Motor Control: Theory and Practical Applications.

Shumway-Cook A, Woollacott MH. Baltimore, MD 21202, Williams Wilkins, 1995, hardback, 475 pp, illus, $43.

The authors' stated purpose for this book 's to bridge the gap between theory and practice. The focus is on a systems model, and a clinical approach is described as a task-oriented approach. The book is divided into four sections. Section 1, "Theoretical Framework," is an overview of motor control and learning. The authors briefly describe traditional and contemporary theories of motor learning, including some limitations of each. A later chapter, "Physiology of Motor Control," is a review of the nervous system, from receptors to higher centers. Contained in these chapters are concepts from motor learning applicable to therapeutic intervention, such as feedback, practice conditions, and recovery of function as per Held. Additional information on learning and traditional theories for recovery of function is located in a separate chapter. The final chapter in this section is the authors' conceptual framework for assessment and intervention. They briefly review some current frameworks, relying on the frameworks found in current neurologic physical therapy texts.

The next two sections are concerned with postural control and control of normal mobility. Section 2, "Posture/Balance," reflects the authors' strong interest in these areas. The five chapters are well developed and range from postural control in the child and older adult to postural deficits in the neuromusculoskeletal areas. The final chapter covers assessment and intervention.

Section 3, "Control of Normal Mobility," details mobility functions, including a brief overview of gait and stair walking. The authors extend mobility to include transfers, sit-to-stand, supine-to-stand, and rolling. I commend the authors for their inclusion of these additional movement patterns. The authors, however, do not fully develop two important areas: the relationship of the center of mass versus center of gravity during balance and movement, and the concept of movement patterns as a dynamic interaction of balance, movement, and transition phases.

The chapter on abnormal mobility describes various deficits in gait and includes causes for the deficits. Most of the causes are related to a neurologic or musculoskeletal limitation. The contemporary concepts of motor, control and life-span motor development, which help explain these deficits, are not fully developed. The assessment and treatment interventions presented include functional activities. The last section, on upper- extremity control, is a nice addition to a physical therapy assessment and treatment textbook.

The organization of each chapter makes the text easy to read. The illustrations are clear and appropriate. This is a good textbook for most entry-level students. For those programs with a stronger emphasis on motor control, other textbooks will be needed to supplement this area.

Roberta A Newton, PhD, T Temple University Philadelphia, Pa

Dr Newton is Director of Advanced Graduate Studies in the Physical Therapy Department at Temple University, and she conducts research on balance abilities in the older adult and selected populations.