Motor Control: Theory and Practical Applications, 2d ed.

Motor Control: Theory and Practical Applications, ed 2 Shumway-Cook A, Wollacott MH. Baltimore, MD 20201-2436, Lippincott Williams & Wilkins, 200.1, hardcover, 624 pp, illus, ISBN: 0-683-30643-X, $52.95.

The second edition of this textbook expands on the information in the previous edition and addresses the text's purpose of linking theory (primarily systems theory of motor control) to the clinical examination and treatment of patients with motor control disorders. The authors characterize their approach to motor control dysfunction as a task-oriented approach, and its concepts are applicable to both physical therapy and occupational therapy interventions.

The 19 chapters in the text are divided into 4 sections--theoretical framework, control of posture and balance, mobility, and upper-extremity manipulation functions. Each section follows a similar format that progresses from content on normal motor control, to age-related issues, to information on abnormal function, to clinical applications. Each chapter begins with a topical outline. References to the research literature are incorporated throughout the text. The summary at the end of each chapter enumerates the key points.

In the first section, the authors establish the theoretical framework for the task-oriented approach by reviewing the theories and physiology of motor control and motor learning. The task-oriented approach to examination and intervention is discussed, as are the neurological impairments that act as constraints on motor control.

Aspects of normal and abnormal postural control throughout the lifespan are explored in section 2. Discussion of the clinical management of the patient with a postural control disorder includes functional tests and measures, examination at the strategy and impairment levels, evaluation, and interventions at the level of impairment, strategy, and functional task.

Section 3 on mobility function repeats the structure of section 2 by reviewing aspects of normal mobility control (from a life span perspective) and abnormal mobility control. The chapter on clinical management of the patient with a mobility disorder provides details on the examination at the functional level (including standard tests), strategy level, and impairment level. The process of goal setting is discussed as the transition to treatment. Interventions are presented for problems determined at each level in the examination process and address not only ambulation, but also stair walking, transfers, and bed mobility.

Reach, grasp, and manipulation are the topics of section 4. Using the same structure as sections 2 and 3 (normal motor control, changes across the life span, abnormal motor control, and clinical management of motor control disorders), the final chapter in the section on clinical management of reach, grasp, and manipulation disorders is coauthored by Susan Duff, who is both an occupational therapist and a physical therapist.

The second edition is a substantial expansion of the previous version (an increase of 139 pages). The new material expands and clarifies concepts from the first edition and introduces additional and updated references. Most chapters contain a few laboratory activities to reinforce the concepts being presented. Several chapters present case studies that are based on a recurring set of patients. Concepts within the text are amplified with black-and-white photographs, illustrations, figures, and tables. Some of the photographs, however, are too dark and do not provide a clear depiction of the subject, and some aspects of the illustrations of people are not in proper proportion. A glossary of terms is included at the end of the book.

This textbook is a valuable tool for guiding the learning of entry-level physical therapists as well as for challenging practitioners to re-examine their practice in light of new research findings. The text is presented in a readable and logical format that enhances the understanding of the task-oriented approach. The recurring references to the patients in the cases studies provide an effective means of linking the concepts to clinical practice. This edition continues to be an excellent resource for students and clinicians who work with people with motor control dysfunction.

Rebecca E Porter, PT, PhD
Indiana University
Indianapolis, Ind

Dr Porter is Associate Professor in the Physical Therapy Program at Indiana University and Graduate Program Chair at Rocky Mountain University of Health Professions. Her teaching and clinical practice are in the areas of neuroscience and neurologic physical therapy.