Neurological Sports Medicine: A Guide for Physicians and Athletic Trainers.

Bailes JE, Day AL, eds. Rolling Meadows, IL 60008, American Association of Neurological Surgeons, 2001, paperback, 304 pp, illus, ISBN: 1-879284-75-8, $65.

As the title implies, this text is a guide for health care practitioners who manage athletic injuries involving the neurological system. The editors are both neurological surgeons, whereas the contributors include clinicians with backgrounds in medicine, athletic training, physical therapy, and psychology. The purposes of the text are to address the issues involved in contemporary neurological sports medicine and to give practitioners concise and reader-friendly access to this information.

Although one chapter does focus on peripheral nerve injuries, the text concentrates on traumatic injuries involving the central nervous system. Four chapters cover head injuries (eg, concussions), including a chapter each on the general management of head injuries and the classification and management of concussions. In addition, the sideline examination and the more comprehensive examination of athletes with concussions are covered in separate chapters.

Similarly, acute spine injuries are covered in 3 chapters; 2 of these chapters take a regional approach to spine injuries. Although the cervical spine content involves common mechanisms of injury for spine injuries followed by brief content on evaluation and intervention, the lumbar spine content is presented from a pathology perspective and covers common subacute clinical conditions such as the disk and bony defects. A short chapter on surgical intervention provides a general overview on decision making, along with brief descriptions of the techniques used in microendoscopic discectomy and laminotomy.

The discussion of the role of the athletic trainer is brief and focuses primarily on 2 areas--acute assessment and management--along with the pre-contest preparation necessary to manage potential injuries optimally. This is followed by 2 chapters that contrast the neuropsychological assessment of amateur and professional athletes. The chapter on amateur athletes includes a more extensive literature review of neuropsychological assessment tools, and the chapter on professional athletes includes model assessment procedures for a variety of sports.

A sport-specific approach is used to cover neurological injuries in sports, such as auto racing, boxing, ice hockey, and football. The extensive chapter (including more than 500 references) written by Miele and Bailes is particularly noteworthy, because it provides an encyclopedic reference of head, spine, and peripheral nerve injuries in sports and dance. The final chapter covers research and trends in sports medicine, including the use of general and sport-specific evaluation tools used to diagnose and manage neurological injuries.

This text is well written, and the content covers a broad range of topics. Although there is a redundancy in the content of some chapters, the editors have adequately maintained chapters that highlight the core content. The presentation of the material varies across chapters. Although some chapters are primarily text, most provide a nice balance of text and graphics, which consist of black-and-white photographs, radiographic illustrations, and highlighted text boxes that are especially effective in summarizing main points.

Because of the potentially serious nature of neurological sports injuries, all health care practitioners involved in the management of these injuries need to be proficient in the content covered in this text. Although the text is primarily written from the perspective of physicians and athletic trainers, physical therapists involved in the acute care of injured athletes also should have a working knowledge of this content. For those clinicians, this text should be a valuable reference.

Tim Noteboom, PT, PhD, SCS, ATC
Regis University
Denver, Colo

Dr Noteboom is Assistant Professor in the Department of Physical Therapy. His primary teaching and research interests are in orthopedic management and the evaluation of outcomes associated with physical therapy intervention.