Hydrotherapy in Paediatrics, 2d ed.

Campion MR. Stoneham, MA 02180, Butterworth-Heinemann, 1991, paperback, 266 pp, illus, $29.95.

The philosophy of Hydrotherapy in Paediatrics is that "each and every individual who so wishes should have the opportunity to enjoy the freedom of movement that water ensures." The author thus presents hydrotherapy procedures for children with mild to severe disabilities at any age level.

The text is divided into three major chapters: the "Introduction," "Activity in Water-Ways and Means," and "Specific Disabilities and Their Handling." The "Introduction" begins with the author's rationale for water therapy. Guidelines for introducing a child to water are also presented. The author also provides recommendations for a safe and comfortable hydrotherapy environment. The physics of water, its effects on the child with a physical disability, and the child's responses are addressed in detail. Finally, this chapter outlines the specific therapeutic, physiological, and psychological effects of hydrotherapy.

Chapter 2, "Activity in Water-Ways and Means," presents individual and group activities. Beginning techniques that are presented include holding and disengagement procedures; facilitation of breath control; and control of head, trunk, and limb postures. Pool entry and exit techniques are addressed, with special consideration given to the disability of the child, the body mechanics of the therapist, and accessibility to community pools. Games that provide both therapy and recreation are taught. Each game's presentation includes rationale for its use, its therapeutic aims, holding/support guidelines, and instructions for how to play the game. The progression of each game starts at a primary level and advances in difficulty. Water activity culminates in swimming strokes.

Chapter 3, "Specific Disabilities and Their Handling," is grouped into five sections: "Disorders of Bones, Joints, Muscles," "Neurological and Developmental Disorders," "Sensory Disorders," "Mental Retardation and Behavior Disorders," and

"Respiratory Disorders." Diagnoses within each category are listed, as well as a description of the diagnosis, signs and symptoms, and goals for intervention. Hydrotherapy is outlined specifically to the disorder.

This text has many strengths. It is comprehensive in the ages, disabilities, and therapeutic goals it addresses. It is systematic in its presentation, from the initial approach to the child with a disability to the application of hydrotherapy for multiple disabilities. The explanations of hydrophysics and the child's responses are easy to read and comprehend. The text provides tools for the creative therapist to develop additional, highly individualized activities. It is obvious that the author has multiple years of experience in both hydrotherapy and pediatrics. She writes with authority and practicality.

Various clinicians would find this text to be useful. The experienced therapist will appreciate the attention to the child's head control, balance, body awareness, and spatial relationships. The ideas presented in this text may lead to the development of new treatment techniques by its readers. For the new pediatric physical therapist, this text will enhance observation skills and provide for a systematic progression of activities. Finally, if a consulting physical therapist is searching for a comprehensive resource, this text contains simplified swim programs and handling procedures and thorough explanations for transition into and out of the water. All these areas are written in layperson's terminology and would be useful in educating pediatric hydrotherapy aides.

Renee Mabey, PT Univ of North Dakota Grand Forks, ND