General Medical Conditions in the Athlete.

General Medical Conditions in the Athlete

Cuppett M, Walsh KM. St Louis, MO 63146, Elsevier Mosby, 2005, hardcover (with DVD), 464 pp, illus, ISBN: 0-323-02623-0, $57.95.

Although the target audience for this text is athletic trainers, the information presented is useful to a variety of health care professionals who care for athletes, including physical therapists. Many texts on the care of athletes focus primarily on musculoskeletal injuries, and, although this book contains a chapter on musculoskeletal disorders (chapter 14), the text focuses on the overall general health of the athlete. Athletes may have medical concerns that do not stem from injuries but may still significantly affect their participation in a given physical activity. Diabetes mellitus, thyroid disease, and cancer are a few examples covered in chapter 11 on systemic disorders.

The book contains 16 chapters, 7 appendixes, and a glossary. The introductory chapter provides information about pre-participation examinations, medical histories, effective communications, and prevention of disease transmission, including standards for preventing the transmission of blood-borne pathogens. A brief section on legal considerations includes topics such as standards of care, medical referral, obligatory reporting of specific conditions, and privacy issues related to the Health Insurance Portability and Accountability Act (HIPAA) and the Family Education Right and Privacy Act (FERPA).

Chapter 2 describes medical evaluation techniques and evaluative equipment. The body system review, which is similar to the procedures and language in APTA's Guide to Physical Therapist Practice, is briefly described. The symptom review and physical examination as described in this book are somewhat different in the way they list the systems of the body along with states of being, such as mental status; dietary considerations; and several potential areas of concern for each. The assessment of vital signs, along with tables of normal values, is covered in detail. Other areas of the examination included are neurological assessment, selected laboratory tests with normal values, and percussion and auscultation techniques. Many of these techniques are covered in more detail in subsequent chapters related to these topics.

Chapter 3 deals with basic pharmacology and lists a number of drugs, along with their approved uses, indications, dosages, and adverse reactions. Routes of administration, controlled substances of the Drug Enforcement Agency (DEA), and the difference between administering and dispensing drugs are discussed. A list of 10 Web sites containing important drug information about anaphylaxis, consumer information, and regulations regarding substances banned by various athletic organizations and associations also is included. The sites are up to date, but the list does not indicate how often they are updated.

Chapter 4 is devoted to respiratory disorders, and the next 12 chapters describe the signs and symptoms, referral and diagnostic tests, differential diagnosis, and treatment and prognosis for various other conditions. For instance, chapter 5 covers cardiovascular disorders, and chapters 6 and 7 cover gastrointestinal disorders and genitourinary/gynecological disorders, respectively. Chapter 8 is devoted to neurological disorders, and chapter 9 gives an extensive review of disorders of the eye and includes a number of very graphic color photographs of the eye conditions discussed. Similar coverage of disorders of the ear, nose, throat, and mouth, accompanied by color photographs, is provided in chapter 10.

The next 3 chapters focus on systemic disorders, infectious diseases, and dermatological conditions. Again, these areas are described in detail, and colored pictures of many of the conditions are included. Musculoskeletal conditions are covered in chapter 14. The conditions described are generally not related to an athletic injury but would certainly have a significant effect on an athlete's suitability and ability to participate. Chapter 15 covers a number of mental conditions that are not the result of an athletic injury, but could have a profound effect on an athlete's ability to safely and successfully engage in physical activity or participate in competitive sports. The final chapter is rifled "Special Populations" and is devoted to a number of conditions: tetraplegia and paraplegia, amputations, cerebral palsy, visual and hearing impairments, and intellectual deficits.

Appendix A is an example of a pre-participation physical examination history form, and is followed by several appendixes that include measurement and temperature conversion tables, a body mass index table, and a list of drug classes banned by the National Collegiate Athletic Association (NCAA).

This text is richly illustrated with more than 400 photographs and drawings, many in color. Easy to access information is included in "key point" and "red flag" boxes along with Web resource listings for each chapter. Although there are a number of expert contributors, the chapters are written in a consistent style and format, making this a very reader-friendly book. The National Athletic Trainers Association's (NATA) competencies and proficiencies for general medical assessment and pharmaceuticals are covered. The NATA competencies are discussed throughout the book. Pharmaceuticals are addressed in chapter 3, and the NCAA banned drug classes for 2004-2005 are in Appendix G.

A companion DVD is included with the book. Each chapter in the text has a corresponding section on the DVD. The DVD, however, will not play in a standard DVD player. It will work only in a DVD computer drive connected to the Internet, with Internet Explorer as the browser. The Web links listed in each chapter are live on the DVD and make it easy to connect to these sites. In addition, there are animations and video segments for most of the chapters. The videos include a demonstration for assessing blood pressure, several common reflex tests such as the patellar reflex, and percussion and palpation techniques. There also are animations of pulmonary and cardiac system functions, with other reference materials such a dermatome chart and color pictures of a number of dermatological conditions. The respiratory and cardiovascular chapters also have audio sections that provide examples of heart and lung sounds. Several of the DVD sections have short self-test and other self-assessment activities.

Health care professionals who are experienced in the care of athletes may find they already know much of what is presented, but those with less experience working with athletes will find this book to be a very useful reference.

[Minimum system requirements for the DVD: For PC: Pentium III 500MHz CPU (with MMX) or faster, 256 MB RAM (512 MB or greater recommended), 2x or greater DVD-ROM drive and a video card with 16-bit or higher color (24- or 34-bit recommended). For Macintosh: Power-based 500 MHz CPU or faster, 256 MB RAM (512 MB or greater recommended), 2x or greater DVD-ROM drive, and a video card with 16-bit or higher color (24- or 34-bit recommended). Display resolution of 1024 x 768 or greater and a sound card and speakers.]

John P Sanko, PT, EdD

University of Scranton 

Scranton, Pa

Sanko is Associate Professor and Chair of the Physical Therapy Department. He teaches cardiovascular and pulmonary physical therapy, research, and sports physical therapy.