Functional Progressions for Sport Rehabilitation.

Tippett SR, Voight ML. Champaign, IL 61825-5076., Human Kinetics Inc, 1995, paperback, 118 pp, illus, $26.

This book serves as an introductory guide to functional progressions in the rehabilitation of the injured athlete. Basic components of a functional program are discussed, as well as the principles and physiological rationale of such a program. This book would be useful to physical therapists, athletic trainers, and others involved with the rehabilitation of the injured athlete.

The book contains eight chapters, and is divided into two major parts. A three-page glossary and more than 100 references are included. Part 1 discusses the use of functional progressions for rehabilitation and is divided into three chapters. The first chapter discusses the benefits and prerequisites of a successful functional program. Much of the information here is review: progressing from slow to fast speeds, simple to more complex tasks, and shorter to longer distances. Perhaps what is most valuable, however, is the presentation of the basic functional program. This progression starts with bilateral support drills (minisquats); progresses through unilateral support drills (step-ups), bilateral nonsupport drills (jumping), unilateral nonsupport drills (hopping), acceleration/ deceleration pivoting drills, figure-eight drills; and ends with cutting maneuver drills. This progression can then be used as a guideline for sport-specific needs.

Chapter 2 offers a good review on the neurophysiology of functional exercises, particularly the section on mechanoreceptors. Chapter 3 addresses functional testing. I find the terminology confusing, as the authors attempt to delineate between functional testing, functional progressions, and functional training. I also find the information to be too basic at times. For example, the authors describe in detail how they would compute a percent deficit when comparing an involved limb with an uninvolved limb during a functional test. The importance of incorporating functional tests to determine functional capabilities, however, is emphasized. Examples of bilateral and unilateral tests for the upper and lower extremity are reviewed, as are agility tests.

Part 2 applies the fundamental principles of functional progression to specific sport,s. These include collision and contact sports (eg, football, hockey, soccer, basketball), combat sports (eg, wrestling, karate), running activities, and throwing activities. Each chapter in this part includes several illustrations. The authors probably should have made more of an attempt to include pictures of women participating in sports; all but I of the 26 illustrations in this part are of men participating in sports. There is also a good chapter on plyometric training, which includes the physiological principles and program development. I wish there would have been case studies incorporated into the end of the these chapters, as this would have been a good way to examine treatment progression.

Despite some shortcomings, this is a very practical book and serves as a useful guide for any clinic involved with the rehabilitation of athletes. it is also the only hook I know of that solely addresses functional progressions. Although geared toward the athlete, many of the concepts can be applied to the noncompetitive population of patients.

Hilary B Greenberger, PT Ithaca College Ithaca, NY

Ms Greenberger is assistant professor in the physical therapy program and specializes in the treatment of patients with orthopedic injuries. Her area of research interest is in functional testing and training.