Grieve's Modern Manual Therapy: The Vertebral Column, 2nd ed.

Boyling JD, Palastanga N, eds. New York, NY 10011, Churchill Livingstone Inc, 1995, hardback, 870 pp, illus, $159.

With the retirement of Grieve, the new editors of the second edition of this highly valued reference book have succeeded in presenting the current state of physical therapy evaluation and treatment of the spine. Although the basic organization of this second edition remains unchanged, the emphasis on clinical problem solving, evaluation, and current treatment approaches is new. This information will be helpful both to experienced clinicians and to students learning about manual therapy for the spine.

Section 1, "Structure and Function," has 17 chapters. Ten of the chapters are new or significantly updated. Of particular interest are chapters on dynamics of the central nervous system, diagnostic ultrasound, and innervation of the intervertebral disk. As the title implies, this section emphasizes the anatomy, biomechanics, and kinesiology of the vertebral column and related structures. Section 2, "Clinical Considerations" consists of 4 chapters devoted to the description of acute, referred, and chronic pain and the effect of the autonomic system on vertebral pain syndromes.

Section 3, "Some Common Clinical Problems," consists of 12 chapters. Clinically relevant topics include cervical headaches, vertebral artery insufficiency, osteoporosis, lumbar instability, and syndromes found at each region of the vertebral column. Section 4, "Examination and Assessment," contains 12 chapters and is intended to emphasize to the reader the importance of patient examination. One chapter of particular interest includes the presentation of a clinical reasoning process that aims to improve the problem-solving abilities of the clinician. Other topics include the use of imaging techniques for the spine, palpation techniques, temperature testing, and McKenzie's approach to spinal examination. Two chapters are devoted to the examination of the peripheral and central nervous systems, using neural tension tests.

In section 5, "A Review of Clinical Procedures and Rationale," the majority of 18 chapters present treatment approaches that will be familiar to the experienced manual therapist. Topics include joint mobilization methods, muscle energy techniques, management of back pain during pregnancy, soft-tissue mobilization, and traction. Treatment topics include neural tension techniques, hydrotherapy for back pain, and ergonomics. A new chapter written by Grieve ends the book. It deals with identifying conditions that may appear to be musculoskeletal problems.

This book is primarily intended to be a reference book for physical therapists who have an interest in expanding their knowledge about the evaluation and treatment of dysfunction of the spine and related structures. Although the majority of the information can be found elsewhere, this book is one of the few resources that contains such a voluminous amount of high-quality information. This book will certainly serve as an excellent reference in any physical therapy department or as a textbook for either undergraduate or graduate students. In addition, this book should attract the attention of other health care practitioners who treat disorders of the spine. The editors of this text have successfully handled the difficult task of taking the work of 54 different authors and presenting a cohesive book that is well written, illustrated, and referenced.

J Randy Walker, Jr, PhD, PT The Univ of Tennessee at Chattanooga Chattanooga, Tenn

Dr Walker is Associate Professor in the Department of Physical Therapy and the Acting Dean of the College of Health and Human Services at The University of Tennessee at Chattanooga. He has published and presented professional continuing education programs on the topic of manual therapy.