Key Issues in Cardiorespiratory Physiotherapy.

This book, which is part of a series of books entitled Physiotherapy: Foundations for Practice, is designed to facilitate clinical decision making within the practice of cardiopulmonary physical therapy. The first chapter is an overview of the decision-making process.

Chapter 2, 3, and 4 cover the assessment or data-gathering phase, including clinical history, physical assessment, performance and interpretation of pulmonary function tests, and chest radiology. Within these chapters, discussion of normal anatomy and physiology of the cardiopulmonary system is interspersed with related procedures to encourage a greater understanding. Common abnormal findings are also addressed. The chapter on pulmonary function tests provides a concise introduction, along with more detailed testing procedures and analyses for future reference. Helpful illustrations are included throughout, especially in the chest radiology chapter, in which outlines of specific structures are overlaid on normal radiographs.

The authors develop and present a system of analysis in chapter 5 and use it in their examination of the complex interactions of neurological, musculoskeletal, and pulmonary systems leading to normal ventilation, and the cascading effects of dysfunction on normal ventilation. The figures in this chapter help to explain this model. Within the examples of specific diseases, at each component level, is a discussion of general interventions and goals for patients. This book, however, is not written to be an exhaustive reference on pathology or medical and pharmacological regimens. The reader encounters more detailed treatments of mucociliary clearance in the next chapter and in the appendix dealing with postural drainage positions. Chapter 7, presented in a case-study format, introduces normal exercise physiology and describes pulmonary limitations to exercise performance. The final chapter deals with the principles of cardiac rehabilitation. The first appendix is composed of a series of case studies designed to focus on interpretation of clinical findings and on treatment planning,

In summary, this textbook only partially accomplishes the editors' goal of designing a conceptual framework for studying cardiorespiratory physiotherapy. The authors omitted all the integral tools that students need to know about in order to make effective clinical judgments regarding patients with cardiopulmonary problems. Missing from this book is any mention of breathing retraining rationale or techniques, and principles of pulmonary rehabilitation are only discussed briefly. Only one chapter is devoted to cardiac rehabilitation, with no detailed discussion of cardiac assessment included.

I would not recommend this text as the primary reference for students. Portions of this book, however, would be effective if used as a supplemental source. Educators could use the text as a means of facilitating students' conceptualization of the interactions of various systems on ventilation, the effects of dysfunction, and the rationale for treatment.