Functional Movement Development Across the Life Span.

Cech D, Martin S. Philadelphia, PA 19106, WB Saunders Co, 1995, hardback, 389 pp, illus, $32.95.

This new text is unique in its concept. The authors have presented the relationship of structure to function across the life span. This is a daunting task. They have approached this objective by describing the normal movements that occur from conception through old age and relating these movements to the changes that occur in structure and thus in function.

The book is well written and easy to read. Even with contributions from several authors, the material is presented consistently. There are a fair number of illustrations and tables that help to clarify the content. The chapter on the development of prehension, in particular, is very richly illustrated with appropriate and useful diagrams and tables.

The book is organized into three units. The first unit is titled "Definition of Functional Movement." Included in this section is a chapter on functional independence that includes health status models, such as the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) and the Nagi model. Also described is the concept of function from a life-span perspective that explores the effects and interactions of the physical, psychological, and social domains. These definitions and descriptions are essential in establishing the framework of the text.

Theories of development and motor skills and insights into motor control and motor learning also are presented in the first section. Some of these descriptions are sketchy, undoubtedly because of space restraints and ultimate relevance of the theories to the main topics of the text. Older insights that suggest certain reflexes must be present or inhibited as a prerequisite to particular movements are perhaps given more press than they deserve. The chapter on functional assessment is very helpful in providing insights into this difficult task and contains an overview of methods available to assist the therapist in determining functional capacities.

The second section of the book is devoted to the body systems that contribute to functional movement. The skeletal, muscular, cardiopulmonary, nervous, and sensory systems are presented along with the changes that occur in these systems across the life span. The major changes in cellular, tissue, organ, and system structure as they relate to changes in function are presented in a well-organized manner. It is difficult to find such information in one place, and this content should be extremely useful to students and, in particular, to therapists who are involved with pediatric or geriatric populations.

The last unit of the text addresses functional movement outcomes from a life-span perspective. The authors have chosen to address the development of three major movement outcomes: posture, locomotion, and prehension. These are considered the core movements in function and require the interaction of multiple systems. These movements are explored from theoretical perspectives and include recent research and observations concerning their evolution. A chapter on vital functions addresses those functions necessary for survival. The final chapter stresses the importance of health and fitness in achieving optimal functional performance and independence.

The authors have accomplished their goal of presenting relevant material and insights in the development of functional movement across the life span within the context of normal development and the interaction of many body systems and functions. The text is well written, well organized, and visually appealing. It should be useful as a background text in courses that explore life-span development. Practicing therapists will find a wealth of information in this text and, although it may not be of sufficient depth in some areas for the true specialist, it should provide an important reference for all concerned.

Dr Crutchfield is a professor in the department of physical therapy, where her teaching responsibilities include neuroscience, therapeutic approaches to neurologic dysfunction, functional anatomy, human development, and electromyography.