same is true for the section on lower-extremity orthoses. Although the book has an excellent review of the types of components and materials used in orthoses, there is no summary table of gait deviations and possible orthotic revisions.

Other chapters provide much more useful information to the physical therapist. The chapter on spinal cord injury contains an excellent summary of injury classification, skin care, orthostatic hypotension, autonomic dysreflexia, bladder management, heterotopic ossification, medications for tone (ie, the velocity-dependent resistance to stretch that muscle exhibits) management, and outcomes based on levels of injury. The chapter on pulmonary rehabilitation is comprehensive and includes a very good summary of the goals and methods for pulmonary rehabilitation.

The field of orthopedics is large, and not all topics can be covered in a book such as this one. However, the most common diagnoses are well covered in the 2 chapters titled "Orthopedic Rehabilitation" and "Spine and Musculoskeletal Medicine." The orthopedics chapter describes the background, examination, evaluation, and treatment for the most common fractures of the pelvis, hip, knee, ankle, and foot. This chapter also discusses hip and knee replacements as well as the management of shoulder instability and common fractures of the upper extremity.

The chapter on spine and musculoskeletal disorders is the most consistently written chapter. The background, history, imaging and diagnostics, and treatment are presented for each of the conditions in this chapter. For the axial skeleton, the chapter describes neck pain, low back pain, and cervical and lumbosacral radiculopathies. For the upper extremity, the conditions described include shoulder impingement and instability, rotator cuff tears, adhesive capsulitis, lateral epicondylitis, cubital and carpal tunnel syndromes, and tenosynovitis. For the lower extremity, the conditions described include osteoarthritis, knee ligament and meniscal injuries, Osgood-Schlatter disease, patellofemoral disorder, ankle sprains, and Achilles tendon conditions.

The chapter on electrodiagnostic medicine is comprehensive. It begins with a review of basic neuroanatomy and neurophysiology. It also describes nerve conduction and motor and sensory studies. The authors then review the background, clinical findings, electrodiagnostic findings, and approaches for the most commonly involved nerves. The chapter concludes with 2 excellent tables presenting clinical and electrodiagnostic correlations of radiculopathies and motor, sensory, and needle electromyographic findings and lesion sites.

This book definitely meets its purpose in providing a summary of physical medicine and rehabilitation. Some of the information may have been more clearly presented with the use of illustrations. There are only 5 line drawings in the entire text. Although the book may be more suitable for a medical student, physical therapists may find some of the chapters beneficial as reference material.

Carolyn Vaillancourt

C Vaillancourt, PT, NCS, is Senior Physical Therapist at Braintree Rehabilitation Hospital, Braintree, Mass.

[DOI: 10.2522/ptj.2007.87.6.816]