Motor Control and Physical Therapy: Theoretic Framework and Practical Applications.

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Montgomery PC, Connolly BH, eds. Hixson, TN 37343, Chattanooga Group Inc, 1991, paperback, 161 pp, illus, $34.95.

This book was edited and written by physical therapists who have a broad range of clinical experience and expertise in the areas of neurophysiology, biomechanics, and human motor control. This text is intended to fill a significant void in the clinical literature, as it bridges the gap between motor control research (in the broadest sense) and practical clinical applications for physical therapists. The editors state that the purpose of the text is to provide both physical therapy students and practitioners with practical applications of current information in the areas of neurophysiology, biomechanics, motor control, motor learning, motor development, and cognitive training. A case-study format amplifies the principles of motor control research and demonstrates the transfer of information from research studies to the clinical setting. This format is intended to foster the development of problem solving from theory.

The book is very successful in achieving its goals. It is well written, and the flow of the text is even, despite the fact that it was written by 13 authors. The illustrations effectively explain and clarify difficult concepts and key ideas, and are integral to understanding clinical examples. Each chapter has a reference list or list of suggested readings, and some chapters have both.

The book is divided into 12 chapters. The first chapter is introductory; it sets the tone for the book and provides a historical review of traditional neurophysiologic treatment approaches and newer theoretical alternatives. This chapter also makes an important contribution in its discussion of "functional outcomes" and provides examples of functional problems, therapeutic goals, and functional objectives. The remaining chapters follow this framework, with presentations of case studies. This approach makes this book of particular value to the physical therapy student and the clinician. Bridging the gap between the research literature and clinical practice is important to the practice of physical therapy and is a key to this book's success. This format is as understandable to the student who has limited clinical exposure as it is practical for the experienced clinician.

In the remaining chapters, the following material is presented: introduction to the terminology of motor control, motor learning, and motor development; review of neural, musculoskeletal, sensory, and cognitive systems underlying the production and control of movement; methods of motor control assessment; and disorders of control of limb movement, balance, and gait. These chapters are interspersed with clinical examples. Four patient cases are presented in the fifth chapter. These cases represent common clinical problems for the clinician and are used throughout the book to facilitate clinical problem solving. In this way, the reader is provided with an opportunity to understand the breadth of motor control research and its relationship to solving clinical problems.

I highly recommend this book for the physical therapy student, to foster understanding about clinical issues and clinical problem solving and to ensure successful clinical experiences in the evaluation and treatment of patients with deficits in motor control. This book is also highly recommendable for the practicing clinician, to test understanding about impairments in motor control and to challenge the development of new strategies for patient care.

It will be exciting to watch for future editions of this work, which will be a challenge to the editors' abilities to make motor control research clinically relevant for the practice of physical therapy.

Barbara M Myklebust, PhD

VA Medical Center

Milwaukee, Wis